Middle Ear Infection

An infection behind the eardrum causing ear pain and fever, very common in young children, often after a cold.

EarsInfectionChildrenLast updated: 21 October 2026

Quick Summary

Primary Symptoms

Ear pain, fever, irritability in babies, pulling at the ear, reduced hearing, and sometimes discharge from the ear.

Common Treatments

Pain relief and fever control; most clear in a few days. Antibiotics for some children.

Risk Factors

Young age, colds, exposure to smoke, bottle-feeding lying down and attending crèche or nursery.

OverviewSymptomsCausesTreatmentFAQ

Overview

Middle ear infection (acute otitis media) happens when fluid builds up behind the eardrum and becomes infected, often after a cold blocks the tube between the ear and throat.

It's one of the most common reasons children see a doctor. Most infections get better within three days. Repeated infections or long-lasting fluid can affect hearing and need follow-up.

Symptoms

Ear pain

Babies may cry, pull at the ear or not feed well.

Fever

Often with a cold.

Reduced hearing

Muffled hearing from fluid behind the eardrum.

Ear discharge

If the eardrum bursts, pus may drain and pain usually eases.

Causes & Risk Factors

Biological Causes

Bacteria or viruses infecting fluid trapped in the middle ear when the Eustachian tube is blocked by a cold or allergy.

Key Risk Factors

  • Young age Children's ear tubes are shorter and more easily blocked.
  • Smoke exposure Second-hand smoke increases ear infections.
  • Feeding position Bottle-feeding while lying flat.

Management & Treatment

01. Pain relief

Paracetamol or ibuprofen, as suitable for the child's age.

02. Antibiotics

Given for young babies, severe infection, discharge or symptoms lasting more than a few days.

03. Follow-up

For repeated infections or hearing problems.

Frequently Asked Questions

Should I put oil or drops in the ear?
Don't put anything in the ear unless a doctor advises it.
Is it contagious?
The ear infection isn't, but the cold before it can be.
Can it damage hearing?
Usually not, but repeated infections should be checked.

Sources and further reading

Last updated 21 October 2026. For more detail, see these trusted health organisations.