Ear Infections In Babies And Children

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This blog is for educational purposes only and does not replace professional medical advice or diagnosis. If you have health concerns, consult an AHPRA-registered telehealth GP or request a medical certificate online if clinically appropriate.

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 condition.

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.

What causes ear infections?

Your middle ear is like a small little room behind your eardrum. Now, imagine a tiny pipe called the Eustachian tube connecting this room to the back of your throat. This pipe's job is to keep things balanced, letting air in and fluid out.

But sometimes, this pipe gets clogged – you can think of it like a traffic jam in your ear. This blockage traps fluid, creating the perfect breeding ground for bacteria or viruses, leading to inflammation and a painful earache.

In adults, this blockage is often triggered by the usual culprits: a cold, allergies, or sinus infection.

For kids, their Eustachian tubes are shorter and more horizontal, making them more susceptible to blockages. It's like having a narrower, winding road prone to traffic jams.

Other factors like second-hand smoke, attending daycare, and the prolonged use of a pacifier can also increase the risk for children.

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."

Note: If your child experiences severe, worsening, or life-threatening symptoms, such as a stiff neck, extreme lethargy, or high fever that does not reduce, call 000 immediately or attend your nearest Emergency Department (ED).

Are ear infections contagious?

Thankfully, you can't "catch" an ear infection directly from someone else, like you would a cold.

However, the viruses and bacteria behind those ear infections can be contagious. So, if your friend has a cold and sneezes near you, you might catch that cold, which could then lead to an ear infection if your Eustachian tube gets blocked.

It's like a chain reaction, rather than a direct transfer.

Can the infection jump from one ear to the other?

Unfortunately, it can. The infection can potentially travel through the Eustachian tube to the other middle ear.

How often does this jumping from one ear to the other happen?

While it's possible, it's not a guarantee. The chances of it spreading depend on things like how severe the infection is and how strong your immune system is.

How long do ear infections last?

Most ear infections last a few days, even without management.

But if the pain is intense, it lingers for more than a couple of days, there is purulent discharge coming from the ear, or there is a fever with vomiting, it's worthwhile seeing the doctor.

A doctor or medical practitioner can assess the condition and provide a management plan if clinically appropriate.

How to tell if an ear infection is viral or bacterial?

Symptoms alone might not give it away.

Your doctor can examine your ear and sometimes take a fluid sample to identify the culprit. This is important because some infections may require prescription medication based on the practitioner's professional judgement, while others may resolve with supportive care.

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 doctor or medical practitioner. They can diagnose the infection, recommend appropriate management options (if clinically appropriate), 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 online doctor or medical practitioner.

A doctor or medical practitioner in Australia can provide an initial assessment of 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 doctor or medical practitioner.

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.

How to make an ear infection go away?

If it's a mild viral infection, your doctor might suggest a wait-and-see approach, along with pain relievers for comfort.

A warm compress on the ear can also be very effective.

For some infections, prescription medication may be required following a clinical assessment. If medication is prescribed, it is important to follow the practitioner's instructions for the duration of the management plan.

Can ear infections cause any serious issues?

While most ear infections clear up without any drama, sometimes they can lead to complications like hearing loss, eardrum perforation, or even (rarely) more serious issues.

So, don't ignore those persistent symptoms and see your doctor.

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.
• Keep your child's ears dry, especially during swimming or in the bath.
• Avoid second-hand smoke: Keep your baby away from smoke, as exposure to tobacco smoke can increase the risk of ear infections.
• Manage allergies effectively.
• 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. Keeping your child upright during feedings can also help reduce the risk of ear infections.

Early diagnosis and appropriate management 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 management 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.

How Hola Health may help

If your child develops symptoms of an ear infection, Hola Health provides convenient access to Australian-registered doctors or medical practitioners through online telehealth consultations. Our doctors or medical practitioners can:

• Assess your child's symptoms and discuss possible causes.
• Provide medical advice and recommend appropriate management options (if clinically appropriate).
• Advise whether your child needs an in-person examination or urgent medical care.
• Issue prescriptions (if clinically appropriate).
• Arrange referrals to a specialist or for further investigations if required.
• Provide a dr certificate online for a parent or carer (if clinically appropriate).

Hola Health offers affordable telehealth appointments, available Australia-wide — including bulk-billed* services for eligible patients. You can access trusted medical advice and care within a few minutes, without leaving home.

Telehealth may not be suitable for every ear infection. A definitive diagnosis usually requires examination of the ear canal and eardrum using an otoscope. If a physical examination is clinically necessary, your doctor or medical practitioner will advise you to attend an in-person medical service.

In conclusion

Ear infections are a pain, but they're usually not contagious, and most clear up on their own or with simple management. By understanding the causes, symptoms, and management options, you can tackle them head-on and prevent any complications.

FAQ

Should I cover my child's ears outside if they have an ear infection?

No, fresh air won't make it worse.

Can my child swim with an ear infection?

It's best to avoid it, especially if the eardrum is ruptured or there's fluid drainage. Water can enter the middle ear and worsen the infection.

Can I fly or go to high altitudes with an ear infection?

Changes in air pressure can be painful. Talk to your doctor before traveling.

Can ear infections cause long-term damage to my child's hearing?

Most ear infections do not cause long-term hearing problems, especially if managed promptly. However, recurrent or untreated ear infections can lead to complications, including hearing loss. It's important to monitor your child's symptoms and seek medical advice if needed.