Ear infections

Middle ear infections (also known as otitis media) occur when there is inflammation or infection of the air-filled space behind the eardrum. The infection often begins with a cold, flu, sinusitis or throat infection. Bacteria or viruses enter the nose and throat and can travel up the Eustachian tubes (these tubes connect the nose and throat to the ears) to the middle ear. This space can fill with mucus, block and become infected causing inflammation and pain. Otitis media is very common in children due to the narrowness of their Eustachian tubes which get blocked easily, but older children and adults can still get ear infections. Those most at risk are children between the ages of six months and two years old, children in daycare, and babies that are bottle fed when they are lying down. Ear infections tend to be more common in autumn and winter and for people exposed to smoke or pollution.

The painful symptoms of an ear infection often come on quickly, especially in young children and babies. You may see your child rubbing or pulling at their ear, not reacting to certain sounds or they might lose their balance. They may be off their food, vomit or be irritable or restless. Older children may be able to tell you they feel pain, have a headache or a feeling of pressure or fullness inside their ear. Babies can be hard to settle at night as the pain in the ear increases when lying down. Along with some of these symptoms your child is likely to have a temperature, they may have a discharge from the ear or show an area of irritation or scaly skin in and around the ear.

Otitis media does not always need to be seen by a doctor. Often these infections will start to get better in around three days. For a mild ear infection, the best home treatment is to manage pain (use paracetamol and/or ibuprofen), use a warm flannel or wheat bag on the affected ear, and keep background noise to a minimum. It is important to keep a close eye on the infection and be aware that if it doesn’t clear up on its own, antibiotics may be needed. 

One complication associated with middle ear infections is a condition called ‘glue ear’. This is when fluid stays in the ear canals and causes deafness. Glue ear can take several weeks to clear up and if it doesn’t resolve, a patient will need to see an ear, nose and throat specialist (ENT) to see if grommet surgery is needed. If it isn’t treated in children they can experience delayed speech, may not reach developmental milestones or they may have behavioural issues. Ear grommets are tiny tubes placed through the eardrum to allow air into the middle ear. They allow fluid to drain and will decrease the risk of fluid building up if there are any more ear infections. Grommets can decrease the incidence of recurrent otitis media after insertion.

Another complication that can happen with frequent ear infections is ear drum rupture. When fluid builds up, pressure in the Eustachian tube increases and the ear drum can burst. The ear drum will repair itself but if ear infections keep happening the ear drum can develop scar tissue causing permanent hearing loss.

The best means of preventing ear infections is to keep your house warm, dry and smoke-free. Breastfed infants also tend to suffer fewer ear infections. It is also very important to keep up-to-date with your child’s immunisations. Always see a GP if the earache doesn’t start getting better after three days, there is a very high temperature or the person feels hot and shivery. If there is swelling around the ear or fluid coming from it, this also needs medical assessment. Regular ear infections (more than three episodes in six months or more than four episodes in a year) or any signs of hearing loss or a change of hearing also need to be checked by a doctor.

This blog provides general information and discussion about medicine, health and related subjects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.

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