Middle ear infections (otitis media) are a very common reason for parents taking their children to the GP.


Paediatric Ear, Nose and Throat (ENT) Surgeon Dr George Sim from Kids-ENT says it’s quite common for children to have one or two ear infections a year that are not severe.

“Children are more susceptible to ear infections as their Eustachian tubes are smaller and at a very flat angle, making them more prone to getting middle ear infection,” Dr Sim says.

“From six or seven years of age, the Eustachian tube gets a bit bigger so ear infections become less frequent.”

“Also, their immune systems are still developing so it’s much more difficult to fight off infections.”

However, if your child is having frequent recurrent ear infections, it’s best to seek advice and treatment.

Take your child to see a GP if you believe he or she has an ear infection, as they are treatable with antibiotics.

Seek immediate medical treatment if your child experiences sudden hearing loss, severe pain, dizziness, fever, a stiff neck, redness, swelling and pain behind or around the ear, or if they are not moving the muscles on that side of their face.

“If symptoms are ignored, the outcome is that your child might end up with speech or hearing issues.”

These symptoms are sometimes hard to identify, especially when your baby or child is too young to be able to tell you about their pain.

“Look out for signs of pulling or tugging at the ears and sometimes fluid coming from the ear.”

“Irritability, trouble sleeping and a fever can also indicate ear issues.”

Dr Sim says there are three different scenarios which might require intervention.

The first is acute otitis media, which is an acute middle ear infection and symptoms include high temperatures, pain and irritability.

“Give your child Panadol or Nurofen initially and if symptoms persist for more than two days or if your child is running a temperature of 39oC or above, visit your GP for some antibiotics.”

Second scenario is recurrent otitis media. This is when children experience several episodes of ear infections throughout the year – if there are three episodes in six months or four in a year, do seek your GP’s opinion.

“This is when its best to get a referral to see an ENT surgeon but also use antibiotics and pain killers as necessary.”

The third scenario is chronic otitis media with effusion, also known as glue ears which tends to show more subtle symptoms and is characterised by fluid in the middle ear.

“Kids with glue ear have hearing loss, their speech can be affected and they may start falling behind at school.”

“These kids do need to see a GP and if they aren’t improving, need to see an ENT surgeon who will do a hearing test and insert grommets if necessary.”

Grommets are small tubes that bypass the poorly functioning Eustachian tubes to provide an alternative ventilation pathway. It is a simple day procedure in which the surgeon inserts the grommets while your child is under general anaesthetic.

Grommets usually last for a year and are easy to maintain. Your child needs to wear earplugs and a headband to prevent water getting into the ears when swimming.

Can you help prevent ear infections in your children?

“Not really, but you can look at risk factors that your child is exposed to that might predispose them to middle ear infections,” Dr Sim says.

“Passive smoking has been shown to affect middle ear health, so make sure your children are not around people smoking.”

“Children in day care tend to have more middle ear issues as well, as they are exposed to more viruses and bacteria than they otherwise would be.”

“Bottle feeding, using a dummy and gastric reflux can also predispose them to middle ear infections.”

If you feel like your child is taking too long to recover from earaches or that they are recurring too frequently, ask your GP for a referral to see a Paediatric ENT Surgeon for further advice and treatment.


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