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Otitis Media in Children

What is otitis media?

Otitis media is inflammation or infection in the middle ear. It’s very common in babies and children.

There are several types of otitis media. They are:

  • Acute otitis media. This is a sudden middle ear infection. It causes swelling, redness, pain, and fluid in the middle ear. 
  • Otitis media with effusion. Fluid (effusion) stays in the middle ear after the infection goes away. Your child may have a feeling of fullness in his or her ear. It may affect your child’s hearing.
  • Chronic otitis media with effusion. Fluid stays in the middle ear for a long time. Or it goes away and comes back. This may increase the chance of your child having ear infections. It may also affect your child’s hearing.

What causes otitis media?

An ear infection often starts after your child has a sore throat, cold, or other repertory infection. It can also occur with swelling and congestion from allergies.

In babies and young children, the tube between the throat and middle ear (eustachian tube) is very small. Infections can get to the middle ear from other parts of the respiratory system easily through this tube.

Who is at risk for otitis media?

Any baby or child can get an ear infection. The following factors may increase your child’s risk:

  • Not being breastfed
  • Being around secondhand smoke
  • Not having all of the recommended vaccines
  • Not washing his or her hands often. This spreads infection.
  • Being in daycare
  • Drinking from a bottle while lying down
  • Drinking from a bottle instead of a cup

What are the symptoms of otitis media?

Symptoms can occur a bit differently in each child. They can include:

  • Ear pain
  • Tugging or pulling at his or her ears
  • Fussiness or irritability
  • Trouble sleeping
  • Fever
  • Fluid draining from his or her ears
  • Trouble hearing

The symptoms of otitis media may look like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is otitis media diagnosed?

Your child's healthcare provider will ask about your child's health history and symptoms. He or she will check your child's ear, nose, and throat.

Your child's healthcare provider will also check your child's ears with a lighted instrument that lets him or her see inside of your child’s ear (otoscope). Your child’s healthcare provider may use a special type of otoscope that blows a puff of air into the ear (pneumatic otoscope). This tests your child’s eardrum movement.

Your child may also need the following tests:

  • Tympanometry. This test checks for any pressure changes in your child’s middle ear. This test doesn’t hurt. But your child needs to stay still. He or she can’t cry, talk, or move.
  • Audiometry. This is a hearing test. It may be done if your child gets ear infections often.

How is otitis media treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is and what type of otitis media your child has.


Your child's healthcare provider may prescribe antibiotic medicine right away. Or he or she may wait for 2 to 3 days and recheck your child. Some symptoms go away without medicine. Your child may also need other medicine to treat the pain and fever.


Your child's healthcare provider may recommend that small tubes be placed in your child’s ears. This is done through surgery called tympanostomy or myringotomy. 

In this surgery, your child’s surgeon will make a small opening in the eardrum. This is done to drain the fluid and relieve the pressure from the middle ear. A small tube is placed in the opening of the eardrum. This allows air to move in and out. It also stops fluid from building up. Your child's hearing normally returns once the fluid drains. The tubes often fall out on their own in 6 to 12 months. 

Your child’s healthcare provider may suggest tubes if your child has the following:

  • Fluid in both ears for 3 or more months and hearing problems.
  • Fluid in one or both ears for 3 or more months and problems related to having fluid. These issues may include trouble with balance, ear pain, problems in school or with behavior, and frequent ear infections.

Your child's healthcare provider may also recommend surgery to take out the glands above your child’s nose and mouth (adenoids) if they’re infected. This helps some children with otitis media.

What are the complications of otitis media?

If ear infections aren’t treated, your child may have the following:

  • Permanent hearing loss
  • Problems with speech and language development
  • Serious infections in other parts of the ear and bones of the head (skull) 

Can otitis media be prevented?

Ear infections can’t always be prevented. But you can take actions to reduce your child’s risk of infections. Follow these tips:

  • Avoid secondhand smoke.
  • Make sure your child washes his or her hands often. This stops the spread of germs. 
  • Make sure your child gets all vaccines. All members of your family should get the flu shot every year.
  • Breastfeed your baby for the first year of life.

Key points about otitis media

  • Otitis media is inflammation or infection of the middle ear. This is common in babies and young children.
  • This condition often follows a sore throat, cold, other respiratory infection, or allergies.
  • Your child’s healthcare provider will diagnose an ear infection by looking in your child’s ear. If your child gets ear infections often, he or she may need a hearing test.
  • In some cases, ear infections must be treated with antibiotic medicines. Some children may need tympanostomy tubes put in their ears.
  • Breastfeeding your child, staying away from secondhand smoke, and having the recommended vaccines can reduce your child’s risk of ear infections.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
Otitis Media in Children - WellSpan Health

Online Medical Reviewer: Berry, Judith, PhD, APRN
Online Medical Reviewer: Holloway, Beth, RN, M.Ed.
Last Review Date: 2015-06-01T00:00:00
Last Modified Date: 2016-06-23T00:00:00
Published Date: 2016-06-23T00:00:00
Last Review Date: 2007-03-30T00:00:00
© 2016 WellSpan Health. All Rights Reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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