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Ear Infections (Acute Otitis Media)

What is it?

An infection of the ear often occurs when the eustachian tube (tube between the ear and the throat) closes from a cold, allergy, or congestion and fluid gets trapped and potentially infected. Children have shorter, more horizontal eustachian tubes and they also catch more colds, which result in a greater chance of ear infections.

Who is affected?

85% of children will have an ear infection by age three with many having three or more infections during their first three years of life1.

What are the symptoms?

Your child may have an ear infection if they have one or more of the following symptoms, usually following a cold or upper respiratory infection:

  • Unusual fussiness

  • Fever

  • Ear tugging

  • Balance problems

  • Difficulty sleeping

  • Signs of hearing difficulty

  • Fluid draining from the ear

  • Ear pain

    • Ear pain may also be a symptom of teething, sore throat, an accumulation of earwax, an object in the ear, air pressure changes, fluid buildup without infection

How can I prevent and treat ear infections?

To prevent ear infections:

  • Breastfeed to give your child immunity
  • Feed infants in an upright position (which prevents fluid from entering the Eustachian tube)
  • Do not allow smoking in your home
  • Avoid exposure to second hand smoke
  • Avoid exposure to other children with colds
  • Do not put your baby to bed with a bottle
  • Do not allow your baby to hold or prop up his or her own bottle
  • Do not insert anything (such as a cotton swab) in the ear, gently cleanse the outside of the child's ear with a warm wash cloth

If your child does get an ear infection:

  • Don't assume you need an antibiotic - studies show that 50-80 percent of ear infections can be resolved without antibiotic treatment1
  • Older children can chew gum to relieve pressure in the ear
  • Increase fluids
  • Apply a warm washcloth to the ear
  • Treat the pain with an OTC analgesic

Important additional information

Contact a health care professional if:

  • Has a headache, fever, and stiff neck
  • Has fluid draining from the ear
  • Appears sick
  • Has a severe earache that lasts longer than one hour


The following are examples of over-the-counter (OTC) medications that can be used to treat the symptoms of ear infections:

Symptom relief Helpful medications Active ingredients* to look for in generic and name brand OTC products
Earache Pain reliever

Example: Children's Advil®
(Drops are indicated for children 6 to 23 months. Pills are indicated for children two years old and older. For treating children under the age of six months consult a health care provider.)

(Indicted for children two years old or older. Children less than 6 years old should receive liquid form. For treating children under the age of two consult a health care provider.)

* Active ingredients: ingredients in a medication that produce a therapeutic response


1 Wyeth Consumer Healthcare, Do you hear what I hear? OTC Self Care Connection

Note: This information is intended to provide readers with health information. The information provided is not a substitute for consultation with a healthcare provider. Brand names included on this Web page are provided for examples only. Their inclusion does not mean that they are endorsed by Blue Cross and Blue Shield of North Carolina.