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Otitis in children, what it is, causes and treatment

If your child has ear pain and feels unwell, it could be because of an ear infection. How can you detect it and what can you do about it? We explain it to you.

How does an ear infection develop?

Ear infections usually occur due to inflammation in one or both Eustachian tubes (which connect the middle ear to the back of the throat). The Eustachian tubes allow the drainage of mucus from the inner ear into the throat.

A cold or cold, a throat infection, acid reflux, or allergies can also cause the Eustachian tubes to swell. This obstructs the drainage of mucus. Then, they can grow viruses or bacteria in the mucus and make pus, which will accumulate in the middle ear.

Otitis media with effusion or effusion is when an uninfected fluid builds up inside the ear. It may not cause any symptoms, but in some children, the fluid creates a feeling of a stuffy ear or of the ear being uncovered.

How do I know if my child has an ear infection?

Most ear infections happen to children before they have learned to speak. If your child is not old enough to say “My ear hurts” you should try to understand their complaints in another way.

Typical symptoms of these infections are ear pain and difficulty hearing. Young children may pull or pull on the affected ear, have difficulty sleeping, and cry more than usual. Some children may even have fever, headaches, and lose their appetite. Severe cases can cause the eardrum to rupture and pus may come out of the ear.

Medical examination and diagnosis

Doctors diagnose acute middle ear infections using a handheld light called an otoscope to look for the bulging and redness of the eardrum and fluid behind the eardrum. They may need to clean the ear wax first so they can see more clearly. Doctors may use a rubber bulb and a tube connected to the otoscope to insert air into the ear to see if the eardrum moves. If the eardrum does not move or moves only slightly, there may be fluid in the middle ear, which is a sign of infection.

Why are children more likely than adults to get ear infections?

There are several reasons why children are more likely than adults to get ear infections.

The Eustachian tubes are smaller and more level in children than in adults. This makes it difficult to drain fluid from the ear, even under normal conditions. If the Eustachian tubes are swollen or blocked with mucus due to a cold or other respiratory illness, the fluid may not be able to drain.

A child’s immune system is not as effective as an adult’s because it is still developing. This makes it harder for children to fight off infections.

As part of the immune system, adenoids respond to bacteria passing through the nose and mouth. Sometimes bacteria get trapped in the adenoids, causing a chronic infection that can then pass into the Eustachian tubes and middle ear.

Is the infection caused by viruses or bacteria?

Most upper respiratory infections are caused by “cold” viruses. These cause a sore throat and inflammation and infection of the middle ear. Therefore, it follows that viruses are the basis of most middle ear infections.

However, bacteria can also colonize already infected areas, as the lining of the middle ear has been weakened by the virus. Mucus sits in the middle ear and cannot be cleaned properly, making it an ideal place for bacteria to live. The most common groups of bacteria are Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae and Moraxella catarrhalis. All of these are usually treatable with amoxicillin or similar antibiotics.

Treatment of ear infection in children

Most ear infections go away within three to five days and don’t need any specific treatment. If necessary, paracetamol or ibuprofen should be used to relieve pain and fever. Make sure the painkillers you give your little ones are appropriate for their age.

Antibiotics are not routinely used to treat middle ear infections, although they may be prescribed occasionally if symptoms persist or are especially severe and only if your doctor has prescribed them. Never give your child antibiotics without first consulting with your child’s doctor.


Rarely, an acute middle ear infection leads to more serious complications. The eardrum can rupture, causing blood or fluid to drain from the ear. In addition, nearby structures can become infected, cause symptoms, and require emergency treatment:

  • Infection of the bone surrounding the ear (mastoiditis) causes pain.
  • Infection of the inner ear (labyrinthitis) causes dizziness and deafness.
  • Infection of the tissues surrounding the brain (meningitis) or accumulations of pus in the brain cause headache, confusion, seizures, and other neurological problems.
  • If infections recur, abnormal skin tissue called cholesteatoma can grow in the middle ear and potentially through the eardrum. A cholesteatoma can damage the bones of the middle ear and cause hearing loss.

Can ear infections be prevented in children?

That’s hard. Eight out of ten children get a middle ear infection one or more times before the third year. As I mentioned earlier that’s because they haven’t developed their immune system yet. In any case, be sure to let the water out of your ear after swimming or showering. Keep your head aside and let it move a couple of times. If your child still has earache after swimming, you can ask him or her to wear a bathing cap. It is also useful – a pair of earplugs.

Do you use cotton swabs to clean your child’s ear? It is not entirely recommended and especially if you do it frequently, you can damage your child’s eardrum.

Just washing the pinna with warm water and a washcloth is enough. With a cold, it is good to keep the airways open, if necessary, you can ask the pediatrician for a few nasal drops or spray to keep the nose and cavities open and hopefully prevent an ear infection.

Recurrent middle ear infections are also common. These can be treated in the same way, as and when they occur.

Middle ear infections (acute otitis media) are very common in young children, but they reduce the frequency as children get older. 



All the information we give you in this article is indicative as each child and each family is different and unique.


Carolina González Ramos

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