Ear Infections In Babies And Children

Overview

If your baby or toddler seems unusually distressed, especially if they are also pulling at their ears, an ear infection might be the cause. Here’s what you need to know about this common childhood problem. In Australia, it is estimated that more than 80% of children will have at least one ear infection before they turn three years old. Aboriginal or Torres Strait Islander children and children with other medical conditions are more prone to complications from ear infections.

Note: The content of this blog is for informational purposes only and does not replace professional medical diagnosis, advice, or treatment.

Types of ear infections

The ear comprises three parts: the outer ear (ear lobe and ear canal), the middle ear (the area behind the eardrum that connects to the throat), and the inner ear (which contains nerves important for hearing and balance). The two most common ear infections are middle ear infections and outer ear infections.

• Middle ear infection: Also known as Otitis Media, this is an infection in the fluid behind the eardrum or in the middle part of the ear. The middle ear is connected to the throat by a short tube known as the Eustachian tube. This tube is especially small in babies, making them more susceptible to ear infections when they have a cold, as the infection can spread through the tube and affect the middle ear.
• Outer ear infection: Also known as Otitis Externa, this infection occurs in the ear canal or outer ear due to excess moisture in the ear canal after activities such as bathing or swimming (often called swimmer’s ear). It can also be caused by damage to the ear canal from cotton buds or inserting other foreign objects into the ear.

Symptoms of ear infections

Infants may not be able to communicate their discomfort verbally, so it is important for parents and caregivers to watch for behavioural changes and signs that may indicate an ear infection. While many ear infections resolve quickly, prompt medical attention can help prevent complications. Some common symptoms of ear infections in babies and children include:

• Ear pulling or grabbing: Babies may pull or rub their ears due to pain or discomfort.
• Irritability and crying: Increased fussiness and crying, especially during feeding or when lying down, can indicate ear pain.
• Difficulty sleeping: Ear pain may become more noticeable when lying down, making it harder for babies to sleep.
• Feeding difficulties: Babies with ear infections may find sucking or swallowing painful during feeding.
• Changes in appetite: A decrease in appetite or refusal to eat may occur.
• Fever: Many babies with ear infections develop a fever, so it is important to monitor your baby’s temperature.
• Fluid drainage: In some cases, fluid or pus may drain from the ear, which could indicate a ruptured eardrum.
• Changes in balance: Ear infections can affect the vestibular system, which may lead to balance issues such as clumsiness or unsteadiness.

Difficulty hearing: Babies may seem less responsive to familiar sounds or appear to have trouble hearing. Older toddlers and children may describe their hearing as “muffled.”

When should I consult a doctor?

If you feel your child is experiencing any of the above symptoms, it is important to speak to a general practitioner as soon as possible to ensure the infection does not lead to complications such as a ruptured eardrum, hearing issues, or glue ear.

Most ear infections resolve on their own with simple pain relief to help ease the baby’s discomfort and may not require antibiotics. However, if the condition does not improve within 1–2 days, consult your GP. They can diagnose the infection, recommend appropriate treatment such as antibiotics if necessary, and provide a referral to a specialist for further investigation if the condition is severe.

If the infection occurs at night, after hours, or on weekends when in-person care may not be available, you can consult a GP online. A telehealth doctor can assess your child’s symptoms and determine whether a prescription is clinically appropriate for the condition. Telehealth can also be particularly helpful for people living in rural or remote areas, parents who cannot travel long distances with a child, or those who may otherwise wait long hours to see a GP. Through telehealth, you can access an initial clinical assessment and management plan.

Note: A definitive diagnosis of an ear infection typically requires a physical examination of the ear canal and eardrum using an otoscope. Telehealth consultations are suitable for initial assessment and advice, but a face-to-face visit may be required if a physical examination is clinically necessary.

What can I do to prevent or reduce the occurrence of ear infections in children?

While it may not be possible to prevent all ear infections in babies, there are several steps that may help reduce the risk:

• Good hygiene: Maintaining a clean environment and practising good hygiene can reduce the chances of catching colds that may lead to middle ear infections.
• Avoid second-hand smoke: Keep your baby away from smoke, as exposure to tobacco smoke can increase the risk of ear infections.
• Regular check-ups: Schedule routine well-baby check-ups with your paediatrician to monitor your child’s health and identify potential issues early.
• Vaccinations: Childhood vaccinations, such as the pneumococcal vaccine, can help reduce the risk of some types of ear infections.
• Breastfeeding: Breastfeeding may offer some protection against ear infections during the first six months of life due to antibodies present in breast milk.

Early diagnosis and appropriate treatment can help manage symptoms and prevent complications related to ear infections. It is always advisable to consult a General Practitioner rather than attempting to self-diagnose or treat your baby’s condition. Your doctor can assess the situation, provide an accurate diagnosis, and recommend the most appropriate treatment plan.

Note: Please call 000 or visit your nearest Emergency Department immediately if your child is lethargic, has a stiff neck, a high fever that does not reduce, swelling or redness behind the ear, or appears extremely unwell.