Ear infections in children

Young children are prone to all manner of infections and ear infections are no exception. They tend to peak between the ages of six months to two years but may

  • PublishedJanuary 12, 2018

Young children are prone to all manner of infections and ear infections are no exception. They tend to peak between the ages of six months to two years but may well continue up to four years in cases of chronic infections. Ear infections manifest themselves as sharp, burning or dull aches that are persistent or come and go. Children suffering from earaches tend to be irritable, restless and suffer poor or lack of sleep, appetite loss, high temperature, tug the ear incessantly, and have balancing challenges. They may also have a cough and runny nose and drainage of whitish, brownish or yellowish fluid from the ear indicating a rapture of the eardrum.

There are several factors affecting the onset of earaches including:


Children tend to have shorter eustachian tubes (a small passage that connects the middle ear to the back of the throat behind the nose), which make it easier for bacteria to find their way there. Moreover, the adenoid glands located at the back of the upper throat and close to the eustachian tubes, tend to be large in children and can interfere with the opening of the tubes and hence the flow of fluids.

Cold and throat infections

The anatomy of the ear is such that the ear, nose and throat are linked. The middle-ear cavity produces small amounts of fluid that drains out through the eustachian tube. When the tube becomes swollen due to a cold, sinus infection or allergy and stops functioning properly, fluid accumulates causing an ache. Sometimes the viruses or bacteria causing the cold or throat infections travel all the way to the ear. The reverse is also true where in certain cases, an earache acts as an indicator to another problem altogether, such as a sore throat.

Blockages and injuries

In addition to foreign objects stuck in the ear, excessive wax build-up also causes earaches. Vigorous scrapping of the ear can also cause injuries such as a ruptured eardrum.


Babies who are bottle-fed should ALWAYS be seated upright and where necessary, assisted but NEVER fed lying down. This will prevent milk from flowing onto the eustachian tube, signaling a hotbed for infections. The use of pacifiers should also be minimal, as children tend to suck fluids from the throat and nose which then end up in the eustachian tube. Second hand smoke has also been identified as a contributing factor in the development of earaches among children.

Types of ear infections

Outer ear infections

Commonly referred to as otitis externa or swimmer’s ear, these are infections of the tube connecting the outer ear and eardrum. They are caused by too much moisture in the ear, which then leads to the breakdown of the skin in the canal, allowing bacteria to penetrate. It is more common in children who spend a lot of time in water.

Middle ear infections (glue ear)

These are infections of the parts of the ear behind the eardrum and refer to the build up of fluid inside the ear. They are categorised as otitis media with effusion (OTE) or acute otitis media (AOE). OTE tends to be painless and clears on its own after several days. However, in AOE the fluid is accompanied by a bacterial or viral infection while the fluid build-up also puts pressure on the eardrum causing pain and even temporary hearing loss.


According to doctors, most ear infections tend to be painless and go away on their own. However, in the event of an ache:
• Hold a warm or cold compress to the ear to relieve pain.
• Do not let water inside the ear.
• Get over the counter eardrops from your pharmacist depending on your symptoms.
• Use painkillers to relieve pain.

If ignored or poorly treated, middle ear infections can lead to inner ear infections, scarring of the eardrum, hearing loss, infection of the skull, meningitis, speech problems and facial paralysis. Contact a doctor immediately incase of:

• High fever
• Persistent aching over several days
• Ear swelling
• Vomiting.
• Object is stuck in the ear
• Discharge of fluid, pus or blood from the ear.

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