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Ear infections in children – when to seek help

19 August 2021

Childrens health
Middle ear infections (otitis media) are a very common reason for parents taking their children to the GP. Paediatric Ear, Nose and Throat Surgeon Dr George Sim says it’s quite common for children to have one or two ear infections a year that are not severe.

Why do children get ear infections? 

Children are more susceptible to ear infections as their eustachian tubes are smaller and at a very flat angle.

When children get to about six or seven years of age, this tube gets a bit bigger so ear infections become less frequent.

They are also more susceptible to ear infections as their immune systems are still developing so it’s much more difficult to fight off infections.

When to get help

However, if your child is having frequent recurrent ear infections, it’s best to seek advice and treatment.

Take your child to see a GP if you believe they have an ear infection as they are treatable with antibiotics.

Seek immediate medical treatment if your child experiences sudden hearing loss, severe pain, dizziness, fever, a stiff neck, redness, swelling and pain behind or around the ear, or if they are not moving the muscles on that side of their face.

If symptoms are ignored, it can lead to speech or hearing issues.

Symptoms can be hard to recognise, especially in babies

These symptoms are sometimes hard to identify, especially when your baby or child is too young to be able to tell you about their pain.

Look out for signs of pulling or tugging at the ears and sometimes fluid coming from the ear.

Irritability, trouble sleeping and a fever can also indicate ear issues.

The three most common ear infections

There are three different scenarios which might require intervention. You should take your child to your GP if you think they have an ear infection.

1. Acute otitis media

Acute otitis media is an acute middle ear infection and symptoms include high temperatures, pain and irritability.

2. Recurrent otitis media

Recurrent otitis media occurs when children experience several episodes of ear infections throughout the year – if there are three episodes in six months or four in a year.

3. Chronic otitis media

Chronic otitis media with effusion, also known as glue ear, tends to show more subtle symptoms and is characterised by fluid in the middle ear.

Kids with glue ear can experience hearing loss, their speech can be affected and they may start falling behind at school.

A referral to an ENT surgeon is important for these children as the ENT surgeon can do a hearing test and insert grommets if necessary.

Grommets are small tubes that bypass the poorly functioning eustachian tubes to provide an alternative ventilation pathway. It is a simple day procedure in which the surgeon inserts the grommets while your child is under general anaesthetic.

Grommets usually last for a year and are easy to maintain. Your child needs to wear earplugs and a headband to prevent water getting into the ears when swimming.

Can you do anything to prevent ear infections?

Not really, but you can look at risk factors that your child is exposed to that might predispose them to middle ear infections.

Passive smoking has been shown to affect middle ear health, so make sure your children are not around people smoking.

Children in day care tend to have more middle ear issues as well, as they are exposed to more viruses and bacteria than they otherwise would be.

Bottle feeding, using a dummy and gastric reflux can also predispose them to middle ear infections.

Getting help

If you feel like your child is taking too long to recover from earaches or that they are recurring too frequently, ask your GP for a referral to see a paediatric ENT surgeon for further advice and treatment.