If you have a little one, then you have undoubtedly experienced at least one bout of a gnarly ear infection. Today, Parents Ask expert Dr. Adam Friedman, a board-certified Otolaryngologist (also known as an E.N.T.) answers this commonly asked question:

Why does my child get so many ear infections and what should I do about it?

A: Children commonly get two types of ear infections.  “Otitis Externa”, commonly referred to as swimmer’s ear, is an infection of the skin of the ear canal.  This occurs when excess moisture disrupts the normal environment in the outer ear.  Symptoms include pain, redness, foul-smelling drainage, and diminished hearing due to a build up of debris in the ear canal.  Treatment of these infections involves having the ear cleaned out by an ear doctor who has the appropriate equipment to do so properly, keeping the ear dry at all times by using ear plugs or putting a cotton ball covered with Vaseline in the ear when bathing, and using antibiotic drops that your physician will give you.  Oral antibiotics are almost never necessary.

The other ear infection that children commonly suffer from is “otitis media”.  This is an infection behind the ear drum where fluid or pus can accumulate in the middle ear causing fever, pain, and hearing loss.  Rarely, the build up of pressure in the middle ear can cause a rupture of the ear drum resulting in drainage.  Fortunately, these holes typically heal on their own. Children get frequent ear infections because the muscles of the face and the tube that drains the middle ear (the “eustachain tube”) are not fully developed until about 8 years of age. 

Typically, otitis media is treated with a course of oral antibiotics.  Additionally, some physicians may also choose to use a decongestant, steroid, or allergy medication.  The antibiotics generally help relieve the pain and lessen the fever within 48 hours.  Although the infection may resolve, the fluid that has accumulated behind the ear drum may remain for as long as 12 weeks.  This can cause a temporary hearing loss which almost always improves when the fluid is absorbed.

Children who have frequent infections (4 infections in 6 months or 6 infections in 1 year) or in whom the fluid does not disappear, are often candidates for the placement of “ear tubes” (also called “PE tubes”).  The tubes are essentially a small, man-made drainage hole in the eardrum that allows fluid to drain out and antibiotic drops to get in.  As a result of this, the hearing is generally improved because there is no remaining fluid and future infections can be treated with drops, rather than oral antibiotics.  Having tubes placed is a minor procedure that can save both parents and children a great deal of suffering and discomfort associated with ear infections.  Traditionally, a hearing test is done both before and after tube placement to document the hearing status. 



Dr. Adam I. Friedman is board-certified in Otolaryngology – Head and Neck Surgery and currently practices in Valencia, California at Santa Clarita Ear, Nose, Throat, and Facial Plastic Surgery Associates.  He completed his medical school and residency at the University of Southern California, where he also had additional training at Children’s Hospital of Los Angeles and the House Ear Institute.  He is currently a member of the Los Angeles Society of Otolaryngology and the American Academy of Otolaryngology – Head and Neck Surgery.  Additionally, he has been invited to join the Department of Otolaryngology – Head and Neck Surgery at the University of Southern California.