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    Ear Infections (Child)

    Risk Factors

    When To Seek Help
    Treatment Options
    Where To Seek Treatment

    Singapore General Hospital
    Contributed by Dept of Neonatal & Developmental Medicine


    Ear infections are common in young children. The infection may involve the outer ear (otitis externa) or middle ear (otitis media).


    Otitis externa is an infection of the lining of the ear canal (outer ear). It can occur when water in the ear irritates the lining of the ear canal, which then develops a secondary bacterial or fungal infection.

    Otitis media is an infection of the middle ear (behind the eardrum). Young children are more prone to otitis media because the tubes (Eustachian tubes) connecting the middle ear to the throat are shorter and softer. These tubes are also more prone to becoming blocked.


    If your child has outer ear infection, he or she may complain of ear pain, itch, difficulty hearing or a blocked ear. There may also be ear discharge.

    If the problem is a middle ear infection, your child could have fever, headache, nausea or vomiting and may feel irritable, drowsy and loses his or her appetite. There could be ear pain and hearing difficulty. Young children may pull their ear or poke their fingers inside. Sometimes, the eardrum may rupture and there is a thick and sometimes bloody ear discharge. The perforated eardrum usually heals naturally.

    Some children have recurrent middle ear infection and this can lead to ‘glue ear’, where there is thick fluid in the ear. ‘Glue ear’ can cause a child to have difficulty in hearing and result in speech, language and other developmental delays as well as behavioural problems like poor attention.

    Risk Factors

    Children below three years old are most susceptible to ear infection. Children with weak immune systems are also more likely to get ear infections than healthy children. Family history also plays a part. A child is more likely to have recurrent middle ear infection if a parent or sibling had repeat ear infections.

    Other risk factors include recurrent colds and upper respiratory infections and exposure to cigarette smoke. Being in a childcare centre with other children also increases risk as viruses can spread quickly among the children, causing colds that could lead to ear infections.

    Primary risk factors:
    Age, weakened immune systems and family history of ear infection.

    Secondary risk factors:
    Recurrent colds and upper respiratory infections, exposure to cigarette smoke and being in a childcare centre with other children.


    Keep your child away from sick children. Have your child vaccinated with the appropriate vaccines, such as pneumococcal and Haemophilus vaccines, to prevent pneumonia and meningitis and reduce risk of ear infections. Keep the ear dry. Avoid swimming and touching the ear.

    When To Seek Help

    You should bring your child to see a doctor at the first sign of a possible ear infection so that your child can be treated promptly.

    Treatment Options

    The doctor may give your child eardrops if he or she has an outer ear infection. For middle ear infection, a course of antibiotics is usually given together with medication to ease your child’s pain and fever. For children with glue ear, tubes (grommets) may be inserted to prevent fluid from accumulating in the middle ear; this helps to restore the child’s hearing. If your child has had recurrent ear infections, he or she may need a hearing test.

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