Seven Tips to Prevent Ear Infections in Children


Dr. Lindsay Rosshirt

Lindsay Rosshirt, MD, Pediatrician

If you’re the parent of a baby or young child, you know the signs: fussiness, cold-like symptoms, fever, sleeplessness, poor feeding, and ear pain. Ear infections are one of the most common ailments in babies and young children.

Nearly 80 percent of children under the age of two will have at least one ear infection annually, and most will have repeated infections. Besides causing your child to feel miserable, ear infections lead to the use of repeated antibiotics and can affect hearing and balance.

What causes ear infections?

Before we talk prevention, it’s important to understand what causes ear infections.

The ear is divided into three parts: the outer ear canal, the middle ear space where infections happen, and the inner ear where the nerves and balance center are located. A thin, membranous eardrum divides the outer and middle ear.

The middle ear contains the small bones that conduct the vibrations of the ear drum to the brain. It is also connected to the back of the nose via the Eustachian tube. Infants and young children have a shorter and more horizontal Eustachian tube. This makes it more difficult for fluid to drain out of the middle ear, and much easier for bacteria to move from the nose and throat into the middle ear space, leading to infection.

Ear infection prevention tips

Now that you know what causes ear infections, here are some tips to help prevent the bacteria from collecting in the middle ear space:

  1. Get a flu vaccination. The most common cause of an ear infection is an upper respiratory viral infection, such as a cold or the flu. In addition, the routine pneumococcal vaccination given in childhood has been shown to decrease the incidence of ear infections.
  2. Wash hands frequently. This simple step is so important. It prevents the spread of germs and can prevent your child from catching a cold or the flu.
  3. Keep the nose clear. Middle-ear infections usually follow a cold, so what's coming out of the nose often reflects what's going on in the ear. Try to keep the nose clear by using saline nose drops, steam, and suctioning.
  4. Control allergies. Allergies lead to inflammation in the ear and may cause fluid accumulation that can promote ear infections.
  5. Bottle-feed upright. If your baby is bottle fed, feed in an upright position (at least 30 degrees) and keep him/her upright at least 30 minutes after feeding. Breastfeeding has also been associated with a decreased risk of ear infections.
  6. Ditch the pacifier. Studies show a correlation between the frequency of pacifier use and ear infections. Limit pacifier use to when baby is falling asleep at night, especially after six months or older.
  7. Don't smoke. Ear infections are more common in kids who are exposed to cigarette smoke in the home.

The good news about ear infections is that kids generally outgrow them. By the time kids are five or six, their Eustachian tubes are three times as long and are positioned more vertically, making it easier for fluid to drain.


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