Babies and children between the ages of four months and five years are the most likely to suffer from middle ear infections (otitis media). By the time children reach three years, they have probably suffered at least one ear infection. Allergies such as hay fever, or an upper respiratory infection, such as a cold caused by a virus, also cause middle ear infection.

Swelling and inflammation, of the sinuses and the eustachian tubes, are caused by both colds and allergies and can result in middle ear infections. The eustachian tubes in children are shorter and narrower and therefore, don’t allow air in, to balance the pressure as well as an adult’s. The inflammation and swelling are able to block the tube completely because of its smaller size, which traps the fluid in the middle ear. The fluid buildup in the middle ear causes discomfort and reduces hearing, by preventing the eardrum and the bones in the middle ear from vibrating normally in response to sounds.

Fluid may remain in the middle ear for months without causing an infection however; since it creates the perfect environment for bacteria to grow sometimes, it becomes infected. When that happens, the child has acute otitis media. Some children have ear infections that won’t resolve or ear infections that clear up, but come back within a few weeks, that child has recurrent otitis media.

Some children, like boys and infants, are more likely to be affected by ear infections that other children. A family history of recurrent ear infections is a risk factor as well as being born prematurely, having a cochlear implant, having siblings in the household, or having a disease such as a cleft palate, Down’s syndrome, asthma, allergies, or other immune system disorders. Children of American Indian, Alaskan Inuit and Canadian Inuit descent may have genetic factors that affect the shape of the auditory tube and increase their risk.

Exposure to lots of children in a group daycare setting will make your child more likely to get ear infections than children who are not. Allowing anyone to smoke in the same room, house, or car where your child is will increase your child’s risk for ear infections. Allowing an infant to lay flat while drinking from a bottle will increase the risk as well.

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