Follow these tips to help treat and prevent ear infections.

Your infant has a cold for a week and suddenly wakes up screaming one night. You take them to see the doctor the next morning, and sure enough, they have an ear infection.

Nearly every day, especially during the winter season, I see two or three patients for possible ear infection. The medical term for ear infection is otitis media, or inflammation of the middle ear. Repeated ear infections can scar the eardrum, preventing it from vibrating properly and interfering with hearing. In the early years, when your child is developing speech and language abilities, be vigilant about recognizing your child’s ear infections early and treating them properly.

Ear infection signs

Older children complain of pain and notice they can’t hear well out of the infected ear because the fluid in the middle ear dampens the vibration of the eardrum and diminishes hearing.
Yet, for infants and younger children, diagnosing an ear infection may not be so easy.

When to see your doctor:

  • Cold symptoms, such as a runny nose, last for a few days
  • Fever may or may not be present
  • Your child seems sicker than you would expect with just a common cold
  • Increasing crankiness and irritability following a cold
  • Child wakes at night in pain
  • Eye discharge accompanying a snotty nose
  • Child doesn’t like to lie flat (the infected fluid presses on the eardrum)

Tip: Increasingly snotty discharge (eyes and nose), plus increasingly irritable behavior — suspect an ear infection

What your doctor may do

New insights into the treatment of middle ear infections reveal that many mild ear infections will often resolve without antibiotics. For mild ear infections, the American Academy of Pediatrics recommends the “wait-and-watch” approach. Based on the most recent studies, here is the approach that we use in our pediatric practice:

“Watch” does not mean do nothing. Rather, it’s a time to carefully observe your child for signs that their symptoms may be worsening. “Wait” simply means the doctor might not immediately prescribe antibiotics, and you can focus on natural treatments instead. If the infection does worsen, your doctor will prescribe an antibiotic according to the severity of your child’s ear infection. Be sure to complete the whole course of the doctor-prescribed treatment regimen, even if your child feels better after 24 hours. Stopping the antibiotic too soon risks a recurrence. Be sure to have your health care provider recheck your child’s ears, usually a week or so after the treatment is finished.

Keep a journal. Treating ear infections is a partnership between parents and pediatrician. I advise parents to be an astute observer and an accurate reporter. Track your child’s ear infections: how often they occur, how severe they are and what treatment works best. This information is vitally important for the doctor to know if and when a child needs antibiotic treatment, which antibiotic to prescribe and how long it needs to be used.



Infants and preschool children are more prone to ear infections for two reasons. One, their immune systems are still developing, and, two, the short, wide, horizontal Eustachian tube allows infected secretions to easily flow from the nose and throat into the middle ear. As your child grows, the immune system strengthens and the Eustachian tube becomes longer, narrower and more angled so that secretions do not accumulate within the middle ear as easily.

Good news for parents — a study released in March of 2016 by the University of Texas revealed the rates of ear infections in young children have dropped. Why? Researchers who studied this terrific trend found that the main preventive-medicine interventions are:

More mothers are breastfeeding exclusively for the first six months, and breastfeeding longer. This improves the maturity of the child’s immune system.

These seem to be effective against the germs causing ear infections.

Not smoking
Keep an allergy-free environment. Allergens such as house dust, mold, cigarette smoke and animal dander cause fluid to build up in the nasal passages and the middle ear. This fluid serves as a culture-medium for bacteria. Fuzz-proof your baby’s sleeping environment by keeping stuffed animals, real animals and other furry things at a distance while baby sleeps.

As with most childhood nuisances, ear infections will soon be a worry of the past.

Bill Sears, M.D., is a father of eight and the author of 42 books on family health, including The Healthiest Kid in the Neighborhood. A practicing pediatrician for over 40 years, he is an Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. Dr. Sears is a fellow of the American Academy of Pediatrics (AAP) and a fellow of the Royal College of Pediatricians (RCP).