What is a Middle Ear Infection?

Q: My child has an ear ache. How can I tell if it is an infection?

A: An ear ache can be mild but it can also cause a great deal of pain, especially for children.

The middle ear is the small part of the ear, behind the eardrum. Infection happens when germs from the nose and throat become trapped. A small tube, called the Eustachian tube, connects the ear to the throat. A cold can cause this tube to swell, which can trap fluid inside the ear.

Ear infections are common in young children because their tubes are smaller and can get blocked more easily. Babies and young children may be fussy and pull at their ears and cry.

Symptoms of a middle ear infection often start two to seven days after the start of a cold or other upper respiratory infection. Symptoms include fever; ear pain; drainage from the ear that is thick and yellow or bloody; loss of appetite, vomiting and behavior changes; trouble sleeping; and trouble hearing. The symptoms that follow fluid build-up include popping, ringing or a feeling of fullness or pressure in the ear; trouble hearing; and problems with balance or dizziness.

If you see thick, yellow fluid coming from the ears then the infection has caused the eardrum to burst. This is not serious and usually makes the pain go away. The eardrum should heal on its own.

If fluid builds up but does not get infected, children often say that their ears just feel plugged. They may have trouble hearing, but their hearing usually returns to normal after the fluid is gone. It may take weeks for the fluid to drain away.

Most ear infections go away on their own, although antibiotics are recommended for children under the age of 2 and for children at high risk for complications. Often ear infections get better without antibiotics but it depends on how old your child is and how bad the infection is. Talk to your doctor about using this medicine.

At home, use over-the-counter pain medicine like acetaminophen, a warm washcloth or heating pad on the ear, and rest.

Minor surgery to put tubes in the ears may help if your child has hearing problems or repeat infections.

You can help prevent ear infections. Do not smoke because ear infections happen more often to children who are around cigarette smoke. Practice hand-washing and have your child immunized. Try to limit the use of group child care.

By Gil Burgstede, MD, ThedaCare Physicians-Waupaca.