Why does my child get so many ear infections?

Written by: Mr Mike O`Connell
Edited by: Lisa Heffernan

Young children are more prone to infections, especially those affecting their ear, nose and throat. Most children have ear infections in their first three or four years of life and in Britain, 80% of children will have at least one ear infection by the time they are five and 90% by the age of six.


Mr Mike O’Connell tells us a little bit about why children are so susceptible to ear infections and what you can do if your child has an ear infection, or if you suspect that they may have one.

Young children are more vulnerable to ear infections for three main reasons:


  1. Their Eustachian tubes are not fully functioning until about 7-10 years of age. The ears are connected by a narrow channel, the Eustachian tube to the back of the nose. Its main function is to balance the pressure in the middle ear to aid hearing. As this does not work so well for the first years, the middle ear where infections occur is more easily blocked and vulnerable.
  2. A child’s immune system is developing and less effective when compared to adults in dealing with an infection.
  3. The adenoids at the back of the nose lie adjacent to these Eustachian tubes. Infection in the nose can reside in the adenoids or cause them to swell, thus blocking the Eustachian tube preventing them from working and clearing the ear.


How do I know if my child has an ear infection?

Children with ear infections usually show the following symptoms:

  • Rapid onset of earache, affecting one or both ears
  • “Cold” symptoms such as a snotty and blocked nose
  • High temperature
  • Uncomfortable due to ear pain, crying/screaming because of discomfort
  • Poor hearing
  • Tugging or pulling at ears
  • Discharge from the ear, often yellow


Your child may not point to their ear, but they may hold it or cry with the pain. They can become rapidly sick and unhappy after just three to four hours of feeling completely well.


Sometimes a child might have reduced hearing or the eardrum might perforate. Perforation will cause yellow discharge to be released from the ear, the child’s temperature will return to normal and the pain will settle. Most perforations will heal over 4 to 6 weeks however, a few will persist.


Sometimes your child may have longer-term hearing difficulties over many months, without the signs of raised temperature or ear pain, and this is called glue ear. Children experience muffled hearing and they start to mispronounce words, often dropping consonants such as “b”, “p” or “t”. If your child has the TV turned up too loud or they don’t respond to you calling their name or they become frustrated, these are signs that they may have trouble hearing and you should bring them to their GP.


How do you treat ear infections in children?

As soon as symptoms present, such as ear pain, high temperature and feeling unwell, it’s best to treat straightaway and start paracetamol and ibuprofen. In children over six years, decongestant syrups or nose drops, which are bought over the counter at a chemist, can also be helpful. This:

  1. Reduces pain
  2. Lowers their temperature
  3. Ibuprofen acts as an anti-inflammatory medication to reduce irritation


Children over six years can also take decongestants, such as xylometazoline or pseudoephedrine, in nose spray or syrup form and these can be bought over the counter at a chemist. If the eardrum has perforated, symptoms may settle on their own. If symptoms worsen or there is no improvement in the first 24 hours, the child will need to visit their GP.


Can ear infections cause long-term damage?

Ear infections are a major problem for young children, but most of these children will go into their teenage years and adult life without any major consequences from the ear infections. After the age of seven, most children start to grow out of ear infections. However, there are some risks, including:

  • The risk of chronic ear infections
  • Perforation of the eardrum may require surgical repair
  • Scarring in the ear can occur after ear infections causing hearing difficulty
  • A condition known as tympanosclerosis causes eardrum stiffness and calcium deposits in the eardrum, but this rarely affects the hearing
  • Mild hearing changes


What are ear tubes exactly?

The ear tubes are better known as the Eustachian tube, which connects the back of the nose to the middle ear. In adults, it's about 2 mm wide. Its purpose is to maintain pressure in the middle ear to permit optimal hearing. Most adults will notice this tube working when they descend in an aircraft or have a cold, as the tube pops and crackles or causes pain or results in temporary deafness. Normally, swallowing or yawning opens the tubes to balance out the pressure but when the tubes don’t function correctly, it causes mild hearing loss and blocked ears. The Eustachian tube in children up to the age of seven do not work as efficiently as their parents, often leading to blocked ears, hearing loss and susceptibility to ear infections.


What can I do for my child’s ear infection at home?

Within the first 24 hours, it’s important to give the child paracetamol and ibuprofen to reduce the pain and lower their temperature. If the child is six years or older, they can be given over-the-counter decongestants, such as xylometazoline or pseudoephedrine. The child should stay out of water, avoid cleaning their ears or using cotton buds and avoid swimming. If after 24 hours, there is no improvement, the child should be taken to their GP.


Do you suspect that your child has an ear infection? Contact Mr Mike O’Connell for a consultation.

Mr Mike O`Connell

By Mr Mike O`Connell
Otolaryngology / ENT

Mr John Michael O'Connell is an expert consultant ENT and nasal plastic surgeon based in Brighton, Sussex and Surrey. With over 17 years of experience, he specialises in a wide range of ear, nose, throat (ENT) and neck operations, including pinnaplasty, balloon sinuplasty, and rhinoplasty, and treats all general ENT conditions in adults and children. In his private practice, he mainly deals with cosmetic nose and ear surgery, sinusitis, nasal problems, ear conditions, tonsil problems and paediatric ENT.

He trained at centres of excellence in London in both ENT and plastic surgery. He won various scholarships to train and work with leading surgeons in Germany, France and America. He completed his masters at the University of Sussex and was awarded the Royal Society of Medicine Otology prize for his thesis. Following this, he published research on rhinoplasty, facial surgery and ear disease.

He is a UK leader in balloon sinuplasty, the latest development in sinus surgery, which has greatly improved the surgical ability to deal with sinusitis. He also introduced coblation adenotonsillotomy to the Royal Alexander Childrens Hospital, Brighton, which notably reduces both the post-operative pain and the risk of bleeding after surgery.

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