Otitis Media (Ear Infection)

Otitis media is inflammation of the middle ear. It often occurs at the same time as a viral upper respiratory tract illness (cold, viral sore throat). It’s one of the most common diagnoses for U.S. children. More than 80 percent of children have at least one episode of otitis media by the time they are 3 years old.

While any child may develop an ear infection, the following are some of the factors that may increase your child's likelihood of developing ear infections:

  • Exposure to cigarette smoke on a regular basis
  • Family history of ear infections
  • A poor immune system
  • Daycare (if child is two years old or younger)
  • Absence of breastfeeding
  • Having a cold
  • Bottle feeding while the child lays on their back

What Causes Otitis Media (Ear Infection)?

Young children do not ventilate their ears as well as older children and adults because of the anatomy of the eustachian tube, the structure responsible for ventilating the middle ear space.

The eustachian tube opens when we swallow. We are not usually aware of this unless there is a significant difference between the middle ear pressure and the outside air pressure, which occurs when we are descending to land in an airplane. The sensation of our ears popping occurs when the eustachian tube opens, and the pressure within the ear suddenly changes.

As children grow, the anatomy of the eustachian tube changes and function improves. This is one reason children usually outgrow ear infections.

When a child develops an upper respiratory viral illness, the mucous membranes of the nose and throat become swollen including the tissue lining the eustachian tube. This swelling decreases the ventilation of the middle ear and increases the likelihood of an ear infection starting.

Allergies that cause congestion of the nose and throat can also reduce ventilation of the middle ear through the same mechanism. If your child has symptoms of allergies which cause chronic congestion of the upper respiratory passages, allergy management may be helpful in managing his or her middle ear problems. However, most children who have ear infections do not have allergies as the main underlying cause.

Factors other than eustachian tube dysfunction, such as a less mature immune system, probably contribute to the more frequent occurrence of ear infections in younger children.

How Is Otitis Media (Ear Infection) Treated?

While most ear infections will resolve without treatment or medication, depending on the severity of the child's symptoms and age, a range of treatments may be recommended. The options include:

  • A warm compress to lessen pain
  • Antibiotics
  • Ear drops
  • Pain medication
  • Ear tubes

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