Ear infections in toddlers and preschoolers

How can I tell if my child has an ear infection?

If your child has a cough or a runny nose, and develops a fever between three days and five days later, she may have an ear infection. Signs of an ear infection are:

• tugging at her ear and complaining of ear pain
• balance problems
• irritability and restlessness at night
• a cough
• diarrhoea
• lack of response to quiet sounds (NHS 2012)

Ear infections are very common in young children, especially during winter.

What has caused my child's ear infection?

Your child probably has a cold that has caused her middle ear to become inflamed (NHS 2012). The inflammation will have trapped fluid inside her ear, creating a warm, wet environment where bacteria and viruses can spread.

When the infection sets in, pus develops, and pressure on your child's eardrum causes inflammation and the drum will bulge. This can cause pain that is very distressing to your child. Your child may also develop a fever, as her body attempts to fight the infection. This type of ear infection is called otitis media.

Another reason your child may get ear infections is because the tube in her middle ear is short and horizontal, as it is still developing. As she grows up, the tube will triple in length, from 1.25cm (0.5in) to 3.8cm (1.5in), and will become more vertical, reducing the chance of infection.

How can my child's ear infection be treated?

Take your child to the doctor if your think your child has an ear infection. Many ear infections get better without treatment, but your doctor may prescribe antibiotics, if they are needed. Symptoms should start to improve within three days or four days, with or without antibiotics.

You can give your child infant paracetamol or ibuprofen to reduce the pain and fever. Check the dosage information on the packet, or ask your pharmacist or doctor about how much to give your child.

Why is pus oozing from my child's ear?

Pus or bloody-yellowish fluid coming out of your child's ear means she has developed a small hole in her eardrum. The hole will actually relieve the pressure in the middle ear and the pain will improve. Though this should heal by itself within about two weeks, you should take your child to a doctor, so she can be checked (CKS 2009).

My child's ear infection still hasn't improved. What should I do?

If your child's ear infection hasn't improved after four days, with or without treatment with antibiotics, ask your doctor to examine her ear. Your child could have a more serious ear infection that can spread into the bone around the ear (mastoiditis) and require more intensive treatment.

If your child gets regular ear infections, this can also lead to persistent fluid in the middle ear and results in hearing loss and scarring of the ear drum. It is important to treat the ear infection properly, to prevent the development of these complications.