ear infection child with fever

Overview

An ear infection is a swelling of the middle ear – the space behind the eardrum. In children, it often happens after a cold and can cause ear pain and fever.

Yes. It is one of the most common reasons children under 5 visit a doctor.

It is most common in children aged 6 months to 6 years, especially those who go to daycare or have frequent colds.

Symptoms

Common symptoms

• Ear pain (tugging or rubbing the ear)
• Fever (usually around 38°C or higher)
• Muffled hearing
• Feeling irritable or tired
• Poor appetite or trouble sleeping

Symptoms in children

• Pulling or tugging at an ear
• Crying more than usual, especially when lying down
• Being unusually fussy or clingy
• Trouble sleeping or waking at night
• Loss of appetite or being less interested in feeding

Symptoms in older adults

• Ear infections are less common in older adults, but if one happens, symptoms may include ear pain, hearing changes, or dizziness.

Causes

Main causes

• Bacteria or viruses from a cold can travel into the middle ear, causing swelling and fluid build-up.
• The Eustachian tube – the small passage in the ear – is shorter and more horizontal in children, so it blocks more easily.

Risk factors

• Being under 2 years old
• Going to daycare or having many siblings with colds
• Drinking from a bottle while lying flat
• Exposure to cigarette smoke
• A previous cold or flu

When to see a doctor

See a doctor urgently if:

• Your child is under 3 months old and has a fever
• Fluid, pus, or blood is coming from the ear
• Your child has a very high fever or seems severely ill
• Ear pain or fever gets worse after seeming to improve

Book a routine appointment if:

• Younger than 2 with ear pain and fever that lasts more than a day
• Ear pain lasting more than 2–3 days
• Fever lasting more than 3 days
• You are concerned about hearing or language development

Diagnosis

A doctor will ask about your child’s symptoms and look inside the ear with a small light called an otoscope. They may also gently puff air against the eardrum to see how it moves.

Tests that may be done

• Ear exam with an otoscope
• Checking how the eardrum moves with air
• Sometimes a hearing test if infections keep coming back

What to expect at your appointment

The visit is quick and usually nothing feels painful. The doctor may explain what they see and discuss the best next steps with you.

Treatment

Treatment focuses on making your child comfortable and giving the body time to fight the infection. Antibiotics are not always needed, and many ear infections clear up on their own.

Self-care at home

• Ask a pharmacist about safe pain relief for your child’s age, and follow the dosing advice exactly
• Place a warm (not hot) cloth over the ear for a few minutes
• Keep your child hydrated with plenty of fluids
• Let your child rest, but gentle activity is fine
• Raise your child’s head slightly with extra pillows while sleeping, if age-appropriate

Medical treatments

A healthcare provider may prescribe antibiotics if the infection is severe, if there is a high risk of complications, or if the child is very young. Ear drops are sometimes used. Always follow the prescriber’s instructions and never give aspirin to a child.

When is surgery considered?

If ear infections keep coming back, or fluid stays in the ear for a long time, a doctor might recommend a tiny ventilation tube (grommet) in the eardrum. This is usually considered after specialist review.

Living with this condition

Keep your child comfortable, reassure them, and watch for any signs that they are getting worse. Most children improve within a few days.

Lifestyle tips

• Encourage plenty of rest and sleep
• Offer fluids regularly, especially water or warm drinks
• Keep your home smoke-free
• Stay close and comfort your child – they may be anxious or irritable

Diet and exercise

No special diet is needed. Offer normal foods if appetite allows. Gentle play is fine, but don’t force activity if your child is tired.

Mental health and emotional wellbeing

It can be stressful when your child is unwell. You might feel anxious or exhausted. Remember that this is common and that asking for help is a sign of strength.

Prevention

Not completely, but you can reduce the risk by avoiding smoke, practicing good hand hygiene, breastfeeding if possible, and keeping vaccinations up to date.

Vaccines

Some childhood vaccines, such as the flu vaccine and pneumococcal vaccine, may help prevent infections that lead to ear infections.

Complications

If left untreated

• Short-term hearing changes that usually get better
• Trouble with balance in young children
• Very rarely, the infection can spread to the bone behind the ear (mastoiditis)

Long-term outlook

With the right care, almost all children make a full recovery. If infections keep returning, a specialist can help you plan ahead.

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