Ear Infection

What is an ear infection?

A middle ear infection, also called otitis media, is inflammation in the middle ear, the space between the ear drum and the inner ear. Middle ear infections are often associated with colds, sore throats or upper respiratory tract infections. When a child has an ear infection, fluid builds up in the middle ear, often putting pressure on the eardrum. 

Middle ear infections are common in children. More than 80 percent of children have at least one ear infection by the time they are 3 years old. In the U.S., ear infections account for about 30 million visits to the pediatrician each year — the most common reason children visit their doctor. 

What are the symptoms of an ear infection?

Common symptoms of an ear infection may include:

  • ear pain
  • fever
  • irritability
  • trouble sleeping
  • tugging or pulling at the ears
  • fluid draining from ear
  • feeling of being off balance
  • trouble hearing
  • nausea and vomiting
  • decreased appetite

Although any child can get an ear infection, children may be at higher risk if they are:

  • around people who smoke cigarettes
  • in daycare or preschool with other children, increasing the risk of getting a cold or upper respiratory tract infection
  • bottle-fed, especially if given bottles while lying in bed

What causes ear infections in children?

Children most often get ear infections after being sick with a cold, sore throat or upper respiratory tract infection. Viruses or bacteria may then settle in the middle ear space, causing fluid buildup behind the eardrum.

One reason children are more likely to get ear infections than adults because they have smaller Eustachian tubes, the canals that link the middle ear with the back of the nose. These Eustachian tubes normally help drain fluid and allow air into the middle ear space, equalizing the pressure inside the ear, but when they become swollen, the excess middle ear fluid cannot drain out.

How we care for ear infections

Our physicians in the Boston Children’s Hospital Department of Otolaryngology and Communication Enhancement have extensive expertise treating ear infections, particularly as a chronic condition. The department is the oldest and one of the largest and most recognized centers for pediatric otolaryngology in the U.S.