Otitis Media (Ear Infections)

What are the signs and symptoms of ear infections in kids?

If your baby or child has the following symptoms, they may have an ear infection:

• Fever
• Ear pain
• Irritability
• Ear drainage
• Balance problems
• Difficulty hearing
• Tugging or pulling at their ears

Sometimes, a child may have no symptoms and a doctor finds fluid in the middle ear during a routine examination.

Learn how to spot the differences between ear infection symptoms and symptoms of other respiratory infections.  

How do we diagnose ear infections?

Your child’s doctor can diagnose a middle ear infection with a thorough examination. They will also ask you about your child’s symptoms. Doctors can look in the ear to see if the area behind the eardrum has pus or fluid. They may use an instrument to apply air pressure to the eardrum to see whether or not it moves, which can help determine if there is fluid buildup.

Occasionally, your child’s doctor may recommend a hearing test to see if the fluid in the middle ear has caused any hearing loss.

What can we expect from a hearing test?

There are two types of hearing tests:

• A tympanogram is a pressure test to tell if there is fluid behind the eardrum. It takes 3 minutes.
• A formal hearing test (audiogram) usually takes 10 to 20 minutes.

An audiologist performs these tests, tailored to each child based on their symptoms, age and development. Your child should experience little to no discomfort during these tests.

How do we treat an ear infection? 

Your child's ear infection may clear up on its own without any treatment. Infant ear infections — as well as more severe infections in toddlers — may be treated with antibiotics.

If the fluid will not go away, or your child gets several ear infections in a year, your doctor may recommend ear tube surgery.

What is ear tube surgery?

Ear tube surgery is a procedure to insert tubes into the ears to allow them to drain. The tubes allow extra fluid from ear infections to drain, resulting in less inflammation, fewer ear infections and better healing. Ear tubes also help equalize pressure between the middle ear and the environment to reduce pressure and pain.

During ear tube surgery, your child’s surgeon makes a small incision in the eardrum and cleans any fluid out of the middle ear. The surgeon then places a small, hollow tube into the incision.

Ear tube surgery is a ten-minute outpatient procedure. Your child will have general anesthesia — they sleep through the procedure and feel nothing.

For some children, their doctor may recommend an adenoidectomy at the same time as ear tube surgery. An adenoidectomy is surgery to remove the adenoid, lymphoid tissue located behind the nose. Adenoids help fight off infection by trapping bacteria that enter through the mouth. In some cases, bacteria can get trapped in the adenoids and continue to spread into the ears, leading to chronic ear infections.

Learn more about ear tubes surgery and adenoidectomies.

What can we expect after my child’s ear tube surgery?

Ear tubes generally stay in place for up to 12 months. After that time, the tubes will fall out on their own. The most common complication of the procedure is drainage of watery or bloody fluid from the ear soon after surgery. Drainage usually clears up with antibiotic ear drops. Rarely (in about 1% of children), a small hole may remain on the eardrum after the tube falls out.

Your child will have an appointment with the surgeon three to four weeks after surgery to make sure the tubes are working well. They’ll also have a hearing test. Your child will see their doctor every 6 months or so after surgery and continue to see them until the tubes fall out.

How can I help relieve my child’s ear pain at home?

To manage ear infection pain at home, you may give your child acetaminophen (Tylenol) or ibuprofen (Motrin, Advil). Call your doctor if your child has severe pain or pain that doesn’t go away after a few days.

Why choose Children's Hospital Colorado for ear infection treatment?

Doctors at our Department of Pediatric Otolaryngology (Ear, Nose and Throat) and Audiology Program have specialized training in the best way to care for kids. We are one of the largest fellowship-trained pediatric ENT teams in the Western United States and treat thousands of kids for ear, nose and throat conditions every year, including ear infections.

The high volume of children we see for these conditions has given us a wealth of experience. Seeing children with different types of these conditions and different levels of severity helps us know the best time to recommend traditional treatment and when it’s time to use a more aggressive approach to treatment. Knowing the difference between this can prevent more serious complications later in life, like hearing loss. Our extensive experience combined with a multidisciplinary team and a focus on kids mean your child is getting the highest quality care possible.

• The National Institute of Health provides additional details about ear infections, including prevention tips and current research on ear infections.
• The American Academy of Otolaryngology–Head and Neck Surgery provides more details about otitis media with effusion along with in-depth information on ear tube surgery.