Advice: Ear Infections

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Suite #100 Rockville, MD 20850

Ear Infections (Acute Otitis Media)

Ear infection basics

Acute otitis media is an infection in the middle ear that sometimes occurs during or after a cold or viral illness. This is different from an external or “swimmer’s ear” infection.
Symptoms can include: fever, ear pain/tugging, fussiness, decreased appetite, trouble hearing, vomiting.
Antibiotics are commonly used to treat ear infections. If started, the entire course of antibiotics should be taken as prescribed, even if symptoms improve quickly. If your child is 2 or older, healthy, and doesn’t have high fevers or severe pain your doctor may choose to wait 24-48 hours before starting antibiotics.
Antibiotic side effects include diarrhea, upset stomach, allergic reactions, or rashes.
Ear infections are not contagious so your child can return to school/daycare once fever free for 24 hours without needing fever reducing medications.
Children with frequent ear infections (ie, 3 in 6 months or 4 in 12 months) may benefit from seeing an Ear, Nose, and Throat specialist (ENT) to discuss ear tube surgery.
Routine childhood vaccines help prevent ear infections.

Treatment

Your doctor may elect to start an antibiotic based on your child’s age and symptoms.
Fever/Pain control: Use Acetaminophen every 4 - 6 hours (up to 4 times/day) and Ibuprofen every 6 hours (up to 4 times/day) to control fever. These may be alternated or given together.
Hydration - We expect a minimum of 4 voids per day. Small, frequent sips of water, Pedialyte or formula/breast milk are best.
Congestion - Use nasal saline drops/spray followed by suction or nose blowing; humidifiers and steamy bathrooms can also help improve congestion. Clearing the nose helps ears drain more efficiently.

When to seek care

If symptoms (fever or bad ear pain) are still present 72 hours after starting treatment
If your child is not making a minimum of 4 voids per day
If you notice bloody drainage from the ear
If your child develops a rash while on antibiotics
If you are concerned

When to go to the Emergency Departent

If your child is in respiratory distress (nostrils flaring, ribs showing, significant belly breathing, head bobbing, grunting, or very fast breathing)
If your child is lethargic or difficult to arouse
If your child is showing signs of severe dehydration: lethargy, little/no urine output, dry lips, sunken fontanelle (soft spot)
If you are worried

Additional Resrouces

Potomac Pediatrics will always be fully focused on helping your child and you to overcome any healthcare hurdle, with innovative, comprehensive and compassionate care.