Ear Infection (Child)
Your child has a middle ear infection (acute otitis media). It's caused by bacteria or viruses. The middle ear is the space behind the eardrum. The eustachian tube connects the ear to the nasal passage. The eustachian tubes help drain fluid from the ears. They also keep the air pressure equal inside and outside the ears. These tubes are shorter and more horizontal in children. This makes it more likely for the tubes to become blocked. A blockage lets fluid and pressure build up in the middle ear. Bacteria or viruses can grow in this fluid and cause an ear infection.
The main symptom of an ear infection is ear pain. Other symptoms may include pulling at the ear, being more fussy than usual, fever, decreased appetite, and vomiting or diarrhea. Your child’s hearing may also be affected. Your child may have had a respiratory infection first.
An ear infection may clear up on its own. Or your child may need to take medicine. After the infection goes away, your child may still have fluid in the middle ear. It may take weeks or months for this fluid to go away. During that time, your child may have temporary hearing loss. But all other symptoms of the earache should be gone.
Home care
Follow these guidelines when caring for your child at home:
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Because many ear infections can clear up on their own, the doctor may suggest waiting for a few days before giving your child medicines for infection.
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If the doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.
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Give your child acetaminophen or ibuprofen for fever, pain, or fussiness. Do not use ibuprofen if your child is less than 6 months old unless the doctor gave you instructions to use it. Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.
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Don't smoke in the house or around your child. Keep your child away from secondhand smoke.
To help prevent future infections:
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Don't smoke near your child. Secondhand smoke raises the risk for ear infections in children.
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Make sure your child gets all recommended vaccines.
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Don't bottle-feed while your baby is lying on their back. (This position can cause middle ear infections because it allows milk to run into the eustachian tubes.)
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If you breastfeed, continue until your child is 6 to 12 months of age.
Follow-up care
Follow up with your child’s doctor as directed. Your child will need to have the ear rechecked to make sure that the infection has gone away. Check with the doctor to see when they want to see your child.
Special note to parents
If your child keeps getting ear infections, they may need ear tubes. The doctor will put small tubes in your child’s eardrum to help keep fluid from building up.
When to get medical advice
Contact your child's doctor if your child has:
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New symptoms, especially swelling around the ear or weakness of face muscles.
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Continued pain after trying over-the-counter pain relievers.
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Redness or swelling around or behind the ear.
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Symptoms that don't improve with antibiotics after 48 hours.
Follow your doctor's instructions for when to call for a fever.
Call 911
Call 911 if your child:
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable, but it may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it, and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child’s fever, tell them which type you used.
Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.
When to call a doctor about your child’s fever
First, ask your child’s doctor how you should take the temperature.
For a baby under 3 months old:
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the doctor
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the doctor
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the doctor