Middle Ear Infections

(Otitis Media)

Children are prone to middle ear infections because their natural middle ear drainage pathways, i.e. Eustachian tubes, are shorter, smaller, and less vertical. This allows for bacteria from the nose and sinuses to travel up the Eustachian tube to middle ear, get trapped, and cause an infection.

Otitis media is not caused by swimming or water exposure. Eighty-five percent of all children have one episode of otitis media by 15 months of age. Many of these will resolve in time without complication and are managed well by primary care physicians. Others are more frequent, more symptomatic, utilize many antibiotics, or result in hearing impairment that necessitates an ENT for management. 

While it's not always possible to prevent an ear infection, there are ways to lower the risk of your child developing one. These include breast-feeding your baby (if possible), making sure they are up-to-date on vaccinations, practicing good hygiene (e.g., regular hand-washing), keeping your child away from tobacco smoke, and enrolling them in as small a day care or preschool facility. 

With time and patience, many children with mild symptoms can be treated with medication and may outgrow their otitis media without needing surgery. However, for others with more severe symptoms, ear tube surgery may become a more appealing option.

Problems Caused by Middle Ear Infections

The majority of middle ear infections are transient, short lived, and may result only in some discomfort, fussiness, and decreased sleep. This may be harder to tolerate though if the episodes are more severe or closer together. Antibiotics are usually tolerated well, but they can cause GI upset, allergic reactions, and the bacteria associated with the infections can be less responsive to antibiotic treatment. In some cases the infection goes away, but the remaining middle ear fluid results in temporary hearing loss that could affect development. In rare circumstances, ear infections can spread to the bone behind the ear (mastoiditis) which requires more immediate treatment. While rare with todays vaccines, meningitis can still be caused by a middle ear infection.