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Otitis Media and Otitis Media with Effusion

(757) 668-7000


What is otitis media?

Otitis media is a common childhood condition that can affect one or both ears. It often happens when a child has a cold. Fluid builds up in the middle ear when the eustachian tube gets blocked with mucus. Germs can grow in the trapped fluid and cause an infection. This can cause pain, temporary hearing loss, fever and make the eardrum red. Fluid alone may clear with the use of antibiotics (if infected); allergy medications or with time (can take up to 3 months to clear on its own).

What causes middle ear infections and middle ear fluid?

  • Children under 3 years old have shorter, narrower and straighter eustachian tubes than adults. It is easier for bacteria and viruses to get into the middle ear of young children. By age 4 the tube usually grows longer and drains fluid better.
  • Colds caused by bacteria or viruses
  • Children in daycare tend to get ear infections more often. Ear infections are not spread from person to person, but colds are.
  • Middle ear fluid may persist even after the successful treatment of a middle ear infection. This fluid can take up to 3 months to completely clear even with the use of antibiotics.
  • Large or infected adenoids can block the eustachian tube in the back of the nose so it does not drain well.
  • Allergies with cold-like symptoms may lead to middle ear fluid.
  • Second-hand cigarette smoke may irritate the eustachian tube, causing swelling and blockage.
  • Bottle feeding or using “sippy” cups while the baby is lying down –milk can enter the eustachian tube from the throat which provides a breeding ground for germs.
  • Some children are more prone to ear infections than others because of their genetics. Middle ear problems tend to run in families.

What can I do to prevent ear infections?

  • Breast-feed your baby as long as you can. This helps prevent infections.
  • Limit use of a pacifier after 2 years of age.
  • NEVER give your baby a bottle to drink while lying down. Hold the baby at an angle to drink.
  • DO NOT SMOKE in the house or around your child.
  • Keep your child’s vaccinations up to date.
  • If your child must be in daycare, find the smallest group of children.
  • Wash your hands and your child’s hands often. Germs from hands can cause colds.

Symptoms of ear infections:

  • Pain (earache)

If you child cannot tell you he/she is in pain look for these symptoms:

  • Drainage from the ear
  • Pulling or rubbing the ears
  • Loss of appetite
  • Does not react to soft sounds
  • Can’t sleep, wakes up at night
  • Fever
  • Cranky, cries more than usual
  • Does not want to play
  • Clumsy, falls down, acts dizzy

Symptoms of middle ear fluid:

  • Difficulty hearing
  • Delay in speech and language development
  • Mild earache, fullness
  • Popping sensation in ears


  • The doctor will check your child’s ear to see if the ear is infected or if fluid is present behind the ear drum.
  • If antibiotics are prescribed, be sure to give your child the medicine the total number of days ordered. Your doctor may not prescribe antibiotics if the symptoms are not severe or if there is no sign of infection.
  • Non-aspirin pain medicine, such as acetaminophen or ibuprofen may be given for fever or pain. Read the label or check with your doctor for the correct amount.
  • If your child frequently has fluid behind the ear drum but does not have an ear infection, nasal steroid or oral steroid medications may help.
  • You will need to bring your child back to the doctor to have his/her ears checked again. Your next appointment is _____________________________________.
  • If the infection is not better at the next appointment the doctor may prescribe more antibiotics.
  • If your child continues to get ear infections or build up of fluid in the ears and is having problems with speech or hearing, ear tubes may be recommended.

When should I call the doctor?

  • Fever and pain is not gone after 48 hours of antibiotics
  • You feel your child is getting worse
  • Your child has a stiff neck
  • Your child’s ear looks swollen and bulges out from the side of his/her head
  • You see blood or mucus coming out of the ear
  • One side of your child’s face appears weak

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 10/2018

(757) 668-7000