How to Treat a Middle Ear Infection

Middle ear infections are fairly common in childhood. One of every 10 children will experience otitis media, the medical term for middle ear infection, every year. This is 10 times the number of adults who will suffer from a middle ear infection.^[1] Otitis media (OM) is the second leading cause of doctor’s visits and and the most frequent reason for antibiotic prescription in children.


1.  Determine if the infection is located in the middle ear. The middle ear is an air filled, mucous-lined cavity between the outside of the body and the inner ear. Draining the middle ear is the Eustachian tube which also normalizes pressure between the outside and the inside of the body. Between the middle ear and the outer ear is the tympanic membrane.

2.  Evaluate for risk factors that increase the potential for a middle ear infection.
 Specific risk factors include being between the age of 18 months and six years, attending daycare, and tobacco smoke in the home. Children who use a pacifier and who are fed directly from a bottle and not breastfed are also at higher risk, because the action can change the flow of fluid in the Eustachian tube.

• People are more susceptible in the fall and winter months, if you have underlying medical conditions such as allergies, and if your family has a history of infections. Many ear infections occur during or right after a viral upper respiratory infection.

3.  Watch out for a change in behavior.Infection in the middle ear will increase the pressure, which causes the pain. This can cause the child to be more irritable and to cry more. When lying down, chewing, or sucking, that pressure increases, which also increases the pain.^[6] Children may tug or pull at their ears in an attempt to relieve the pressure and pain. Tugging on his ears does not always mean that your child has an ear infection.

• The infection can also cause difficulty hearing or trouble responding to sounds. When the middle ear fills with bacteria and fluid in an infection, it reduces the transmission of sound waves and affects hearing.

4.  Look for symptoms
There are numerous symptoms of these infections besides ear pain. You may have a fever over 100 degrees Fahrenheit, a headache, a loss of appetite, clumsiness, and trouble with balance. Infection in the middle ear will cause the body temperature to rise as the immune system fights the infection. Headache and loss of appetite may be commonly associated with fever.^[7] Ear infections can also cause vomiting or diarrhea.

• There may also be fluid drainage from the ear. If the pressure in the middle ear builds up high enough and the Eustachian tube is not open enough to allow drainage, the tympanic membrane may rupture. After it ruptures, thick fluid will drain from the ear and the person will no longer experience pain from the pressure. See your doctor if you think your child may have ruptured their tympanic membrane.