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 get a middle ear infection, but they're most common in young children.

You don't always need to see a doctor, because most ear infections get better on their own within 3 to 5 days.

The main symptoms of a middle ear infection (otitis media) are:

• 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 (a perforated eardrum) and pus may run out of the ear. When that happens, the earache goes away. The pain comes from fluid building up and stretching the eardrum, so once the eardrum has a hole in it, that stretching eases.

Young children and babies with a middle ear infection may also:

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

See a doctor 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 doctor's chamber is closed, call a doctor or the 16263 health line.

Most middle ear infections get better on their own within 3 to 5 days, and they don't need any specific treatment.

If you need it, paracetamol or ibuprofen can ease the pain and bring down a high temperature. Read the leaflet that comes with your medicine before you take it, and follow the dosage instructions. If you're not sure which treatments suit you or your child, speak to a pharmacist for advice.

A warm cloth placed over the affected ear may also help with the pain.

Antibiotics are not usually used to treat middle ear infections.

Most middle ear infections start when something like a cold causes mucus to build up in the middle ear. This makes the Eustachian tube (a thin tube that runs from the middle ear to the back of the nose) swollen or blocked. The mucus can't drain away properly, and that makes it easier for an infection to spread into the middle ear.

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

Middle ear infections are more common in younger children, for two reasons:

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

Certain conditions can also raise the risk of a middle ear infection, including:

• having a cleft palate
• having Down's syndrome

You can't completely prevent a middle ear infection. There are a few things you can do, though, that may lower your child's risk of getting one.

• 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 you can, feed your baby breast milk rather than formula milk.

• don't expose your child to smoky environments (passive smoking)
• don't give your child a dummy once they're older than 12 months old
• don't 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 a middle ear infection are fairly rare, but they can be serious.

Most of them happen when the infection spreads to another part of the ear or to the head. Rarely, an infection can leave a perforation (a hole) in the eardrum.

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