Ear Infections in Children: What Memphis Parents Need to Know

Ear infections are the most common reason children are brought to the doctor in the United States, accounting for more than 30 million doctor visits per year. By age 3, nearly 80% of children will have had at least one. If you’re a parent, there’s a good chance you’ll be dealing with this more than once.

Here’s what you need to know: what causes ear infections, how to recognize them, when treatment is necessary, and when it’s time to come in.

What causes ear infections in children?

Most childhood ear infections (officially called acute otitis media) develop after a cold or upper respiratory infection. The Eustachian tube, the small channel connecting the middle ear to the back of the throat can become swollen and blocked. When fluid gets trapped in the middle ear, bacteria or viruses can grow there, causing infection.

Children are more prone to ear infections than adults because their Eustachian tubes are shorter, more horizontal, and less efficient at draining. As children grow, the tubes lengthen and angle downward, which is why most kids have far fewer ear infections after age 5–6.

Risk factors include:

• Attending daycare or school (more exposure to viruses)
• Bottle-feeding while lying flat (promotes fluid buildup)
• Pacifier use after 6 months
• Secondhand smoke exposure
• Family history of ear infections

Signs and symptoms to watch for

In babies and toddlers who can’t tell you their ear hurts:

• Tugging or pulling at one or both ears
• Unusual fussiness or irritability, especially when lying down
• Crying more than usual, especially at night (lying flat increases ear pressure)
• Difficulty sleeping
• Trouble hearing or responding to sounds
• Balance problems or clumsiness
• Fluid draining from the ear
• Fever (though not always present)
• Decreased appetite, sucking and swallowing can increase ear pain

In older children who can communicate:

• Complaining of ear pain (often described as pressure or fullness)
• Saying sounds are muffled or hearing feels “off”
• Difficulty hearing the TV or responding when called
• Headache

Outer ear infection vs middle ear infection

It’s worth noting that there are two main types of ear infections with different causes and presentations.

Outer ear infection (swimmer’s ear): Affects the ear canal, not the middle ear. Usually caused by water trapped in the ear after swimming, creating a moist environment where bacteria grow. It causes pain when you press or pull on the outer ear (the flap or the small cartilage bump near the opening), along with itching and sometimes drainage. It’s unrelated to colds and is treated with antibiotic ear drops rather than oral antibiotics.

Middle ear infection (acute otitis media): This is the classic childhood ear infection described above, typically following a cold. It requires a doctor to look inside the ear to confirm.

How ear infections are diagnosed

Diagnosis requires a physical exam with an otoscope, a small lighted instrument that allows the doctor to see the eardrum. A normal eardrum is pearly-gray and translucent; an infected one is typically red, bulging, or has fluid behind it.

You can’t diagnose an ear infection from the outside. Ear-tugging alone doesn’t confirm it, babies pull at their ears when teething, when tired, and sometimes for no clear reason. Getting it properly checked is worth the visit.

Do all ear infections need antibiotics?

Not always. Guidance from the American Academy of Pediatrics now recommends that for mild infections in children over 2 with no other complications, a “watchful waiting” approach of 48–72 hours may be appropriate, because many mild ear infections resolve on their own without antibiotics.

However, antibiotics are recommended right away for:

• Children under 2 years old
• Children with severe symptoms (high fever, significant pain)
• Infection in both ears
• Ear drainage (fluid coming out of the ear)
• Children with certain underlying conditions
• Cases where symptoms are worsening

Your doctor will assess your specific child and recommend the right approach. If watchful waiting is chosen, a follow-up plan is always in place in case symptoms worsen.

Pain management in the meantime: Acetaminophen or ibuprofen (ibuprofen for children over 6 months) helps with pain and fever. Warm compresses held gently against the ear can also soothe discomfort. Never put anything inside the ear canal.

When to see a doctor right away

Bring your child in the same day if:

• They’re under 6 months old with any fever
• They’re in significant pain or inconsolable
• They have a high fever (above 102.5°F)
• Fluid is draining from the ear
• You notice swelling or redness behind the ear
• Your child seems very unwell or unusually lethargic
• Symptoms are worsening after 48 hours

If your child has had multiple ear infections in a short period, typically defined as three or more in six months or four or more in a year, talk to your doctor about a referral to an ENT specialist. Ear tubes (small ventilation tubes placed in the eardrums) are sometimes recommended for children with frequent recurrent infections.

How Beloved Medical can help

We see children with ear infections regularly at our Cordova, TN clinic. Our family doctors and pediatrician, Dr. Yemi can examine your child’s ears in-office, confirm whether an infection is present, and recommend the right treatment based on your child’s age and symptoms. Same-day sick visits are available and walk-ins are welcome.

To schedule a visit:

• Call (901) 249-0847
• Or book an appointment online

We accept most major insurance and see patients from across Cordova, Memphis, Bartlett, and Germantown.

This blog post is for informational purposes only and does not replace professional medical advice. Please consult your child’s healthcare provider for guidance specific to your child’s situation.