Middle ear infections

Middle ear infection (called otitis media) is an infection behind the eardrum. Ear infections are very common and are usually painful. By the age of six, most children have grown out of middle ear infections and are not likely to suffer long-term problems.

Symptoms of middle ear infections

Infection can cause:

• Earache – mild to severe pain in the ear or face or pulling at the ear and irritability in an infant
• Fever – a high temperature might be the only symptom in babies or young children
• Mild deafness – caused by fluid which builds up from the infection
• Ear discharge – this happens when the eardrum bursts because of pressure behind it.

Children usually recover from mild infections in three to five hours, although your child may feel tired afterwards.

Diagnosis of middle ear infections

Diagnosis is made by the doctor examining the ear drum with an auriscope.

Infections are caused by a virus or bacteria

Middle ear infections are usually caused by a viral or bacterial infection and often happen during or after a child has a cold.

Treating middle ear infections

Mild cases of infection can be treated quickly with paracetamol (for example, Panadol, Dymadon, Tempra). Do not give regular paracetamol medicine for more than 24 hours without seeking advice from your doctor. It will help if you raise the head of your child's bed.

Some middle ear infections lead to the condition known as glue ear, when thick fluid in the middle ear causes slight deafness. This is not permanent, but it may need treatment. This can include antibiotics and surgery to insert pressure-equalising tubes in the ear drums. Children with glue ear usually recover in a few weeks after the fluid has drained away.

When to see your doctor

See your doctor if your child:

• Is six months of age or younger
• Has a high fever or bad earache
• Has an ear discharge that lasts more than 24 hours
• Continues to have fever or bad earache two days (48 hours) after they start treatment
• Still seems to have trouble hearing after six to eight weeks
• Seems to be getting worse or you are worried at any time.

Treatment with antibiotics

Children six months of age or younger will generally require an antibiotic. In older children, antibiotics may not be needed in all cases.

If antibiotics are prescribed, it is important that your child finishes the medicine according to the instructions (usually for five to seven days). Your child must keep taking the medicine, even if they seem better after a day or two.

Your doctor may occasionally prescribe ear drops. Other medications, such as decongestants do not help middle ear infections.

Where to get help

• Your doctor
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Royal Children's Hospital Tel. (03) 9345 5522
• Your maternal and child health nurse
• Your local hospital emergency or casualty department.
• 24 hour Maternal and Child Health Telephone Service: Tel. 13 22 29 for the cost of a local call throughout Victoria.

Things to remember

• Ear infections are very common and usually painful.
• Ear infections do not usually cause long-term problems.
• If the doctor prescribes medicine, it is important your child finishes the whole course.