Ear infections in children: a complete guide for parents

While their immune systems are developing, children will often pick up colds and viruses, but a nasty ear infection can be particularly unpleasant for them. Here, we uncover how to know if your child has an ear infection, as well as causes, treatments, and how best to prevent them.

What is an ear infection?

The most common type of ear infection in children is a middle ear infection, otherwise known as otitis media (OM).

When your child has a cold, fluid can build up behind the eardrum. Sometimes, this can get infected with germs (bacteria or viruses), causing inflammation and pain. This is particularly prevalent in young children, and one of the most common reasons parents bring their child to a doctor.

Most ear infections will clear up on their own within three days, however sometimes symptoms can last up to a week.

What are the symptoms of ear infections in children?

According to the NHS, the symptoms of an ear infection will come on quickly, with signs to look out for including:

• your child rubbing or pulling on their ear
• losing their balance
• increased irritability and restlessness
• getting a fever/temperature of 38C and above
• itching and irritation in and around the ear
• reacting less to sound
• vomiting
• loss of appetite
• telling you they are experiencing earache
• discharge running out of the ear (this is a sign of a burst ear drum)

Child ear infection treatments

Here are some things you can do at home to help your child feel better when they have an ear infection:

• give them infant liquid paracetamol or ibuprofen if they appear to be in pain (note: children under 16 should not be given aspirin, and babies under two months old should not be given infant paracetamol)
• place a warm flannel on the ear which may help soothe them
• remove any discharge by wiping the outside of the ear with cotton wool
• allow them as much rest as possible, and encourage them to drink plenty of water, since drinking can help open the eustachian tube so any trapped fluid can drain.

The pain of an ear infection can make it tricky for your child to sleep, so prepare for some potentially restless nights! Infant paracetamol or ibuprofen may help everyone get some shut-eye.

You can buy liquid paracetamol for children as young as two months old. See more details here at Boots.

As always, we'd advise taking your child to the doctor if you are concerned, or they appear to be getting worse.

How long do ear infections last in children?

Ear infections in children usually last around three days and clear up on their own, although some can last up to a week. In severe cases, a middle ear infection can last six weeks or longer, even after antibiotics.

If it has been several days and your little one still doesn't seem any better, or they have been having recurring ear infections, do seek advice from your GP.

What causes ear infections in children?

Ear infections in young children are very common, particularly when they have had a cold.

According to patient.info, an ear infection is caused by the build up of bacteria or a virus present in mucus in the inner ear. More often than not, the infection is the result of another illness such as a cold, flu or allergy, causing congestion and the swelling of the nasal passages, throat and eustachian tubes.

Babies and toddlers between the ages of six months and two years are far more prone to ear infections than adults. This is because of their smaller eustachian tubes, and because their immune systems are still developing. However children of all ages can get an ear infection.

Children regularly exposed to tobacco smoke or high levels of pollution are at greater risk, as well as kids that suffer from allergies.

It is worth noting that the NHS does not list an ear infection as a symptom of the coronavirus, so it is unlikely to indicate this.

When should I take my child to the doctor for an ear infection?

Most of the time, an ear infection will go away on its own after a few days. But if your child is displaying any of the following, the NHS says you should take them to a doctor as soon as possible:

• a high temperature or feeling hot but shivering
• earache that doesn't get better after about 3 days
• swelling around the ear
• fluid coming from the ear
• vomiting or appearing disorientated
• having already had regular ear infections
• if they suffer with a long-term medical condition – such as diabetes or a heart, lung, kidney or neurological disease

At your appointment, the doctor will check your child's ear using an otoscope (a magnifying tool with a light) to check for blockages which may signal an infection. Antibiotics will rarely be prescribed for an ear infection, because they will do little for the symptoms and often the problem clears up on its own.

Your GP may provide antibiotics in certain situations though, like if your little one has an infection in both ears, has fluid leaking from their ear, or doesn't start to get better after a few days.

In older babies and children, ear drops may be prescribed, especially if they have an outer ear infection. Do follow the instructions on the packaging carefully.

Will my child need grommets for their ear infection?

A grommet is a tiny tube that helps the fluid to drain from the ear. In the past, it was fairly common for them to be used with ear infections, particularly recurring ear infections.

However, they're not used so frequently nowadays, because we know that most kids will stop getting ear infections as they grow.

If your child has very frequent ear infections, this can lead to a build-up of fluid known as glue ear. Glue ear can last for months, and affect your child's hearing, which in turn can affect their language development if it happens when they are very young.

In these cases, your GP may consider grommets. The small tubes will be inserted in your child's ears in hospital, under general anaesthetic. It's a minor procedure, and you should be able to go home again the same day. The grommet will fall out on its own after 6-12 months.

How to prevent an ear infection in children

You can't always prevent an ear infection in children, particularly inner ear infections caused by cold viruses and the flu. There are, however, preventative measures you can take to keep your little one as healthy as possible. These include:

• making sure your child is up-to-date with their vaccinations
• keeping them away from smoky environments
• avoiding giving toddlers a dummy
• washing their hands and your own as frequently as possible to help prevent the spread of germs
• keeping their allergies in check - with children's oral allergy solution if needed
• avoiding other poorly children and adults, and limiting your child's exposure to them

Worried your little one might have an ear infection? Get additional info, advice, and tips from other parents in our forum below...

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