Children Ear Infections: What Parents Should Know

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2 min read

babyboy with maybe ear infection

Middle ear infections (Otitis Media) are very common in young children between the ages of 6 months and 6 years old. While they are not alarming and not contagious, they can bring your child a lot of pain and discomfort. In collaboration with ENT specialist, Dr. David Ho 何志謙醫生, Healthy Matters brings you a practical guide to children ear infections.


What are the causes of ear infections?

Ear infections are caused by bacteria making their way into hollow space behind the eardrum, called the middle ear. When the middle ear is infected, it fills with pus and presses against the eardrum and causes pain, discomfort and hearing loss.

Why are ear infections more prevalent in young kids?

Children under the age of 6 are particularly at risk of ear infections because their ear structures (in particular, Eustachian tubes) have not developed completely and their adenoids are bigger. This combination means that the Eustachian opening is blocked and middle ear fluid or pus cannot drain out back into the nose.


Ear infections often happen in conjunction with colds, throat infections or allergies. When the Eustachian tube's opening swells as a result of another infection, the mucus usually found in the middle ear is not able to drain properly and bacteria grows.

Are ear infections contagious?

Ear infections are not usually contagious but colds and throat infections are so it might seem as though they are when these illnesses are cycling through daycare, playgroups or schools.

What are the signs and symptoms of ear infection?

The main sign of an ear infection is ear pain and ear blockage. Older children will complain about their ears being painful but with children who are not yet able to speak, it’s up to parents and carers to interpret their non-verbal signs. These often include increased fussiness, tugging at the ear, and trouble eating, drinking and sleeping as chewing, swallowing and lying down often aggravate the ear.

In addition to ear pain, children may have a fever, ear discharge, reduced appetite, and hearing loss.

Why do some children have chronic ear infections?

Some children have ear infections more often than others. Dr. David Ho says this is because their adenoids is big and blocks the Eustachian tube opening at the back of the nose. If your child has chronic ear infections, this is something worth talking to your ENT specialist about to address the underlying causes.

What are the remedies for ear infection?

Almost all middle ear infections are bacterial. Children should start antibiotics to help kill the bacteria, otherwise the ear drum will burst. Very rarely, middle ear infection may spread to the cochlea causing hearing impairment, to the bone leading to mastoiditis or to the brain leading to meningitis. Anti-inflammatory like ibuprofen should also be given to relief the pain and fever.

What can prevent an ear infection?

There are several things parents can do to prevent their children developing chronic ear infections:

  • Avoid children’s exposure to secondhand smoke.
  • Breastfeeding for at least 6 months helps to prevent early ear infections.
  • Vaccinations (Streptococcus and Haemophilus) help prevent ear infections.
  • Practice regular hand washing to prevent germs from spreading.

When should I see a doctor?

Dr. David Ho recommends seeing your GP, pediatrician or ENT Specialist if your child has the following signs:

  • Ear pain
  • Ear blockage/Hearing loss
  • Ear discharge
  • Fever of unknown origin

Dr. David Ho 何志謙醫生 graduated from the University of Melbourne Medical School and obtained Otorhinolaryngology (Ear, Nose & Throat) Specialist training under the Royal Australasian College of Surgeons. Before returning to Hong Kong, he worked at Royal Children’s Hospitals in Melbourne, the biggest pediatric medical centre in the Southern Hemisphere and was a specialist ENT consultant at Royal Melbourne, Alfred and Austin Hospitals. He obtained post-fellowship training in New York, Hong Kong and London, Canada. He is now an honorary assistant professor at the University of Hong Kong and an honorary Specialist ENT Consultant for the Matilda International Hospital. His private practice is in Room 707, Central Building, Central: The Hong Kong ENT & Sleep Surgery Centre (+852 2870 1880).

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This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.

Dr. David Ho
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