Ear Infection Questions

Disponible En Espanol

Care at Home

  • WHAT YOU SHOULD KNOW: * Most ear infections are not cured after the first dose of antibiotic. * Often, children don't get better the first day. * Most children get better slowly over 2 to 3 days. * Note: For mild ear infections in older children, antibiotics may not be needed. This is an option if over 2 years old and infection looks viral. * Here is some care advice that should help.
  • KEEP GIVING THE ANTIBIOTIC: * The antibiotic will kill the bacteria that are causing the ear infection. * Try not to forget any of the doses. * Give the antibiotic until the bottle is empty (or all pills are gone). Reason: To stop the ear infection from flaring up again.
  • PAIN MEDICINE: * To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
  • COLD PACK: * Put a cold wet washcloth on the outer ear for 20 minutes. This should help the pain until the pain medicine starts to work. * Note: Some children prefer heat for 20 minutes. * Caution: A hot or cold pack kept on too long could cause a burn or frostbite.
  • CALL YOUR DOCTOR IF: * Fever lasts more than 2 days on antibiotics * Ear pain becomes severe or crying becomes nonstop * Ear pain lasts more than 3 days on antibiotics * Ear discharge is not better after 3 days on antibiotics * Your child becomes worse
  • EAR DISCHARGE: * If pus is draining from the ear, the eardrum probably has a small tear. This can be normal with an ear infection. Discharge can also occur if your child has ear tubes. * The pus may be blood-tinged. * Most often, this heals well after the ear infection is treated. * Wipe the discharge away as you see it. * Do not plug the ear canal with cotton. (Reason: Retained pus can cause an infection of the lining of the ear canal)
  • BRIEF HEARING LOSS: * During an ear infection, fluid builds up in the middle ear space. * The fluid can cause a mild hearing loss for a short time. * It will slowly get better and go away with the antibiotic. * The fluid is no longer infected, but sometimes, may take weeks to go away. In 90% of children, it clears up by itself over 1 to 2 months. * Permanent harm to the hearing is very rare.
  • EARDROPS: * If pain medicine does not help the pain, try eardrops. You can use plain olive oil or mineral oil (baby oil). * Use 3 drops every 4 hours. * There are also prescription eardrops for pain that you can use. (Same dose). Ask your child's doctor about these during office hours. * Caution: Don't use eardrops if has ear tubes or a hole in the eardrum.
  • LIMITS: * Your child can go outside and does not need to cover the ears. * Swimming is fine as long as there is no drainage from the ear. Also, do not swim if there is a tear in the eardrum. * Air Travel. Children with ear infections can travel safely by aircraft if they are taking antibiotics. For most, flying will not make their ear pain worse. * Give your child a dose of ibuprofen 1 hour before take-off. This will help with any pain they might have. Also, during descent (coming down for landing) have your child swallow fluids. Sucking on a pacifier or chewing gum may help as well.
  • RETURN TO SCHOOL: * Your child can go back to school when any fever is gone. * Your child should feel well enough to join in normal activities. * Ear infections cannot be spread to others.
  • WHAT TO EXPECT: * Once on antibiotics, your child will get better in 2 or 3 days. * Make sure you give your child the antibiotic as directed. * The fever should be gone by 2 days (48 hours). * The ear pain should be better by 2 days. It should be gone by 3 days (72 hours).
  • TALKING WITH YOUR CHILD: * Get close to your child and get eye contact. * Speak in a louder voice than you usually use. * Decrease any background noise from radio or TV while talking with your child.
  • CALL YOUR DOCTOR IF: * Hearing loss not better after the antibiotic is done.
  • WHAT YOU SHOULD KNOW: * Some children have ear infections that keep coming back. * If this is your child's case, here are some ways to prevent future ones.
  • AVOID TOBACCO SMOKE: * Contact with tobacco smoke can lead to ear infections. * It also makes them harder to treat. * No one should smoke around your child. This includes in your home, your car or at child care.
  • STOP COLDS: * Most ear infections start with a cold. During the first year of life, try to reduce contact with other sick children. * Try to put off using a large child care center during the first year. Instead, try using a sitter in your home. Another option might be a small home-based child care.
  • BREASTFEED: * Breastfeed your baby during the first 6 to 12 months of life. * Antibodies in breast milk lower the rate of ear infections. * If you breastfeed, continue it. * If you do not, think about it with your next child.
  • DO NOT PROP THE BOTTLE: * During feedings, hold your baby with the head higher than the stomach. * Feeding while lying down flat can lead to ear infections. It causes formula to flow back into the middle ear. * Having babies hold their own bottle also causes milk to drain into the middle ear.
  • GET ALL SUGGESTED VACCINES: * The pneumococcal shot and the flu shot will protect your child from serious illnesses. * The shots also help to prevent some ear infections.
  • CHECK ANY SNORING: * Large adenoids can cause snoring or mouth breathing. Suspect this if your toddler snores every night or breathes through his mouth. * Large adenoids can contribute to ear infections. * Talk to your child's doctor about this.
  • CONTROL ALLERGIES: * Allergies may lead to some ear infections. * If your baby has a constant runny nose and ear infections, suspect an allergy. * If your child has other allergies like eczema, ask your child's doctor about this. The doctor can check for a milk protein or soy protein allergy.
  • VENTILATION (PE OR EAR) TUBES: * Ear tubes are tiny plastic tubes that are put through the eardrum. They are placed by an ENT doctor. * The tubes allow fluid to drain out of the middle ear space. They also allow air to re-enter. * This lowers the risk of repeated ear infections and returns the hearing to normal.
  • EAR TUBES - WHEN ARE THEY NEEDED? * Fluid has been present in the middle ear nonstop for over 4 months. Both ears have fluid. * Also, the fluid has caused a hearing loss greater than 20 decibels. * Hearing should be tested first. Some children have nearly normal hearing and tubes are not needed. * Ear infections that do not clear up after trying many antibiotics may need tubes. * Prevention should be tried before turning to surgery. * Talk to your child's doctor about when ear tubes are needed.
  • WHAT TO EXPECT: * In most cases, the tubes come out after about a year. They fall out of the ear on their own. This happens with the normal movement of earwax. * If the tubes stay in the eardrum for over 2 years, ask your child's doctor. The surgeon may need to take them out.
  • RISKS OF EAR TUBES: * After the tubes come out, they may leave scars on the eardrum. They may also leave a small hole that doesn't heal. Both of these problems can cause a small hearing loss. * Because of these possible problems, there is a small risk with ear tubes. There is also a small risk when having to give anesthesia to young children. Therefore, doctors suggest ear tubes only for children who really need them.
  • FEVER: * For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. See Dose Table. Note: Lower fevers are important for fighting infections. * For ALL fevers: Keep your child well hydrated. Give lots of cold fluids. * For babies, dress lightly. Don't wrap in too many blankets. Reason: Can make the fever higher.


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