Middle ear infection (otitis media)

Middle ear infection (otitis media)

Otitis media is an infection of the middle ear. It causes inflammation (redness and swelling) and a build-up of fluid behind the eardrum.

Anyone can develop a middle ear infection, but they’re most common in young children.

You do not always need to see a GP as most ear infections get better on their own within 3 to 5 days.

Symptoms of a middle ear infection

The main symptoms of a middle ear infection include:

• earache
• a high temperature (fever)
• being sick
• a lack of energy
• slight hearing loss – if the middle ear becomes filled with fluid

In some cases, a hole may develop in the eardrum (perforated eardrum) and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.

Signs in young children

Young children and babies with an ear infection may also:

• rub or pull their ear
• not react to some sounds
• be irritable or restless
• be off their food
• keep losing their balance

When to get medical advice

Speak to your GP practice if:

You or your child has:

• symptoms that do not improve within 2 or 3 days
• regular ear infections
• a lot of pain
• a discharge of pus or fluid from the ear
• an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make complications more likely

If your GP practice is closed, phone 111.

Treatment for middle ear infections

Most ear infections get better on their own within 3 to 5 days and do not need any specific treatment.

If needed, paracetamol or ibuprofen can be used to relieve pain and a high temperature. Always read the leaflet that comes with your medicine before taking it. Follow the recommended dosage instructions. If you’re not sure which treatments are suitable for you or your child, speak to a pharmacist for advice.

Placing a warm cloth over the affected ear may also help relieve pain.

Antibiotics are not usually used to treat middle ear infections.

What causes middle ear infections?

Most middle ear infections occur when an infection, such as a cold, leads to a build-up of mucus in the middle ear. This causes the Eustachian tube (a thin tube that runs from the middle ear to the back of the nose) to become swollen or blocked. The mucus can’t drain away properly, making it easier for an infection to spread into the middle ear.

An enlarged adenoid (soft tissue at the back of the throat) can also block the Eustachian tube. The adenoid can be removed if it often causes ear infections.

Middle ear infections are more common in younger children because:

• the Eustachian tube is smaller in children than in adults
• a child’s adenoids are relatively larger than an adults

Certain conditions can also increase the risk of middle ear infections, including:

• having a cleft palate
• having Down’s syndrome

Can middle ear infections be prevented?

It’s not possible to prevent middle ear infections. There are some things you can do that may reduce your child’s risk of developing one.

Do

• make sure your child is up-to-date with their routine vaccinations – particularly the pneumococcal vaccine and the DTaP/IPV/Hib/HepB (6-in-1) vaccine
• if possible, feed your baby with breast milk rather than formula milk

Don’t

• do not expose your child to smoky environments (passive smoking)
• do not give your child a dummy once they’re older than 12 months old
• do not feed your child while they’re lying flat on their back

Children who go to nursery or school can pick up infections from other children who are unwell.

Complications of middle ear infections

Complications of middle ear infections are fairly rare, but can be serious.

Most complications are the result of the infection spreading to another part of the ear or head. Rarely, infections can leave a perforation or hole in the eardrum.

If complications do develop, they often need to be treated immediately with antibiotics in hospital.