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Reducing the Risk for Middle Ear Infections

Most children have had at least one middle ear infection by the age of 2. Treatment may depend on whether the problem is acute or chronic, as well as how often it comes back and how long it lasts.

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Reducing risk factors

Some behaviors or surroundings increase your child’s risk of ear infection. Reducing such risk factors can be helpful at any point in treatment. The tips below may help.

  • If your child goes to group daycare, he or she runs a greater risk of getting colds or flu, which may then lead to an ear infection. Help prevent these illnesses by teaching your child to wash his or her hands often.

  • If your child has nasal allergies, do your best to control dust, mold, mildew, and pet hair in the house. Also stop or greatly limit your child’s contact with secondhand smoke.

  • If food allergies are a problem, identify the food that triggers the reaction and help your child avoid it.

Watching and waiting

  • If your child is diagnosed with an ear infection, the doctor may prescribe antibiotics and will suggest a period of “watchful waiting.” This means not filling any prescriptions right away. Instead of antibiotics, a trial of medications to relieve symptoms including those for pain or fever, is advised, along with waiting some time to see if a child improves without antibiotic therapy. Whether or not your doctor prescribes immediate antibiotics or a period of watchful waiting depends on your child's age and risk factors.

  • During this time, your child should be monitored to see if his or her symptoms are improving and to make sure new symptoms, such as fever or vomiting, don't develop. If a child doesn't improve within a few days or develops new symptoms, antibiotics will usually be started.  

Preventing future problems

Here are things you can do to help avoid more ear problems in the future:

  • Reduce your child’s exposure to cigarette smoke.

  • Bottle-feed only when your child is sitting up, not lying down.

  • Keep the ear canal dry after swimming by placing a few drops of alcohol in the ear. (Don’t do this if your child has ear tubes or a hole in the eardrum.)

  • Don’t put any rigid object (such as a cotton swab) in the ear, even to clean it.

When to call the health care provider

Call your child’s health care provider if you notice any of these signs or symptoms:

  • A rectal temperature of 100.4°F (38.0°C) or higher in an infant under age 3 months

  • Fever of 104°F (40.0°C) or higher in any child

  • A fever that lasts more than 24 hours in a child under age 2

  • A fever that lasts more than 3 days in a child age 2 or older

  • Seizure caused by fever

  • Cold symptoms such as a runny nose

  • Severe ear pain, or an ear that feels hot to the touch

  • Any kind of discharge from the ear

  • Aching or ringing ears, dizziness, or nausea after an injury to the head

  • The possibility of an object in the ear

  • Itching in the ear that won’t go away

  • Ear pain that gets worse or doesn’t go away after a few days



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