Dr Bryan Betty: Middle Ear Infections in Children

What is a ‘middle ear’ infection? 

- One of the most common infections that occur in children. 

- By school age most children would have had an infection, and it becomes less common as they get older. 

- An infection of the middle ear: air filled space behind the ear drum, which contains the vibrating bones of the ear we hear with. 

What do we need to look out for? 

- Often starts with a cold. 

- Tube that drains the middle ear to the back of throat becomes blocked. 

- Middle ear fills up with fluid and can become infected with viruses or bacteria. 

- Symptoms include pain in the ear, temperatures, headaches, and trouble hearing. 

- Babies may cry a lot, pull at their ears, stop feeding, or be irritable. 

- Drum may burst and discharge fluid from the ear 

How is it diagnosed? 

- Your doctor will look into the ear with a magnifier called an otoscope. 

- They’ll look at the drum and see if it’s infected behind the drum. 

How do we treat it? 

- Most middle ear infections will clear themselves after four days. 

- Simple pain relief such as paracetamol or brufen is used for symptom control, fluids, many cases don’t need antibiotics. 

- With severe symptoms such as fever or vomiting, they’re more likely to use antibiotics. 

Where there is risk of complications:  

- Those younger than 2 years, Māori/pacific children, or underlying medical conditions. 

Any long term concerns? 

- Recurrent infection or can develop glue ear: thick mucus that won’t clear behind the drum. 

- Can interfere with hearing. 

- You may need to see an ear specialist to insert a grommet or drain. 

- If you have hearing concerns, see your GP. 

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