Does my toddler need ear tubes? 7 questions with Med/Ped Melissa Knudson-­Johnson, M.D.

By Kristy Bleizeffer Apr 25, 2016

Up to 80 percent of children will have an ear infection by the time they turn 3, according to the American Academy of Otolaryngology.

Excluding the common cold, ear infections are one of the most frequent illnesses affecting young children. According to the American Academy of Otolaryngology, about 60 percent of infants will experience at least one ear infection by one year of age, and up to 80 percent of children will have one by the time they turn 3.

Ear infections can be vexing for parents, too, especially if your child is too young to tell you what’s wrong. Here, Dr. Melissa Knudson-Johnson, a pediatrician and internal medicine physician at Mesa Primary Care, answers seven common questions about ear infections.

Middle Ear Infection by Bruce Blaus

1. What causes ear infections?

There are multiple different types of ear infections. External ear infections, typically known as swimmer’s ear, are caused by an infection of the ear canal itself. There are also middle ear infections which are infections caused by either a bacteria or a virus behind the tympanic membrane. The virus or the bacteria puts pressure on the membrane causing pain in the ear itself. There is always a small amount of fluid behind the tympanic membrane, but it increases with allergies, colds and other respiratory problems.

2. Why do children seem to get more ear infections than adults?

The Eustachian tubes in children are shorter and more horizontal than in adults, preventing the fluid in the middle ear to drain as easily. This may cause fluid to build up, resulting in more ear infections. Once the child grows, the Eustachian tube gets bigger and the ear infections become less frequent.

3. What are the symptoms of ear infections?

Older children may complain of pain in their ears which may be accompanied by fevers. Parents may notice younger kids tugging on their ears, acting irritable or crying more than usual, having difficulty sleeping or drainage coming from the ear.

4. Will ear infections resolve on their own, or should I see the doctor?

Since ear infections can be both bacterial and viral, and because it is difficult to know the difference, we recommend that if the child has ear pain and fever they should be evaluated. If there is ear pain in the setting of a cold but there is no fever and the child is older than 3 months, then we say you can monitor at home. If the parent is ever uncomfortable with the child’s presentation, they should bring the child in to be evaluated.

5. When are antibiotics appropriate for treating ear infections?

Typically antibiotics are prescribed when it is felt that the ear infection is bacterial and not viral. Again, this is difficult to determine at times and that is why it is important to be evaluated by a provider. If antibiotics are deemed appropriate, they may be administered either orally or via antibiotic drops. Sometimes the infection warrants both oral antibiotics and antibiotic drops.

6. How can I manage my child’s pain?

If the child is over 6 months of age, you can use ibuprofen or Tylenol. If the child is between 2 and 6 months old, then Tylenol can be used. Some children will find relief from warm compresses as well. Children under 2 months old with fevers should always be evaluated by a provider.

7. How do I know if my child needs implanted ear tubes?

Occasionally, if there are an excessive amount of ear infections (usually more than six infections in one year,) an Ear, Nose and Throat specialist will place a tube into the tympanic membrane to help drain the fluid until the Eustachian tube is able to grow on its own.

Melissa Knudson-Johnson, MD

Melissa Knudson-Johnson M.D.

Dr. Knudson is a Med/Peds, a type of medical specialty that focuses on both internal medicine and pediatrics. She was born and raised in North Dakota and earned her medical degree from St. Matthew’s University School of Medicine in the Cayman Islands. She is board certified in pediatrics, and is accepting patients of all ages at Mesa Primary Care. Schedule an appointment at (307) 234-6765.