Ear Infections in Children: Signs, Causes, and How to Protect Your Child

It is essential for mothers to carefully observe their infants, because babies cannot express pain or discomfort with words. Instead, they show it through certain behaviors. For example, if a baby is constantly pulling or rubbing at their ear—especially while crying—this may be more than just a random movement. It can be an early sign of an ear infection, particularly if the child is bottle-fed.

Dr. Mahmoud Alayan, consultant in ENT (ear, nose, and throat), explains the signs of ear infections in children, their causes, and how to prevent and treat them.

What Is the Middle Ear and Why Is It Important?

The middle ear is a cavity located behind the eardrum. It connects to the throat through the Eustachian tube, which equalizes air pressure on both sides of the eardrum. Inside the middle ear are three tiny bones—the hammer, anvil, and stirrup—that transmit sound to the inner ear.

When the middle ear becomes inflamed, children often suffer from pain, dizziness, and hearing problems, which makes it one of the most common childhood illnesses.

Signs of Ear Infection in Children

• Fever: A sudden rise in body temperature is common.

• Crying and irritability: Babies often seem unusually fussy and restless.

• Pulling at the ear: A clear sign, especially when repeated frequently.

• Hearing difficulties: Older children may ask for the TV volume to be louder or not respond when called.

• Sleep problems: Poor rest, constant tiredness, or lethargy.

• Ear discharge: In advanced cases, pus or fluid may drain from the ear.

Causes of Ear Infections

1. Skin irritation: Sunburn, allergies, or insect stings can cause outer ear infections.

2. Injuries: A hit or scratch to the ear can trigger infection.

3. Improper cleaning: Using unsafe methods can damage the ear canal and cause infection.

4. Cold, flu, or sore throat: Bacteria can travel from the nose or throat to the middle ear.

5. Feeding mistakes: Bottle-feeding a baby while lying flat may allow milk to enter the middle ear, creating bacterial growth.

6. Pacifier overuse: Frequent use has been linked to repeated ear infections in infants.

7. Tonsillitis: Chronic tonsil infections can contribute to repeated middle ear infections.

Treatment of Ear Infections

• Medical diagnosis is essential: A doctor examines the ear with a scope and prescribes treatment.

• Antibiotics: Given only when necessary, under medical supervision.

• Pain relief & fever reduction: Doctors often prescribe painkillers and fever reducers to protect the child from complications of high temperature.

• Ear care: Always dry your child’s ears after bathing. Keep them away from secondhand smoke, as it significantly increases the risk of recurrent infections.

• Feeding posture: When breastfeeding or bottle-feeding, avoid laying the baby completely flat. Hold them at a slight angle.

• Home comfort: For outer ear pain, doctors may recommend safe topical antibiotics. In some cases, a warm cotton ball moistened with a drop of olive oil can soothe discomfort (placed at the outer ear only, never inside).

Key Takeaway for Parents

• Ear infections in children are very common, but with early detection and proper care, they can be treated effectively.

• Pay attention to your child’s behavioral signs—especially fever, crying, or pulling at the ear.

• Preventive steps like proper feeding position, good hygiene, and avoiding smoke exposure can reduce the risk of infection.

• Always consult an ENT specialist for accurate diagnosis and treatment.