Any adult who has had an ear infection knows how painful it can be—all the more reason why it hurts to see your baby with one. Unfortunately, baby ear infections are extremely common. “Most kids—up to of 80 percent—will have one by age four,” says Sheila Jacobson, a paediatrician at Clairhurst Pediatrics and part-time staff paediatrician at Toronto’s The Hospital for Sick Children.
An ear infection is a viral or bacterial infection in the middle ear. It usually begins with a cold or allergies, which can cause the eustachian tubes—a passage between the middle ear and upper throat—to get blocked. The result: fluid build-up in the areas just behind the eardrum, and the pressure from the inflammation is what causes all that pain.
Kids under age two are unable to simply say, “My ear is killing me,” making a baby ear infection difficult to detect. Jacobson says to look out for fever, especially if preceded by a cold, as well as crying, clinginess, loss of appetite and irritability. Children with an ear infection often won’t sleep well, either, as pressure in the middle ear on the eustachian tubes increases when they’re lying down. And if you see fluid or pus draining from your child’s ear, it’s a sure sign of infection. You may also notice your child pulling on or rubbing their ear.
The good news is that most baby ear infections disappear on their own. Some may require antibiotics, although Jacobson prescribes the wait-and-watch approach, as recommended by the Canadian Paediatric Society. “If your child is over six months old, if he looks well and there’s no high fever, then keep an eye on him before giving antibiotics,” she says, adding that she’ll usually send parents home with a script and tell them to fill it only if their kid shows no sign of improvement after a day or two. If your baby is under six months, your doctor may prescribe antibiotics, depending on the severity of symptoms. Either way, infants’ acetaminophen can help relieve pain in babies over three months, and infants’ ibuprofen can be used with babies over six months. And steer clear of flying—the change in air pressure can cause even further pain in, or may even rupture, the eardrum.
Unlike, say, the stomach flu or strep throat, ear infections are not contagious—though the cold that triggers one most definitely is. And while ear infections aren’t preventable, you can reduce your child’s chances of getting one by hand-washing, breastfeeding if possible, not smoking, and having your child vaccinated (Conjugate pneumococcal vaccines protect against pneumococcal bacteria, which can help reduce ear infections). The flu vaccination may help reduce the risk of ear infections, too. Daycare exposure is also a risk factor, Jacobson says, because more kids means more colds and viruses being passed around.
This story was originally published in November 2016.