Child and Infant Ear Infections

Infectious Diseases


Child and Infant Ear Infections and Tube Surgery


When your baby or infant has an ear infection, your lives may be miserable. Infant ear infections can lead your child to be irritable, eat and sleep poorly and run a fever. Luckily ear infections can be treated pretty easily and your child will likely be back to normal in no time.


What is an ear infection?

The middle ear is located behind the eardrum and is filled with air. When sound enters here it makes the eardrum vibrate which causes the tiny bones in the middle ear to vibrate as well. This is how we hear.


The Eustachian tube equalizes air pressure between the middle ear and the outside world. You have experienced the Eustachian tube adjusting to air pressure in your ears when you feel them pop as you’re yawning or swallowing.


Bacteria or viruses can enter the middle ear through the Eustachian tube and cause an infection. This most commonly happens when a child has a cold or is congested, which leads to fluid in the ear. When the Eustachian tube is filled with fluid, just as in your sinuses, bacteria will grow.


Pressure from the fluid and bacteria pushes on the eardrum and causes pain. When it is infected it cannot vibrate properly and the child may have a decrease in hearing. With antibiotic treatment, the infection will go away, and your child’s hearing will improve when that fluid resorbs.


Ear infection symptoms in babies and kids

  • Sore ear
  • Pressure in ear
  • Rubbing or pulling the ears
  • Fever
  • Irritability
  • Decreased appetite
  • Trouble hearing
  • Fluid or blood coming from the ear



There are some specific signs that we look for in determining whether there is a baby or toddler ear infection

  1. Red drum
  2. Bulging membrane – from fluid
  3. Inability to see the landmarks of the middle ear bones
  4. Fluid or pus behind the drum
  5. Occasionally, a hole, indicating perforation


Lots of things cause the eardrum to be red, so one must exhibit at least some of the other signs in order to identify it as an infection.


Is an ear infection contagious?

No, but the cold that can lead to the infection is contagious.


How to treat an ear infection

As many ear infections are caused by viruses, most resolve on their own with no antibiotic therapy needed.  Many doctors will ‘watch and wait’ ear infections in healthy children older than 6 months and avoid treating the infection for 24 or 48 hours to see if it resolves on its own. If it does not resolve, antibiotics may be necessary.


Most bacterial infections resolve with antibiotic treatment. However in children with recurrent ear infections, placement of myringotomy tubes can help ventilate and equalize the pressure in the ear. This will prevent accumulation of fluid in the ear, normalize hearing and prevent future infections.  This is called tympanostomy. Essentially, the surgeon makes a small hole in the drum, removes fluid with suction and places a small plastic tube (myringotomy tubes) into the hole. It is a fast, easy surgery and most children do very well.


After surgery, the tube prevents recurrent ear infections by allowing air into the ear, while also permitting fluid and bacteria to drain out. Preventing the accumulation of fluid and bacteria decreases the risk of infection. The tube then falls out as the child grows, usually within 1 or 2 years.


How long do ear infections last?

With proper antibiotic treatment, most kids feel relief within 24-48 hours.


To read more about external ear infections (swimmer’s ear), click here.

To read more about how to treat a fever in your child, click here.





Dr. Dina Kulik, MD, FRCPC, PEM

Written By: Dr. Dina Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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