Ear Infections

By Dr Evelyn Lewin

Ear infections are common in children. They can affect the outer ear (otitis externa) or middle ear (otitis media). Otitis externa -This affects the part of the ear that goes from the eardrum to the outside. These infections thrive in a warm, moist environment. They usually occur after having water in the ear, e.g. after swimming. Otitis media – Middle ear infections are more common in smaller children because the tube that connects their ear to their throat is smaller. This means infections (such as colds) don’t have far to travel to reach the ear. Some children are prone to recurrent middle ear infections. Recurrent Otitis Media can lead to glue ear, where thick fluid remains in the middle ear. This can lead to hearing loss and learning problems.


Otitis externa:  Pain is the main symptom. A yellow discharge may be present. The ear can feel ‘full’ and may be red or tender. Otitis media:  Children are often miserable and unwell with a fever, cough or runny nose, and sore ear. They can be nauseous and may vomit. Younger children and babies may pull at their ear, or put their fingers in their ear. Otitis media can lead to perforation of the eardrum from pressure buildup behind the eardrum. The child usually feels better afterwards because the pressure is gone. A discharge may then be noted. After a middle ear infection fluid may remain in the eardrum for several weeks. This can impact hearing, but usually resolves.


See a doctor for diagnosis and treatment of otitis externa and otitis media. Otitis externa – Your doctor will recommend antibiotic drops. Applying drops is best done with your child lying down, with their sore ear up. Keep your child still afterwards to allow the drops to absorb. The ear should be kept dry, and swimming avoided until infection has healed. Otitis media -Pain-killers such as Paracetamol can help relieve pain. Rest and fluids are also important. Antibiotics are unlikely to be of much benefit in most cases. To find out if they may help, discuss this with your doctor. A burst eardrum does not need treatment and should heal on its own. Because fluid can remain in the ear after infection, see your doctor a few weeks after the initial illness to check if it has cleared. Children with recurrent ear infections may benefit from Grommets. These are small tubes inserted into the eardrum that help prevent fluid build-up. If you are concerned your child’s hearing may have been impacted by an ear infection, see your GP. See Nutrition Protocols for Common Childhood infections.

Reviewed by Dr Evelyn Lewin 25 February 2015 references
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This document has been developed and peer reviewed by a KIDS HEALTH Advisory Board Representative and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.

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