Otitis media patient overview

Overview

Otitis media is a middle ear infection. It happens when the space behind the eardrum gets infected and inflamed. This often causes ear pain and temporary hearing loss.

Yes, otitis media is one of the most common reasons children see a doctor. Most children will have at least one ear infection by age 3.

It most often affects children between 6 months and 3 years old, but can happen at any age. It is more common in children who go to daycare, are bottle-fed, or are around cigarette smoke.

Symptoms

Common symptoms

• Ear pain, especially when lying down
• Trouble hearing or muffled hearing
• Fever
• Feeling of fullness or pressure in the ear
• Irritability or fussiness

Symptoms in children

• Tugging or pulling at the ear
• Crying more than usual
• Trouble sleeping
• Loss of appetite or vomiting
• Fussiness after a cold

Symptoms in older adults

• Ear pain or discomfort
• Hearing loss
• Balance problems or dizziness
• Sometimes no pain, just a feeling of fullness

Causes

Main causes

• A bacterial or viral infection that starts after a cold, flu, or sinus infection
• Fluid buildup behind the eardrum that becomes infected

Risk factors

• Being a young child, especially under age 3
• Attending daycare or being around many children
• Bottle feeding instead of breastfeeding
• Exposure to cigarette smoke or air pollution
• Having allergies or a weakened immune system
• Using a pacifier frequently

When to see a doctor

See a doctor urgently if:

• If you or your child has severe ear pain, high fever, or fluid draining from the ear
• If symptoms do not improve after 3 days or are getting worse
• If you notice hearing loss or balance problems

Book a routine appointment if:

• For mild ear pain with no high fever, you can often wait 48–72 hours to see if it gets better on its own
• If you are worried or the symptoms persist, call your doctor for advice

Diagnosis

A healthcare provider will ask about symptoms and look inside the ear with a tool called an otoscope (a light with a magnifying lens). They check for redness, fluid, or a bulging eardrum.

Tests that may be done

• Otoscopy: Looking inside the ear with an otoscope
• Tympanometry: A test that uses sound and air pressure to check how well the eardrum moves
• Hearing test (audiometry): May be done if there are concerns about hearing loss, especially in children with frequent infections

What to expect at your appointment

The exam is quick and usually painless. The doctor may gently pull on the ear to see inside. Your child may need to sit still for a moment. Sometimes a small puff of air is blown into the ear to check eardrum movement.

Treatment

Most ear infections get better on their own without antibiotics. Treatment focuses on relieving pain and monitoring symptoms. If the infection is severe or does not improve, a doctor may prescribe antibiotics.

Self-care at home

• Take over-the-counter pain relievers like paracetamol or ibuprofen (follow the label for age and dose)
• Apply a warm cloth or a warm (not hot) water bottle wrapped in a towel to the ear
• Rest and drink plenty of fluids
• Keep the head elevated while sleeping to help drainage

Medical treatments

If the infection is severe or lasts longer than a few days, a doctor may recommend antibiotics. These can be given by mouth (liquid or tablets) or as ear drops for pain. Your doctor will decide based on your age, symptoms, and past health. Always complete the full course if antibiotics are prescribed.

When is surgery considered?

Sometimes, for children who have many ear infections or fluid buildup that won't clear, a doctor may suggest a small operation. This involves putting tiny tubes (called grommets) into the eardrum to let fluid drain and help hearing. It’s a common, short procedure.

Living with this condition

If you or your child has an ear infection, rest and pain relief can help. Keep the ear dry when bathing or swimming if there is drainage. Follow up with your doctor if symptoms don't get better or if you notice hearing problems.

Lifestyle tips

• Avoid smoking or being around smoke – it can make ear infections worse
• If you bottle-feed, try to keep the baby upright during feeding to help the ear drain
• Limit pacifier use after 6 months to reduce the risk of infections

Diet and exercise

There are no special dietary restrictions, but drinking plenty of fluids is helpful. For children, continue breastfeeding if possible, as it can lower the risk of ear infections. Gentle activity is fine once fever and pain are gone.

Mental health and emotional wellbeing

Ear infections can be frustrating for both children and parents. Pain and hearing loss may make children irritable or affect sleep. Babies may cry more. It's normal to feel worried, but most infections pass without lasting problems. Talk to your doctor if stress or worry is affecting your daily life.

Prevention

You cannot always prevent ear infections, but you can lower the risk. Breastfeeding for at least the first 6 months, avoiding smoke, and keeping up with vaccines can help. Also, try to avoid close contact with sick people and wash hands often.

Vaccines

The pneumococcal vaccine (PCV) and the flu vaccine may help prevent some ear infections. Your doctor can tell you which vaccines are recommended for you or your child.

Screening programmes

There is no routine screening for ear infections. Regular check-ups with your doctor can help catch problems early.

Complications

If left untreated

• Temporary or permanent hearing loss
• A hole in the eardrum (perforation) that may not heal on its own
• Spread of infection to the mastoid bone behind the ear (mastoiditis)
• In rare cases, infection can spread to the brain or the membranes around it (meningitis)

Long-term outlook

Most ear infections get better quickly and cause no lasting problems. Even if complications happen, treatment is usually effective. Hearing loss often improves once the fluid clears. With proper care and follow-up, the outlook is excellent.

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