Ear Infections

Acute otitis media is an infection of the middle ear and is one of the most common illnesses of childhood. There are two different types of otitis media — viral and bacterial — that can occur in one or both ears at the same time. Ten to 20 percent of children will have otitis media three or more times, with fluid staying in their ears an average of one month each time.

When your two-year-old has a cold, the eustachian tube between the ear and the throat can become blocked, causing fluid to build up in the middle ear. The virus can become trapped in this fluid and multiply, causing infection. You can tell your child has an ear infection when she pulls on her ear, has drainage from the ear, has a fever (with acute otitis media), or has trouble sleeping. Talk to your pediatrician if these symptoms occur.


All children have an amazing amount of ear wax. Children probably produce the same amount of ear wax as adults, but then they also have tinier ears. Don't worry too much about ear wax. Clean only what you can see. If there is a problem with the wax, your doctor will help with removal in the office or can recommend wax softeners for use at home.

Your child may have all, some, or none of these symptoms and still have otitis media. Ear infections can be treated by antibiotics prescribed by your doctor. The fever and pain should decrease within two days, but you must continue administering the prescribed medication until all of it is gone.

Hearing Problems

If your child has fluid in her middle ear, the fluid reduces sound traveling through the part of the ear such that sound may be muffled or not heard. Children with middle-ear fluid will generally have a mild or moderate temporary hearing loss. (It feels like you've plugged your ears with your fingers.)

Most problems with otitis media arise during a child's first three years, which coincide with the period when she is learning to speak and to understand words. It may be harder to hear and understand speech if sound is muffled by fluid in the middle ear. Special attention needs to be paid to language development if your child has fluid, because if your child has difficulty hearing as a result of fluid, you may realize it when she misses developmental milestones.

At two, your child should be able to do the following:

  • Understand differences in meaning (go versus stop, big versus little)

  • Follow a two-step sequence (such as, “Get the book and put it on the table.”)

  • Use two-to three-word phrases to talk about and ask for things

  • Ask for or direct attention to objects by naming them

Tubes and Surgery Options

If your two-year-old has a lot of ear infections or fluid is present in both ears for four to six months, your doctor may recommend that she have surgery to place a tube in her ear. This tube allows air to enter the middle-ear space. The procedure, performed by an ear, nose, and throat doctor, helps the lining of the middle ear return to normal and prevents new infections. The tube generally stays in place for six to twelve months and then falls out by itself. Talk with your child's doctor if you think there is a need for these treatments.

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  4. Ear Infections
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