Ear infections in children: When to see a doctor

Although ear infections in children are very common, persistent or recurrent ear infections require intervention from a professional to be resolved. In this informative guide, highly respected consultant paediatric and general ENT surgeon Mr Kiran Varad shares his expert insight on the symptoms of ear infections in young children and details the most commonly-used treatment options. The revered specialist also sheds light on the rare but possible complications of ear infections in children and when specialist advice should be sought.

What are the symptoms of ear infection in young children?

Symptoms of ear infections in young children can include:

• Pain in the ear;
• Fever;
• Decreased appetite and sleep disturbance;
• Irritability and crying;
• Fluid drainage from the ear;
• Difficulty hearing or responding to sounds (particularly if also associated with glue ear);
• Loss of balance.

Can ear infections in children be serious?

The majority of ear infections in children will be self-limiting and will not cause any serious or long-term complications. Rarely, ear infections can lead to more serious complications like mastoiditis (infection in the bone behind the ear), meningitis or brain abscess. Recurrent ear infections can result in time off school or nursery, hearing issues and speech and language delays.

How long does an ear infection last in a child?

The duration of an ear infection in a child can vary, but most ear infections resolve within three to seven days. However, some ear infections can persist for longer periods and may require antibiotics or other medical interventions. If an ear infection persists or worsens after several days, it is important to consult a doctor to determine the best course of action.

What can I do for my child's ear infection. When should I take my child to the doctor?

If you suspect your child has an ear infection, you can take the following steps to help relieve their symptoms:

• Pain relief: Give your child over-the-counter pain relievers like ibuprofen or paracetamol to help relieve the pain and reduce fever;
• Keep them comfortable: Encourage your child to rest and stay hydrated;
• A warm compress can be applied to the affected ear to help relieve pain.

If your child’s symptoms are not improving, it is important to seek medical attention. A doctor can diagnose the infection and decide on further treatment which can include antibiotics.

You should take your child to the doctor if they:

• Have persistent or worsening pain in the ear;
• Have a fever for more than forty-eight hours;
• Have discharge or fluid coming from the ear;
• Have trouble hearing or responding to sounds;
• Show signs of severe illness, such as lethargy or trouble waking up.

Early treatment can help prevent potential complications and ensure a quicker recovery for your child.

How is an ear infection in children treated?

Treatment for ear infections in children typically involves relieving symptoms and treating the underlying infection. In many cases, a "watch and wait" approach will be appropriate, particularly for mild ear infections, to see if the infection resolves on its own.

Common treatments for ear infections in children include:

• Pain relief: Over-the-counter pain relievers like paracetamol and ibuprofen can help relieve pain and reduce fever;
• Antibiotics: For more severe or persistent infections, antibiotics are prescribed;
• Ear drops: Antibiotic or steroid ear drops may be recommended to help relieve symptoms and speed up the healing process;
• Surgery: In severe cases, surgery may be required to drain fluid from the middle ear or repair any damage to the ear drum.

In children with recurrent ear infections, the two main options are using a low dose antibiotic for eight weeks or surgery.

The main antibiotic prescribed is Azithromycin. Azithromycin is beneficial as it has a long lasting effect. It is therefore given as a once daily low dose for three days in a fourteen day cycle. This fourteen day cycle is repeated four times (thus over eight weeks your child will only require a total of twelve doses).

Grommets (a small plastic tube inserted into the ear drum) are beneficial for children with four or more ear infections per year. They reduce the number of infections and severity of ear infections when they do occur. Children may have some leaking from their ear when they have grommets in (this is not painful and can be easily treated with antibiotic ear drops).

If you are concerned about your child’s ear infection and wish to schedule a consultation with Mr Varad, you can schedule a consultation with him by visiting his Top Doctors profile.