When Your Child’s Ear Infection Requires a Visit to the Doctor

As a little girl, I was plagued with frequent ear infections. Unfortunately, my well-meaning mother often managed them at home with hot and cold compresses and various ear drops. Over time, chronic infection led to chronic fluid accumulation behind both my eardrums and I became nearly completely deaf. Thankfully, prompt intervention in the form of tympanostomy tubes placed by an ENT surgeon saved me from permanent hearing loss.

There are two main categories of ear infections: middle ear infections (also called acute otitis media) and outer ear infections (also called otitis externa or swimmer’s ear). Virus or bacteria may cause middle ear infections. Outer ear infections are almost always caused by bacterial. Symptoms and signs of a middle ear infection include ear pain, fluid coming from the ear canal, or hearing loss. Other signs include irritability (may be only sign in babies) and fever. Symptoms and signs of an outer ear infection include severe ear pain, especially with ear manipulation and greenish or white discharge from the ear canal.

If you are suspicious or worried your child might have an ear infection, prompt evaluation by your child’s physician is very important. Not all ear infections are caused by bacteria, but it is impossible to distinguish without looking into the ear with an otoscope. Your doctor will decide whether you can watch and wait (done with viral ear infections) or whether you will need an oral antibiotic or topical antibiotic. If given an antibiotic, it is important your child takes it as prescribed.

Unfortunately, there are some bacteria that are resistant to the common antibiotics we prescribe. It’s important for us to know if treatment isn’t working, as we might need to switch your child’s antibiotics. I tell my patients to give a full 48 hours for symptoms to improve. If after 48 hours the child is still symptomatic, then I need to see them again and assess whether the child needs a different antibiotic.

If your child has frequent ear infections (usually at least 3 in a 6 month period) your physician may recommend that your child be evaluated by ENT for possible ear tube placement. While they don’t eliminate ear infections completely, ear tubes can dramatically decrease the number of ear infections as well as help prevent hearing loss associated with ear infections. Ear tubes are usually inserted in a same-day surgery center. The actual procedure is usually only 5 minutes. Recovery is quick and almost pain free.

Thanks to modern medicine, ear infections can be effectively treated. Long term hearing loss is completely avoidable if children’ receive the appropriate medical care for ear infections.

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Rachel Nelson MD

graduated from Loma Linda University and completed a pediatric residency at UC Davis. She has a passion for helping children reach their full potential. She is married to a colorectal surgeon and together they have two children: Amy and Michael. Dr. Nelson enjoys playing outside with her kids, gardening, and music.

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