How to Prevent and Treat Ear Infections

February 21, 2023

Allen Samantha

Samantha Allen, MD

pediatrician examining infants ear

Now that school is back in-person and fewer children are wearing masks, more kids are getting sick and these colds are lasting longer. Unfortunately, a lot of coughs and colds can lead to more ear infections, too.

“It’ll be a tough winter for upper respiratory infections and ear infections,” says Samantha Allen, MD, a pediatric otolaryngologist (ear, nose and throat specialist) at Joe DiMaggio Children’s Hospital. “Most kids start with an upper respiratory infection that begins a cascade of events that leads to the development of an ear infection.”

What Causes Ear Infections?

Adults get colds, too, but rarely have ear infections — the reason why lies in your child’s anatomy.

The Eustachian tubes connect your middle ear (behind the eardrum) to your throat. In kids, this tube is much shorter and more horizontal because their heads are smaller. In adults, it is longer and angled, so fluid drains away from the ear.

When your child gets sick with a cold, fluid (mucous) can collect in the middle ear and get stuck there. This fluid is a perfect place for bacteria to grow, leading to an ear infection. Fortunately, by age 9, Eustachian tubes are angled enough and long enough to help ears drain and reduce the risk of ear infections.

How to Prevent Ear Infections in Children?

You can use many of the same strategies to reduce your child’s risk of ear infections as you do to reduce their risk of getting other illnesses, starting with vaccines.

“Streptococcus (or strep) is the most common bacteria found in ear infections,” says Dr. Allen. “The most realistic thing you can do to prevent ear infections is to ensure your child is vaccinated against strep.”

Dr. Allen also recommends your child receive a flu shot each year. Other prevention strategies include:

  • Limit your child’s exposure to secondhand smoke
  • Limit your child’s use of a pacifier
  • Let your child sit more upright when they feed from a bottle
  • Encourage your child to wash their hands frequently
  • Wear a mask or have your child (age 2 or older) wear a mask in public

How to Treat Ear Infections?

Unfortunately, there are no good home remedies to treat ear infections. But your child’s doctor can help you determine the right treatments for your child.

Dr. Allen says doctors use the following evidence-based guidelines to help kids get the right care.

  • Low fever (below 102.2), mild pain, and an infection in one ear for one day: Your doctor will recommend managing your child’s pain with over-the-counter remedies such as ibuprofen (Advil) or acetaminophen (Tylenol).
  • Higher fever (above 102.2), more severe pain, and a longer-lasting infection: Prescription oral antibiotics can help stop the ear infection.
  • Child keeps getting ear infections: Ear tubes can help deliver prescription antibiotic drops directly into your child’s ear.

Your doctor will talk you through these options so that together you can decide how to care for your child.

When Does Your Child Needs Ear Tubes?

In general, your child may need ear tubes if they’ve had three ear infections in 6 months or four ear infections in a year if their last one has been in the last six months. Children at risk of hearing loss or developmental delay may also benefit from ear tubes.

Dr. Allen says ear tubes can dramatically improve the quality of life for many children and their parents. Children with ear tubes get fewer ear infections and have less ear pain when they do have an infection.

“Ear tubes are great options for the right candidates,” says Dr. Allen. “Though any surgery has risks, we know that benefits of ear tubes outweigh the risks for the right kids.”

If you feel nervous about your child receiving ear tubes, Dr. Allen can reassure you that your child is in good hands.

“At Joe DiMaggio, your child is getting care at a pediatric hospital with pediatric anesthesiologists and nurses — they all have special training to care for just kids,” says Dr. Allen. “That’s the best-case scenario for your child to have surgery.”

At Joe DiMaggio Children’s Hospital, our expert ear, nose and throat specialists perform hundreds of ear tube procedures every year. We help your child hear better — and feel better — without constant ear infections. Learn more about our pediatric otolaryngology (ENT) services.