My 19 month old just got over their first ear infection. How common are ear infections?

Acute otitis media (inflammation of the middle ear), commonly known as an ear infection, is responsible for approximately 24 million visits to the doctor’s office each year.  Ear infections are also the most common reason why antibiotics are prescribed to children.

Up to 90% of children will have at least one ear infection by the time they are 2 years old. Ear infections have a peak incidence in kids between 6 and 18 months old.

Ear infections typically develop from first, a blockage of the narrow tube which allows drainage of fluid from the middle ear into the nose (Eustachian tube).  This tube, while normally closed, will open to allow pressure to equalize in our ears (think about the popping sound when you’re on an airplane).  Blockage leading to an ear infection is often caused by inflammation from an upper respiratory infection (common cold). This allows bacteria or viruses which often colonize a child’s nose to migrate into the middle ear canal which can cause pain and/or fever.

Symptoms of an ear infection can include fever, ear pain, fussiness, or feeding difficulties (in younger children). Not all causes of ear pain are due to infection.  Have your child evaluated by a physician if they are having severe pain in one or both ears. Ear infections must be diagnosed by having a physician look inside your child’s ear with an otoscope.

Some of the risk factors that make children more prone to ear infections are:

  • Age less than 2 years
  • Bottle feeding
  • Pacifier use
  • Exposure to secondhand smoke
  • Day care attendance

Does my child need antibiotics if they have an ear infection?

Depending on the child’s age and severity of the symptoms; some children can be observed for a period of 48-72 hours prior to starting an antibiotic. Infants & children less than 2 years old with a diagnosis of ear infection (acute otitis media) should receive antibiotics. Children older than 2 years can be observed as above, unless they have symptoms including fever above 102.2F or severe pain.  If symptoms continue or worsen after the observation period, they typically will be treated with a course of antibiotics. Children, regardless of antibiotic treatment, also should be treated with pain/fever reducers such as acetaminophen or ibuprofen and/or topical ear drops to help reduce pain. (The amount of medication needed to treat your child’s fever or pain is based on their weight. Ask your pediatrician what your child’s new dose is at each visit.)

Have your pediatrician evaluate your child if you believe they have an ear infection.  Always consult with your physician prior to starting any treatment regimen. For more information on ear infections and their treatment, please consult with your physician.

Follow us on Twitter @Peds_doc