Ear Infections

Ear Infections

Ear pain and concerns about hearing are one of the most common reasons parents take their young children to the doctor.

Illustration by Dr Greta File. Property of KidsHealth.

Illustrations showing inside of a normal ear compared with an ear infection

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Key points to remember about ear infections

If you think your child has an ear infection, take them to your family doctor.

  • ear infections are very common in young children
  • they can cause pain, and often fever
  • if you think your child has an ear infection, take them to your family doctor
  • pain relief is important
  • antibiotics are often not needed
  • always take your child to your family doctor for an ear check 4 to 6 weeks after an ear infection, to make sure the ear fluid has gone
  • most children outgrow ear infections and will have perfect, undamaged ears and normal hearing

What is an ear infection?

There are 2 common types of middle ear problems:

  • an ear infection (acute otitis media) - discussed on this page
  • glue ear (otitis media with effusion)

Read about glue ear.

You can also check some more detailed information about ear infections.

What does the inside of the ear look like?

The inside of the ear can be separated into three parts, the outer, middle and inner ear.

Diagram of the inside of the ear

    What are the signs and symptoms of an ear infection?

    The pain from an ear infection comes on rapidly and doesn't last long. It usually wears off within 24 hours.

    Symptoms in older children

    Older children will complain of significant ear pain and may have a fever. They may also feel unwell and complain of reduced hearing in the affected ear. They may complain of problems with balance.

    Symptoms in babies and younger children

    In babies and younger children, sometimes the only sign of an ear infection is a fever.

    Younger children may also:

    • cry and become very upset, distressed, irritable and hard to settle
    • have very disturbed sleep at the beginning of the infection
    • become 'clingy' and 'grizzly'

    Burst ear drum

    Occasionally, the ear drum will burst and pus will come out of the ear. See your family doctor if this happens.

    What is the treatment for an ear infection?

    Pain relief

    Regular pain relief is important to help your child feel more comfortable. Paracetamol and/or ibuprofen can help reduce pain, and also lower fever which can make your child feel better. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose. 

    Antibiotics are often not needed

    Your doctor may either:

    • wait to see whether the infection will clear up by itself, or
    • recommend treatment with antibiotics, if your child is unwell and feverish

    When should I seek help for my child with an ear infection?

    Go to your doctor if you suspect your child has an ear infection

    If you think your child has an ear infection, take them to your family doctor. 

    Take your child back to your doctor if your child doesn't improve in 24 to 48 hours

    Once an ear infection is diagnosed, your child should start to improve within 24 to 48 hours. If the symptoms are no better or are getting worse, or you are worried about your child, take them back to your family doctor.

    Go to your doctor again 4 to 6 weeks after the ear infection

    Always take your child to your family doctor for an ear check after any ear infection, to make sure the ear fluid has gone. Go to your doctor again 4 to 6 weeks after the ear infection.

    Can I do anything to prevent ear infections in my child?

    It is not easy to prevent ear infections, but the following may help reduce the risk:

    • making sure your child's environment is smoke-free. 
    • breastfeeding your baby for at least 3 to 6 months is thought to be protective against the early development of ear infections - this may be because breastfeeding boosts the infection-fighting system (immune system)
    • keeping your child's room warm and dry
    • making sure your child has all their immunisations on time

    Read about keeping your home warm and dry

    Acknowledgements

    Starship Foundation and the Paediatric Society of New Zealand acknowledge the cooperation of Procare Health Ltd in the development of this content. Procare Health Ltd provides GP (general practice) services in the greater Auckland area.

    Illustrations
    Illustrations by Dr Greta File. Property of KidsHealth.

    This page last reviewed 30 November 2021.

    Call Healthline on 0800 611 116 any time of the day or night for free health advice when you need it