Ear infections are a longstanding nemesis for many parents. Dr. Alan Greene, M.D., notes that ear infections are “the most common reason a sick child will visit the doc, take antibiotics, or have surgery.” (Greene, 2012)  Ear infections are the second most common illness behind the common cold. (Szabo, 8/16/2009) The following pages will help parents better understand this common child health issue.

Statistics and Rates of ear infections in children

There are around 13 million cases of ear infections among children under five each year in the United States. To address chronic ear infections, more than 300,000 kids have surgery every year to implant tubes in their ear. Because these tubes tend to fall out after 12-18 months, about 1 in 3 kids will need repeat procedures. Overall, more than three-quarters of kids will experience an ear infection before the age of 5.

Types of ear infections

There are two basic types of ear infection: outer ear infections and inner ear infections. The typical ear infection is an inner-ear infection, and occurs when fluid behind the eardrum gets infected. Inner-ear infections are commonly associated with colds. Outer ear infections occur when bacteria grow on the other side of the eardrum, and are typically caused by some sort of water or fluid getting into a child’s ears.

What causes ear infections in children?

Ear infections are especially common among young children because in the first few years of life, a child’s middle ears are short, floppy, and thus prone to collecting fluid that can foster bacteria. This bacterium in turn leads to inflammation and creates an infection.

Because human babies are born “underdeveloped” (they must be born prematurely so that their big head can fit through the birth canal), this results in relatively underdeveloped middle ears and the widespread occurrence of earaches. (Martin, 2013)

Germs that cause ear infections

There are more than 100 different types of germs that can cause ear infections, which makes developing a vaccine tricky. It’s also why treating them with antibiotics can involve a lot of guesswork and isn’t always effective.

The anatomy of an ear infection

As Dr. Aaron Carroll & Rachel Vreeman (2009, p. 64) write, “the ear canal is a tube with a wall sectioning off the outer ear canal from the middle ear canal. This wall is called the tympanic membrane (or the ear-drum).” The typical ear infection occurs when fluid builds up behind this wall and becomes infected.

Most ear infections begin during a cold, when germs from the back of the nose are sucked up the eustachian tube and into the middle ear. Fluid buildup in the middle ear offers an ideal place for these germs to multiply, creating an infection. Pus from the infection then fills the middle ear, causing the eardrums to bulge. And because a child’s eustachian tube is shorter, floppier and more horizontal, it’s easier for germs to make their way up this tube, which is why they get more ear infections.

Children prone to ear infections

Kids with allergies are sometimes more prone to ear infections, since allergies can cause a buildup of fluid in the middle ear, which then becomes infected.

Do children grow out of ear infections?

Yes. Ear infections tend to become much less common by the age of three or four, and all but disappear by age seven, as a child’s inner ear becomes more developed.

Ear Infection Resources for Parents

The following information will guide you in treating and preventing ear infection in children:

  • Signs & symptoms of ear infection
  • Treating a child’s ear infection
  • Preventing ear infections
  • Swimmer’s ear
  • Ear tubes in children