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Ear infections are very common in small children. Most infections get better quickly and are not usually serious. The two types of ear infections often seen in children are middle ear infections (otitis media) and outer ear infections (otitis externa). Most ear infections involve the middle ear.
Every time a middle ear infection happens, fluid collects behind the ear drum. This fluid usually slowly clears by itself, but children who get frequent infections may have fluid stay behind the eardrum for longer. This is called glue ear. Glue ear may last for many weeks or months, making it
harder for your child to hear. Occasionally, glue ear can temporarily affect language development.
Babies and young children get more middle ear infections than older children because they have smaller tubes (called the Eustachian tubes) that connect the middle ear to the throat. When your child has a cold, germs from the throat can travel up to the middle ear and cause an
infection. Infections develop more easily in smaller tubes and it's not uncommon for small children to have lots of ear infections in one year, sometimes as often as once every month.
Outer ear infections are usually due to excess moisture in the canal, for example after swimming. They can also be caused by damage to the canal (e.g. from scratching or cleaning with earbuds).
Babies and children may have ear pain with both middle and outer ear infections. This pain can cause irritability. Your child may also have symptoms of a cold (e.g. runny nose, sore throat).
Glue ear is not an infection, but usually follows one or more middle ear infections. Signs and symptoms of glue ear can include:
If you think your child may have an ear infection, take them to see the GP.
A middle ear infection may spread to the firm, bony area behind the ear. You should visit your GP or local emergency department if there is redness, swelling or pain in this area.
If your child has frequent ear infections or their hearing appears to be affected by glue ear, they should have their hearing tested by a hearing specialist (an audiologist). Your GP may also refer them to see a paediatrician or an ear, nose and throat (ENT) specialist.
Can my child go swimming during an ear infection?
If your child has an outer ear infection, wait until one week after treatment to give the ear time to heal before letting your child swim. For middle ear infections and glue ear, swimming is OK but should be avoided if the ear drum is perforated. Discuss this with your GP or specialist.
If my child has speech problems caused by glue ear, will
surgery help their speech improve?
If language delay is caused by difficulty hearing from glue ear, then correcting the glue ear often results in rapid improvements in language. Most children catch up quickly with their peers and the delay is completely corrected.
My child is in a lot of pain with his ear infection. Can I
Painstop is usually not required, and is now only available by prescription. It contains codeine, which may cause nausea or constipation in children. Paracetamol and ibuprofen can be used safely.
Will my child grow out of their ear infections?
As children grow, the tubes in their ears (called the Eustachian tubes) also grow. This is usually associated with fewer - and less severe - ear infections as the child grows. As they get older, children tend to have fewer colds, and this means they will also have fewer ear infections.
Should I clean my child’s ears to prevent a build-up of wax?
No. There is no need to remove the wax in a child’s ears. The body is able to do this by itself. Large clumps of wax that are visible at the opening of the ear canal can be removed, but earbuds should not be used in children.
Developed by The Royal Children's Hospital General Medicine, Emergency and Otolaryngology departments. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
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