Your child has a cold and fever. He’s extremely irritable, sleeping poorly and tugging at his ear. What’s up?
      “You may be seeing the first signs of an acute ear infection,” says Dr. Orval Brown, an ear, nose and throat specialist on the medical staff at Children’s Medical Center Dallas.
      Inflammation of the middle ear (otitis media) commonly follows a viral upper respiratory infection and causes bacterial infection in the middle ear. “By their third birthday, three out of four children have had otitis media,” Dr. Brown says.
      Left untreated, ear infections can cause severe pain and on rare occasions, hearing loss.
      “Hearing loss is usually temporary, but repeated, serious ear infections sometimes can cause permanent damage,” Dr. Brown says.
      Researchers say infants and small children are prone to otitis media because the tube that connects the upper throat to the inner ear is shorter and straighter in children than in adults. When this passage (called the Eustachian tube) functions poorly due to swelling from a cold or infection, the middle ear can’t be ventilated properly. “Fluid begins to collect in the middle ear,” Dr. Brown says. That causes pain, hearing difficulty and loss of balance.

Common signs of acute ear infections

• Unusual irritability.
• Difficulty sleeping.
• Tugging or pulling at one or both ears when accompanied by fever for more than 24 hours.
• Fluid or pus draining from the ear.
• Unresponsiveness to quiet sounds or other signs of hearing difficulty.

Doctors can diagnose the condition by examining the child’s ears. The doctor will check the outer ear and eardrum for inflammation. Doctors may recommend an antibiotic and a pain reliever, if needed. However, antibiotics only work against infections caused by bacteria, not those caused by a virus. And, it is common for uninfected fluid to remain in the middle ear after treatment and usually resolves spontaneously in one to three months.
      In some cases usually involving repeated infections or long-term fluid buildup doctors may recommend surgery.
      “The surgeon makes a small opening in the ear drum and inserts a tube,” Dr. Brown says. “The tube helps ventilate the ear and lets in fresh air, which stops fluid from building up.”
      After an average of 10 months, the tubes will fall out on their own. As children get older, their Eustachian tube function improves. The ventilation tube helps the ear until the child’s own ear function is adequate.
      You may also be able to head off ear infections through vaccinations. In one large study, the pneumococcal conjugate vaccine recommended for children age 2-23 months cut doctors’ visits for ear infections by 9 percent.

Click here to find out more about ear infections on the Children's web site.