What are the types of ear infection?

There are 2 common types of ear infection:

• middle ear infections, also called otitis media, occur on the inner side of the ear drum
• outer ear infections, which occur in the ear canal outside the eardrum

Read more about the ears here.

Middle ear infection

Middle ear infection is the most common. This infection is caused by bacteria or viruses entering the ear from the throat via the Eustachian tube, which runs from the back of the throat to the middle ear. Because children have short and narrow Eustachian tubes, they are prone to middle ear infections.  As they grow, their Eustachian tubes grow longer, and they become less likely to develop ear infections.

A sinus allergy can also cause swelling and blockage of the Eustachian tube, leading to infection. 

Infections lead to a build-up of fluid inside the ear, causing pressure and pain. This fluid usually drains in a few days without any treatment.

If it doesn’t drain quickly enough, the eardrum may burst and you may find a yellow or bloody discharge. Once this happens, the pain goes away because the pressure has been relieved. A burst eardrum usually heals without treatment, but you should take care to prevent further infection. 

Outer ear infection

Outer ear infection is often caused by excess moisture in the ear canal, sometimes after swimming in dirty water. It is also called otitis externa or ‘swimmer’s ear’.

Damage to the ear canal, such as from cleaning ears with cotton buds, can also trigger infection.

Some kids also get outer ear infections after poking beads, insects or other objects into their ears. 

Glue ear

Glue ear is not an infection but a common condition that can follow middle ear infections. Fluid builds up in the middle ear and doesn’t drain away. It might not cause pain, but it can make it hard for your child to hear. 

Persistent glue ear can affect a child’s language development, so it’s important to treat it.

What are the symptoms of ear infections?

Ear infections can be very painful. While older children can tell you this, younger ones can’t. You might see them pulling at or poking their ear. Children also might develop a fever, vomiting or problems with their balance. 

An outer ear infection can make the ear and the area around it red, swollen and painful to touch. 

How are ear infections diagnosed?

If your doctor suspects your child has an ear infection, they will look into their ear to see the ear canal and eardrum. They can also test the pressure in the middle ear with a quick test that measures the movement of the eardrum. 

How are ear infections treated?

Most ear infections clear up without treatment in a few days. Antibiotics generally don’t help, so the main treatment is pain relief. 

You can:

• give your child pain relief medicine in the doses recommended for their age
• use anaesthetic or antibiotic ear drops for an outer ear infection, if recommended by your doctor

You should not:

• clean the ear with cotton buds or cotton wool
• give ear drops unless recommended by a doctor or pharmacist
• let your child get water in their ears if their eardrum has burst, until it has mended

If your child has recurrent infections or glue ear for more than 3 months, your doctor might refer them to an ear, nose and throat (ENT) specialist for treatment. Options include long courses of antibiotics and grommets to allow drainage. Your doctor will be able to explain more about these.

If there is a foreign body in your child’s ear, it needs to be taken out. This can usually be done in a doctor’s surgery or at a hospital emergency department. Very occasionally, surgery is needed.

Can ear infections be prevented?

Middle ear infections generally occur after a cold, so keeping your child generally healthy will help. Keep your child away from cigarette smoke, which reduces fluid drainage in the ear. 

Wearing ear plugs when swimming can help protect your child from swimmer’s ear.

When should I see the doctor?

You should see a doctor if:

• your child is unwell with an ear infection
• your child is getting a lot of infections
• there is redness and tenderness behind your child’s ear
• you are worried about your child’s hearing
• you are worried about your child’s language development