Ear infections are a common illness during childhood. Other ear-related problems encountered during childhood include those that result from objects lodged within the ear canal and trauma to the ear.

Young children are particularly susceptible to ear infections, especially in the first few years of life. Their developing immune systems and the small size of structures within their ears, nose and throat leave them vulnerable to infection.

Ear infections are caused by viruses, bacteria and fungi. Most cases of ear infections among children occur after a cold or the flu, and affect the middle ear (otitis media). Infection can also occur as a result of exposure to excess moisture or injury to the ear canal (swimmer’s ear). Fluid buildup (effusion) is common, and may result in temporary hearing loss. Inner ear infections (labyrinthitis) may affect a child’s balance and result in a spinning sensation. Chronic or untreated ear infections can lead to repeat infections, the spread of infection, as well as structural damage within the ear.

Parents who suspect their child has an ear infection or item lodged in the ear should consult their child’s pediatrician. Symptoms of an earache or pain may differ among children, depending on their age. Infants may cry or refuse feedings as an indication of pain. Young children may tug or pull at an ear. Foreign objects in the ear should not be removed at home since it may cause injury to the ear canal and result in an ear infection.

A visit to a physician will involve a physical examination, including an examination of the ear canal and eardrum. This can usually determine the likelihood of an ear infection. Any ear drainage may be swabbed and analyzed. 

Treatment of an ear infection may depend on its cause. For example, viral infections do not respond to antibiotics and generally resolve on their own without treatment. Bacterial infections, on the other hand, will require treatment with antibiotics. In severe or recurrent cases, a child may have ear drainage tubes placed in one or both ears.

Most ear-related problems encountered during childhood involve infections. Ear infection is the second most commonly diagnosed childhood illness in the United States (after the common cold), according to the American Academy of Family Physicians (AAFP). Other ear-related conditions that affect children include those that result from objects or materials lodged in the ear and trauma to the ear.

Ear infections can occur in the outer, middle and inner ear. The majority of ear infections during childhood occur in the middle ear. Many children experience recurring ear infections.

The outer ear is the visible part of the ear. It includes the entire exterior ear (auricle), which is made up of cartilage and skin, and the earlobe. The outer ear also includes the ear canal (passageway that carries sound from outside the body to the eardrum). The eardrum (tympanic membrane) is a thin membrane located at the innermost end of the ear canal that separates the outer and middle ear.

The middle ear is the small, pea-sized chamber located just behind the eardrum. It is normally filled with air that enters the area via the eustachian tubes (canals that go from the back of the nose and throat to the middle ear). The eustachian tubes (sometimes called auditory tubes) prevent pressure from building up in the ears. They generally remain closed, but open during swallowing or yawning to balance the air pressure in the middle ear with the air pressure outside the ear. The middle ear also contains tiny bones that send vibrations from the eardrum to the inner ear.

The inner ear consists of the cochlea (structure that contains the organ necessary for hearing) and the labyrinth (interconnecting cavities that help maintain balance). Nerve endings in the inner ear convert sound vibrations into signals to the brain that allow hearing to occur.

Infection occurs in the outer ear when the ear canal is exposed to excess moisture that causes an overgrowth of the bacteria and fungi that normally exist within the ear canal. Skin can become soggy, diluting the acidity normally present in the lining of the ear canal that helps to prevent infection. This can lead to inflammation of the ear canal that may extend to the outer ear, causing pain. Fluid may also become trapped in the ear canal due to a buildup of earwax (cerumen).

Although commonly called swimmer’s ear, outer ear infections can also occur when bacteria penetrate and infect the ear through any type of cut in the lining of the ear canal. This may be the result of a scratch or abrasion from objects placed into the ear canal. It can also occur from exposure to irritating chemicals (e.g., hairspray, hair dye) or contaminated water. 

Infection occurs in the middle ear when viruses or bacteria cause the eustachian tubes to swell and become blocked. Without air traveling to or from the middle ear, pressure inside the ear increases. This can be extremely uncomfortable and may feel as if the ear is a blown-up balloon, ready to pop. Middle ear infections also cause fluid accumulation and pus production within the middle ear. This may restrict the ability of sound vibrations to travel from the eardrum to the inner ear, causing temporary hearing loss.

In addition, the eardrum may turn pink or red, and fluid buildup and pus produced in the middle ear may press against the eardrum, causing it to stretch tightly or to bulge and become immobile. However, fluid buildup in the middle ear may also occur without an infection, often as the result of excess fluid produced during a previous episode of a cold or the flu.

Inner ear infections are rare. They occur when viruses or bacteria cause inflammation of the cochlea or labyrinth, resulting in dizziness and hearing loss. Viral causes of inner ear infection include the measles, mumps and flu. Bacterial inner ear infections can occur when a middle ear infection spreads to the inner ear.  

Young children are more susceptible to ear infections than adults because the immune system is not fully developed until about age 7. In addition, children have different size structures within the ear, nose and throat that are more likely to lead to pressure and fluid buildup in the middle ear. For example, their eustachian tubes are small and narrow, and are more easily clogged. These tubes are horizontal in young children, so viruses or bacteria can be easily transferred from the nose to the middle ear. Adenoids at the back of the upper throat (near the eustachian tubes) is large in children, which can interfere with opening of the tubes and contribute to pressure buildup in the middle ear.

Children with ear infections sometimes experience additional medical problems. Some of these conditions may accompany ear infections, whereas others result from infections that are left untreated. These complications include:

• Temporary hearing loss. Fluid trapped in the middle ear or ear canal can impair sound transmission, causing temporary hearing loss. Most children experience some temporary hearing loss during the course of an ear infection. Hearing generally returns after the fluid clears.
  
  
• Speech impairment. Hearing loss as the result of ear infections may impair or delay development of speech in young children.
  
  
• Ruptured (perforated) eardrum. Occurs when the eardrum tears due to the pressure of fluid within the middle ear. After rupture, fluid will drain out of the ear canal, relieving pressure and pain in the middle ear. Surgery may be necessary to repair the tear, although ruptures usually heal on their own. Ruptures are rare, and hearing is not usually impaired.
  
  
• Additional ear infections. Untreated middle ear infections can rupture an eardrum, resulting in the leakage of pus into the ear canal and causing an infection of the outer ear. In addition, untreated outer ear infections can result in recurring infections.
  
  
• Cellulitis. An infection of the skin surrounding the external ear. Outer ear infections that are untreated or do not respond to treatment may recur and lead to cellulitis.
  
  
• Cholesteatoma. Buildup of cellular debris in the middle ear. This is usually the result of chronic ear infections and hearing loss. It may cause damage to structures within the middle ear.
  
  
• Structural damage inside the ear. The small bones of the middle ear and other structures in the ear may become damaged if a middle ear infection is left untreated.
  
  
• Permanent hearing loss. This can occur once there is structural damage to the middle ear. It can also occur with inner ear infections.
  
  
• Acute mastoiditis. Occurs when an ear infection spreads to the mastoid bone of the skull, located behind the ears. This complication is uncommon, and is usually the result of an untreated middle ear infection.

Ear infections can sometimes result from ear piercing. Piercing a child’s ears may lead to infection of the exterior ear (auricle). Bacteria or viruses that cause infection may enter at the site of the piercing via different means. Common reasons for infection include:

• Use of unsterile equipment or jewelry.
  
  
• Piercing an area other than the earlobe. Piercing the cartilage of the ear (rather than the earlobe) can cause infection due to fewer blood vessels in the area, which can trap and foster bacteria growth. Ear cartilage piercings also take longer to heal.
  
  
• Frequent handling of pierced ears with dirty hands.
  
  
• Wearing earrings that are too tight (or posts too short). This prevents air from passing through the hole of the piercing, restricting blood flow and increasing the risk of infection.
  
  
• Scratches on the ear from jewelry.
  
  
• Complication of allergies. Some jewelry worn in the ears may contain nickel. An allergic reaction to nickel can lead to infection in the area. 

The most common ear problems among children involve infections. There are several different types of ear infections. These include:

• Otitis media. Inflammation and fluid buildup in the middle ear. If enough bacteria grow in the area, the fluid may become infected. Otitis media is the most common type of ear infection in young children, occurring most often between the ages of 6 months and 24 months. Three or more episodes of otitis media within a six-month period, or four episodes in one year, is called recurrent otitis media.
  
  
• Swimmer’s ear (also called otitis externa or external otitis). Inflammation that occurs in the ear canal (passageway that carries sound from outside the body to the eardrum). Despite its name, it can occur without swimming. Anything that causes bacteria or fungi to enter a break in the lining of the ear canal can cause swimmer’s ear. Outer ear infections are common in both children and adults.
  
  
• Labyrinthitis. Infection of the inner ear that affects balance and hearing. It is rare and may occur in two different forms:
  
  
• Viral labyrinthitis. Inner ear infection caused by viruses (e.g., viruses that cause the measles, mumps or flu). Viral labyrinthitis usually resolves on its own, without treatment, and leaves no long-term complications.
  
  
• Bacterial labyrinthitis. Inner ear infection caused by bacteria, such as when a middle ear infection (otitis media) spreads to the inner ear, or as the result of the spread of meningitis (inflammation of the protective cover of the brain and spinal cord). Significant permanent hearing loss is a common result of bacterial labyrinthitis, as well as damage to the structures within the inner ear. It is very rare due to the use of antibiotics to treat middle ear infections. However, it may still occur as a complication of bacterial meningitis.

Ear conditions in children may also result from objects becoming lodged in the ear canal. Curious young children may attempt to put small items into their ears (i.e., seeds, beans, nuts, rocks, beads, small wads of paper). These objects are generally too large to go deep into the ear canal. Occasionally, an insect may wander into a child’s ear (although most find their own way out of the ear canal). Parents should consult their child’s pediatrician when any foreign object appears to be stuck in a child’s ear. Attempts to remove the object at home may result in damage to the ear canal, causing an ear infection. If objects do travel deep into the ear canal, they may cause irritation and pain, as well as temporary hearing loss.

The buildup of earwax may trap fluid and bacteria in the ear canal, and lead to an ear infection. Most earwax drains out of the ear canal on its own. Parents who suspect problematic earwax buildup should consult their child’s pediatrician about the best way to remove it.

Middle ear infections (otitis media) are one of the most common problems among infants. In the first year of life, infants are extremely susceptible to infections, including ear infections. Most of these infections occur after a baby has caught a cold or the flu. Parents should keep a close eye on their child after a cold or the flu for signs of a possible ear infection.

Infants will most likely indicate the presence of earache or pain by crying. This cry may sound different than the cries used when a baby is hungry or tired. Infants with an ear infection may also refuse feedings. Sucking motions and swallowing can worsen the pain associated with middle ear infections. In cases where hearing loss may have occurred as a result of an ear infection, an infant may be unresponsive to sounds.

Parents who notice any indication of a possible ear infection in their infant should contact their child’s pediatrician. Physicians may sometimes recommend prescription or over-the-counter ear drops for an infant with an ear infection.

Most children in the United States experience one or more ear infections by the time they enter school. The most common type of ear infection during childhood is otitis media (middle ear infection). Otitis media is a common problem, especially among toddlers.

Otitis media most commonly occurs after a child has had a cold or the flu. Parents should remain alert for signs of a possible ear infection during this time. Young children with limited language skills may be unable to say that they are in pain. Instead, parents may notice their child is pulling, tugging or rubbing the ear. This can be a sign of an ear infection in young children.

Ear infections occur less often as children age, although adolescents may still be at risk of contracting ear infections. They may be more likely to contract swimmer’s ear than a middle ear infection (otitis media). Spending lots of time in the water, as well as the use of irritating chemicals (e.g., hairspray, hair dye) can increase an adolescent’s risk of swimmer’s ear.    

Ear infections are one of the most common illnesses of childhood. They are caused by bacteria, fungi and viruses. In most cases, these germs enter a child’s ear after a cold or the flu – and can cause irritation, inflammation and fluid buildup within the ear. Getting a cold or the flu puts a child at increased risk of an ear infection. Children with a history of allergies or asthma may also face an increased risk of ear infection.

The following may also increase a child’s risk of developing ear infections:

• Lowered immune system response. Anything that affects a child’s immune system, lowering its ability to effectively fight off infection, can increase the risk of ear infections. This includes a child’s age (the immune system is not fully developed until about age 7), or any medical conditions that compromise immune system function.
  
  
• Gender. Boys tend to be slightly more affected by ear infections than girls.
  
  
• History of ear infections. Children who have had previous ear infections may be more likely to experience them again. Children with a family history of ear infection have an increased risk of ear infections.
  
  
• Conditions that affect structure, size or shape of the nose, ear and throat. Children born prematurely or with low birth weight may have smaller-than-average eustachian tubes (air tunnels from the back of the throat to the middle ear), increasing their risk of ear infections. Children with Down syndrome or a cleft palate may also have structural differences within their respiratory system that can make ear infections more likely.
  
  
• Large daycare facilities. Attending daycare facilities with large groups of children can increase the risk of a child contracting a cold or flu virus, which may lead to ear infections.
  
  
• Feeding with formula. Breastfeeding provides antibodies to infants, which can provide a level of protection against ear infections. Using formula to feed an infant may increase the infant’s risk of ear infections.
  
  
• Drinking while lying down. Lying down while drinking promotes infection because liquid may travel up the eustachian tubes, increasing the risk of infection. This may include children who fall asleep with a bottle in their mouths.
  
  
• Exposure to cigarette smoke. Second-hand smoke increases the risk of infections, including ear infections. Children of smokers have more colds and ear infections than children of nonsmokers, according to some studies.
  
  
• Use of pacifiers. Infants (especially those between the ages of 6 months and 12 months) who use pacifiers have a higher risk of developing ear infections. Thumb sucking does not appear to increase the risk of ear infection. Limiting pacifier use in infants over 6 months of age to the times when the child is falling asleep may help reduce the risk.
  
  
• Swimming. Exposing the ear canal (passageway from the outer ear to the eardrum) to excess moisture or contaminated water can increase the risk of infection.
  
  
• Excess earwax. Buildup of wax in the ears may trap fluid in the ear canal and lead to an outer ear infection (swimmer’s ear).
  
  
• Foreign objects in ear canal. Skin lining the ear canal may become stretched or injured when foreign objects (e.g., cotton swabs, bobby pins, beans) enter the ear canal, causing an ear infection.
  
  
• Ear piercing. The use of unsterile equipment or jewelry, frequent handling of the pierced ear with dirty hands and piercing the cartilage of the ear – instead of the earlobe – can increase the risk of infecting the exterior ear (auricle). Infection may also occur when earrings are too tight or when they scratch the ear.
  
  
• Injuries to the external ear. This can provide an opportunity for germs to penetrate the skin of the ear canal, causing an ear infection.
  
  
• Use of irritating chemicals near the ear. Chemicals in hair spray, hair dye and other cosmetic products may irritate the skin of the ear canal, making it more vulnerable to infection.

Signs and symptoms of ear-related conditions in children may differ, depending on the location and cause of the problem. Ear infections are one of the most common childhood illnesses. Although ear infections may occur in the outer, middle or inner ear, most infections that occur during childhood are middle ear infections.  

Often, symptoms of ear infections are preceded by symptoms of a cold or the flu in young children. Parents should be especially alert for signs or symptoms of ear infection after their child has these illnesses.

Common signs and symptoms of ear infections include:

• Ear pain (may be displayed as a tugging at the ear or increased irritability)
  
  
• Discharge from the ear
  
  
• Hearing loss

Signs specific to middle ear (otitis media) infections include:

• Ear pain worsens when sucking, swallowing, chewing, blowing nose or lying down
  
  
• Fever
  
  
• Dizziness
  
  
• Vomiting
  
  
• Decreased appetite (may be displayed as refusal of bottle or breast)
  
  
• Ringing or buzzing in the ears
  
  
• Eardrum is pink or red
  
  
• Eardrum appears as if stretched tightly or bulging

Signs specific to outer ear (swimmer’s ear) infections include:

• Itchiness of the outer ear
  
  
• Pain when the outside of the ear is touched
  
  
• Red, swollen ear canal
  
  
• Red, swollen or flaking skin on the exterior ear (auricle)

Signs specific to inner ear (labyrinthitis) infections include:

• Severe dizziness
  
  
• Spinning sensation
  
  
• Nausea and vomiting

Signs specific to foreign objects lodged in the ear canal include:

• Itchiness around the ear
  
  
• Swelling of the ear
  
  
• Hear buzzing or feel movement inside the ear (if insect in the ear)

Immediate medical attention is required if children develop any of the following:

• Seizures
  
  
• Severe pain that is nonresponsive to pain relievers (e.g., acetaminophen, ibuprofen)
  
  
• Extreme dizziness
  
  
• Unusual fatigue

Parents should contact a pediatrician if they suspect their child has an ear infection or other ear-related problem. Diagnosing the problem may involve a complete medical history, including a description of the type, severity and duration of symptoms, and a physical examination. 

During the physical examination, a physician will likely use an instrument called an otoscope to examine the ear canal and eardrum (located at the innermost end of the ear canal). A physician will look for any signs of swelling, redness or debris in the ear canal.

A bulb may be attached to the otoscope that can push air into the ear canal to test the mobility of the eardrum. A middle ear infection – in which fluid or pressure in the middle ear presses against the eardrum – can restrict movement of the eardrum. A bulging or red eardrum may also indicate the presence of a middle ear infection.

In order to confirm a middle ear infection (otitis media), a sample of fluid from the middle ear must be analyzed. However, this is not often practical since it requires piercing the eardrum with a small needle to get to the fluid on the other side of the eardrum. Young children may not be able to remain still during this test, and this sampling is not often done. Generally, signs of a middle ear infection are enough for a physician to diagnose the illness.

If there is a discharge from an ear, a sample of this fluid may be taken with a cotton swab and analyzed. This can identify the bacteria or fungi responsible for an outer ear infection (swimmer’s ear).  

A physician may also examine the throat and nose for signs of other infections, such as a cold or the flu. If there are any foreign objects lodged in the ear canal, the physician may remove the item during the examination. In rare cases, surgery may be required to remove the object.

Additional devices that may be used during an examination include a tympanogram (analyzes the mobility of eardrum) and an acoustic reflectometry monitor (measures fluid buildup in the middle ear).

Infants and young children with recurrent middle ear infections should periodically have their hearing tested. Hearing loss can occur as a result of chronic ear infections and may delay speech and language development in young children. A hearing test such as an audiogram (uses tones at varying frequencies to identify hearing loss) may be used after a child is treated for an ear infection.

Ear infections are one of the most common illnesses of childhood. Treatment of ear infections will depend upon the severity of symptoms, history of infections and a comparison of the risks and benefits of various treatment options.

The most common ear infection among children is infection of the middle ear (otitis media). This type of ear infection can be caused by viruses (such as those that cause a cold or the flu) or bacteria. Viral ear infections usually resolve without treatment – except for therapies designed to make a child as comfortable as possible, or to reduce symptoms. Bacterial ear infections, however, require antibiotic treatment to stop the infection and prevent its spread.

Because of an increase in its prevalence due to drug-resistant bacteria over the last decade, the American Academy of Pediatrics (AAP) in conjunction with the American Academy of family Physicians (AAFP) issued the first clinical guideline on the appropriate diagnosis and treatment for acute ear infections in 2004. The guideline outlines steps for more accurate diagnosis, including encouraging pain relief efforts, reducing antibiotic-related adverse effects, and targeting antibiotics for children likely to receive the most benefit.  

In order to determine whether the cause of a middle ear infection is viral or bacterial, a fluid sample from the middle ear can be analyzed. This test is often not practical (since it involves piercing the eardrum) and is rarely performed. Thus, for many middle ear infections, a physician may suggest an observation approach – a period of time in which parents carefully watch their child to see if the ear infection appears to be resolving on its own. Many infections may resolve in this manner in just a few days. If a child appears to be getting better, no further treatment may be necessary.

The “watch and wait” approach avoids the unnecessary use of antibiotics. To do so is important because an increase in antibiotic use has led to the development of antibiotic-resistant bacteria, which are difficult to treat. However, antibiotics may be prescribed immediately for patients at risk of complications from ear infections.

Bacterial ear infections (including most cases of swimmer’s ear) are easily treated with antibiotics and usually result in no lasting damage to the child. Antibiotics for ear infections are available in tablet or eardrop form. Follow-up appointments are usually scheduled to ensure the absence of infection following treatment. In addition, a hearing test (e.g., an audiogram) may be required to confirm that a child’s hearing has not been impaired by the infection. 

Steroids may sometimes be prescribed to reduce swelling in the ear. In addition, a physician may place a “wick” in the ear canal that can help carry medicated eardrops into a swollen ear canal. In some cases of ear infection, the ear may need to be drained or cleaned. Any debris in the ear canal may be removed by a physician with a suction device or cotton-tipped probe.

Fluid may remain in the ear even after an infection has cleared. The fluid usually disappears on its own within one to three months. This generally causes no lasting problems, as long as hearing is not impaired and the fluid is not infected. Fluid buildup that occurs without an infection usually clears up on its own within a couple of weeks.

In severe or recurrent cases, a physician may recommend the surgical placement of an ear drainage tube (tympanostomy tube) in one or both ears. A small incision is made in the eardrum while the child is under general anesthesia and the tympanostomy tube is placed inside. The tube helps to drain fluid from the ear and ventilate the middle ear to avoid the buildup of pressure. This procedure takes less than an hour to perform and generally does not require hospitalization. The tube is designed to remain in the child’s ear for up to a year, after which time it often falls out on its own, or may be surgically removed.

Ear tubes may be recommended in the following situations:

• Fluid remains in the ear for more than four months
  
  
• Chronic ear infections occur
  
  
• Hearing loss occurs as the result of ear infections
  
  
• Ear infections do not respond to antibiotics
  
  
• Eardrum rupture or structural damage occurs in the middle ear caused by infection
  
  
• Delayed speech development occurs as the result of chronic ear infections

There are several things parents can do to make their children more comfortable during the course of an ear infection. These include:

• Pain relief medications. Drugs to reduce pain or fever that may accompany ear infections. Since oral antibiotics generally do not provide pain relief for the first 24 hours, these over-the-counter pain relievers may help. Parents should not use any medications without first consulting their child’s pediatrician.
  
  
• Topical anesthetic eardrops. A physician may prescribe these to numb the pain of middle ear infections in children. These eardrops should not be used if a child has ear drainage tubes or a hole in the eardrum.
  
  
• Warm the ear. Warmth may help soothe an infected ear. Parents can hold a hot water bottle filled with warm (not hot) water and wrapped in a dry towel against the infected ear. A child may also lay with the infected ear against the towel.
  
  
• Keep the ear dry. Make every attempt to keep water, shampoo, hair spray or bubble bath from entering the ear canal. For external ear infections, cotton may be placed in a child’s ear and covered with petroleum jelly to make a watertight seal during baths or showers. Swimming or submerging the head in water should be avoided during recovery for several weeks after the infection has cleared.
  
  
• Avoid flying. Postpone or reschedule any airplane flights with a child who has an ear infection since it can worsen symptoms by increasing the pressure in the middle ear.

Some alternative therapies have been used to help alleviate the symptoms of ear infections. These therapies include acupuncture (a technique that uses needles to relieve pain), chiropractic care and herbal medications. Parents should check with their child’s pediatrician before administering any type of treatment to their child.

Anyone with an infection associated with ear piercings should visit their physician for proper treatment. Most mild infections clear within one to two weeks and can be cleaned by swabbing the area with rubbing alcohol. Jewelry should not be worn in the infected ear while it is healing.

Parents who suspect that their child has an object lodged in the ear should contact their child’s pediatrician. Any attempt to dig items out of the ear may result in injury to the ear canal, possibly causing an ear infection. A physician may use a lighted magnifying device that can make removal safe and easy.

The most common ear-related conditions of childhood involve ear infections. Ear infections are not contagious. However, they often occur in children who have recently had a cold or the flu – both of which are contagious viral infections. Taking measures to prevent a cold or flu may also help prevent ear infections. These include avoiding people with colds or the flu, frequent handwashing and avoiding touching one’s own nose, mouth or eyes.  

Parents may also ensure that their child’s immunizations are up-to-date. This can help prevent infection by certain types of bacteria or viruses. One vaccine, called the pneumococcal conjugate vaccine (PCV) is designed to prevent sepsis, meningitis and pneumococcal pneumonia. However, it also prevents some types of bacterial middle ear infections. The PCV is recommended for all children under 2 years of age. The flu vaccine also reduces the risk of ear infections as a result of the flu virus.

In some cases of recurring ear infections, a physician may prescribe long-term preventive antibiotics. This involves taking low-dose antibiotics over an extended period of time, such as a few months. Children should not take antibiotics for more than six months, however.

Additional ways to help prevent ear infections include:

• Do not insert anything into the ear canal. Anything, including fingers and cotton swabs, inserted into the ear may injure the tissue lining the canal and cause an ear infection.
  
  
• Use earplugs. A physician may recommend using earplugs when swimming or bathing to keep the ear canal dry.
  
  
• Dry ears after swimming. Ears may be dried with a towel or hair dryer (on low setting). Use only a soft, damp cloth to clean the ears (no fingers, cotton swabs, etc.)
  
  
• Use eardrops after swimming. In some cases, a physician may recommend certain solutions designed to prevent bacterial growth after exposure to water. This usually involves placing a few drops into the ear canal after swimming. These types of eardrops should not be used if a child has ear tubes or a hole in the eardrum.
  
  
• Breastfeed infants. Babies receive extra immunity against infections through antibodies contained in the mother’s breast milk.
  
  
• Avoid smoke. Exposing a child to second-hand smoke increases the risk of infection.
  
  
• Avoid irritating chemicals near the ears. Chemicals in hair spray, hair dye and other products may irritate the skin lining the ear canal, leaving it vulnerable to an ear infection. Cotton balls should be placed in the ears when using these substances to avoid irritating the ear.

Preparing questions in advance can help patients and parents have more meaningful discussions with their physicians regarding their or their child’s treatment options. The following questions related to ear-related conditions in children may be helpful:

1. How can I tell if my child has an ear infection?
   
   
2. How can I tell if my child’s cold or flu has progressed into an ear infection?
   
   
3. At what point should I bring my child in to see you when I think he/she has an ear infection?
   
   
4. I think my child may have stuck something in his/her ear. Is it safe to try to remove it at home?
   
   
5. What are the benefits and risks of using antibiotics to treat my child’s ear infection?
   
   
6. Should I use over-the-counter pain relievers to relieve the pain of an ear infection in my child?
   
   
7. Are there any other medications (prescription or over-the-counter) you recommend for my child’s ear infection? What are their side effects? What medications should I avoid?
   
   
8. How long will the fluid remain in my child’s ear after a middle ear infection? How can I tell when it’s gone?
   
   
9. What changes in my child’s condition should I report to you?
   
   
10. Is my child a candidate for ear drainage tubes?
    
    
11. After my child’s ear infection has cleared, should his/her hearing be tested?
    
    
12. Is there anything I can do to prevent my child from getting an ear infection?
    
    
13. Should my child wear earplugs while swimming? Will this prevent swimmer’s ear?
    
    
14. Are there any immunizations my child can receive that might help prevent ear infections?
    
    
15. Is it safe to pierce my child’s ears? What can I do to minimize the risk of infection after the ears are pierced?