Ear infections

Ear infections

Ear pain and concerns about hearing are one of the most common reasons parents take their young children to the doctor.

Key points to remember about ear infections

If you think your child has an ear infection, take them to your family doctor.

  • ear infections are very common in young children
  • they can cause pain, and often fever
  • if you think your child has an ear infection, take them to your family doctor
  • antibiotics are often not needed
  • pain relief is important
  • always take your child to your family doctor for an ear check 4 to 6 weeks after an ear infection, to make sure the ear fluid has gone
  • most children outgrow ear infections and will have perfect, undamaged ears and normal hearing

What is an ear infection?

See Ear infections in detail for more information. 

There are 2 common types of middle ear problems:

  • an ear infection (acute otitis media) - discussed on this page
  • glue ear (otitis media with effusion)

How do ear infections happen?

Ear infections often happen either during or just after a cold, in the following way:

  • germs (bacteria and viruses) from a cold (or other upper respiratory infection) travel up the eustachian tube which connects the middle ear (the space behind the eardrum) to the back of the nose
  • the germs infect the middle ear
  • the eardrum bulges out and becomes red and painful

Ear drum bulging out

Can I do anything to prevent ear infections in my child?

It is not easy to prevent ear infections, but the following may help reduce the risk:

  • keeping your child smoke-free
  • breastfeeding your baby for at least 3 to 6 months is thought to be protective against the early development of ear infections - this may be because breastfeeding boosts the infection-fighting system (immune system)

What are the signs and symptoms of an ear infection?

The pain from an ear infection comes on rapidly and doesn't last long. It usually wears off within 24 hours.

Symptoms in older children

Older children will complain of significant ear pain and may have a fever. They may also feel unwell and complain of reduced hearing in the affected ear.

Symptoms in babies and younger children

In babies and younger children, sometimes the only sign of an ear infection is a fever.

Younger children may also:

  • cry and become very upset, distressed, irritable and hard to deal with
  • have very disturbed sleep at the beginning of the infection
  • be harder to settle to sleep
  • vomit, lose interest in eating, seem to have no energy
  • become 'clingy' and 'grizzly'

Burst ear drum

Occasionally, the ear drum will burst and pus will come out of the ear. See your family doctor if this happens.

What is the treatment for an ear infection?

Antibiotics are often not needed. Your doctor may either:

  • wait to see whether the infection will clear up by itself, or
  • recommend treatment with antibiotics, if your child is unwell and feverish

How can I care for my child with an ear infection at home?

  • pain relief is important - your family doctor or pharmacist can advise you on the right dose of pain relief medicine for your child
  • your child may need rest and lots of comforting and cuddles
  • keep your child home from childcare or school while they are unwell or have a fever

Always take your child to your family doctor for an ear check 4 to 6 weeks after any ear infection, to make sure the ear fluid has gone.

When should I seek help for my child with an ear infection?

Go to your doctor if you suspect your child has an ear infection

The symptoms of ear infections also happen in other illnesses. For this reason, if you suspect your child has an ear infection, take them to your family doctor. Your doctor will examine your child to see if an ear infection (or another problem) is the cause of your child's symptoms.

Take your child back to your doctor if your child doesn't improve in 24 - 48 hours

Once an ear infection is diagnosed, your child should start to improve within 24 to 48 hours. If the symptoms are no better or are getting worse, or you are worried about your child, take them back to your family doctor.

Go to your doctor again 4 to 6 weeks after the ear infection

Always take your child to your family doctor for an ear check after any ear infection, to make sure the ear fluid has gone. Go to your doctor again 4 to 6 weeks after the ear infection.

Procare logoStarship Foundation and the Paediatric Society of New Zealand acknowledge the cooperation of Procare Health Ltd in the development of this content. Procare Health Ltd provides GP (general practice) services in the greater Auckland area.

Diagrams / artwork:
Thank you to Dr Peter Allen for allowing reproduction of artwork from his book 'Understanding ear infections'.

Please note: Permission to copy KidsHealth content, with acknowledgement, does not extend to Dr Peter Allen's artwork on this page. Any requests to reproduce this artwork need to be made in writing to:
Dr Peter Allen
Central Family Health Care
7 Mansfield Terrace
Whangarei 0110

This page last reviewed 17 September 2018.
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