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Anyone can get ear infections, but children get them more often than adults. In fact, the National Institutes of Health reports that five out of every six children will have at least one ear infection by their third birthday. It’s the most common reason parents bring their children to a doctor.

Because of that, it’s important for each parent to be able to identify ear infection symptoms quickly.

What Causes Ear Infections?

There are a few kinds of ear infections. The most common one is acute otitis media,” which means your child has a buildup of fluid in the ear that causes a fever, pain, or pus.

When that infection dissipates but the fluid remains, it’s a condition called otitis media with effusion. This condition can also be chronic. When the outer ear is infected because of a bacteria or a virus (more often a bacteria), this is often called swimmer’s ear.

Ear infections are most often caused by bacteria, and they can come along with viruses like the cold or the flu, especially in young children.

Symptoms of an Ear Infection

Childhood ear infection symptoms can, at times, be tough to discern. According to the Centers for Disease Control and Prevention, some symptoms include:

• Ear pain
• Fever
• Fussiness or irritability
• Difficulty sleeping

Sometimes children will also rub or tug at their ear or become fussy, which is a sign that the ear is causing them discomfort and might be infected. Balance issues or trouble hearing may also indicate some kind of ear condition.

When to See a Doctor

If your child has a fever that gets to 102.2 degrees Fahrenheit or higher, you should see a doctor immediately. You can either visit your usual care provider or go to an urgent care clinic or emergency room.

Pus, discharge, or fluid coming out of the ear are also signs that you should see a professional, and hearing loss is another indicator that something might be wrong.

In general, the CDC recommends that symptoms lasting more than two days, or worsening symptoms, mean it’s time to call the doctor.

Treatment for Ear Infections

Treatments for ear infections depend on the type of infection, as well as the severity of the symptoms.

For otitis externa, an inflammation or infection of the ear canal that’s also known as swimmer’s ear, a doctor may prescribe drops as treatment. For acute otitis media, a middle ear infection, antibiotics may be prescribed.

• If your child is over 2 years old and the ear infection symptoms are fairly mild, a doctor might recommend watchful waiting. That means giving the child’s immune system time to fight off the infection. Watchful waiting usually includes extra rest, extra fluids, and taking over-the-counter pain relievers like acetaminophen or ibuprofen. (Note: Children younger than 6 months old should only take acetaminophen, not ibuprofen. Never give aspirin to children.)
• If your child is under 2 years old, watchful waiting is not recommended for an ear infection. Treatment with an antibiotic like amoxicillin can lessen the symptoms and reduce the length of infection, according to a study in the New England Journal of Medicine.
• If your child’s ear infection symptoms are severe, or they don’t let up after a few days, your doctor will likely prescribe an antibiotic like amoxicillin to take over the course of seven to 10 days.

Preventing Ear Infections

According to the CDC, getting recommended vaccines, like the flu vaccine, can help kids avoid ear infections. Basic hygiene practices, like cleaning your hands, can also prevent the passing along of viruses that lead to infections. Some studies also show that breastfeeding until a baby is six months old can reduce their likelihood of getting sick, according to the CDC.

If your child has recurrent middle ear infections, one possible preventive measure is a surgical procedure during which a small ventilation tube is put in the child’s eardrum to improve air flow and prevent fluid backup, according to the NIH. The surgery can drain fluid from the ear and potentially prevent future infections. These tubes usually stay in place for six to nine months, and they eventually fall out.