How To Prevent Ear Infections In Kids

Feelings of pressure, a constant, dull ache, and now your little one is tugging at their ears — yeah, it’s an ear infection alright. When your kid’s ears ache, you just want to hold them close and help them get better. But can you prevent ear infections in toddlers and kids altogether? Nobody is totally immune to ear infections, but there are some tactics you can try if your child has a history of dealing with them.

If your child deals with chronic ear infections, it takes a major toll on everyone involved. Your little one, of course, probably feels uncomfortable, and on top of the ear situation, taking antibiotics can cause stomach upset for some kids. There are usually some missed days of work and daycare, and over time, you might even notice your child isn’t hearing or speaking as well as expected for their age. Fortunately, experts know of a few tried-and-true methods to prevent ear infections in toddlers and kids. They don’t work 100% of the time, but they’re certainly worth trying.

Why toddlers are prone to getting ear infections

If it feels like your little one is constantly running a fever and needing to stay home from school, you’re not alone. Young children are more likely than older kids to get ear infections due to their exposure to viruses and the position of the eustachian tubes in their ears, which is why you and all the other toddler moms seem to be battling them constantly.

Trapped fluid in the eustachian tube

“Every kid 4 and under is at risk of getting ear infections, especially more in the fall and winter months when there are more upper respiratory infections that happen,” explains Dr. Brian Kulbersh, pediatric ear, nose, and throat (ENT) specialist at Children’s of Alabama. “Kids will get a cold or flu and get swelling in the back of their nose, and there’s a tube that connects the back of the nose and the ear called the eustachian tube. Kids younger than 4 and 5, their eustachian tube is flat, so when fluid gets trapped in the ear it has nowhere to drain and gets infected.”

Exposure to viral infections

“Generally we think of the high-risk age for ear infections as somewhere between 9 months and 3 years of age,” says Dr. Anna Messner, FACS, FAAP, division chief of otolaryngology/head and neck surgery at Texas Children's Hospital. “The angle of the eustachian tube is theoretically an issue, but the bigger issue at that age is just the exposure to all the viral infections. Viral infections have been particularly difficult this last year after coming out of Covid. During Covid, ear infections disappeared. It was really amazing, and it was all over North America. Kids were not getting sick with viral infections.”

You might notice more than one member of your family gets ear infections often. It’s probably not a coincidence, experts say. “Some children are more prone than others. There’s known to be a genetic susceptibility, and it tends to run in families,” says Dr. Patricia Yoon, pediatric otolaryngologist at Children’s Hospital Colorado.

Signs your kid has an ear infection

These are some of the typical signs of an ear infection, and oftentimes follow a period of congestion.

• Tugging, rubbing, or holding their ear because they are experiencing pain in and/or around the ear
• Irritability
• Difficulty sleeping
• Fever
• Loss of balance
• Decreased hearing due to fluid buildup in the middle ear

How to prevent ear infections

If your child falls in the super-duper-prone-to-ear-infections category, you’re probably willing to try just about anything to keep them healthy for a change. They’re not guaranteed to work, but in order to try and prevent ear infections in toddlers and kids, consider:

• Steering clear of other sick kids: “Keep your child away from other sick kids when possible (though oftentimes this isn’t possible). Make sure your child washes their hands, or wash their hands for them, or use hand sanitizer,” Messner says.
• Keeping them up to date on their immunizations: “Vaccinations can decrease the risk of ear infections from certain bacteria, so the pneumococcal vaccine and flu vaccines can both decrease risk,” says Kulbersh.
• Protecting them from secondhand smoke: “Cigarette smoke is like exposing them to a cold constantly,” Kulbersh says.
• Avoiding giving your baby a bottle while laying down: “If your child is lying on his or her back, the reflux of milk into the eustachian tubes can contribute to ear infections,” says Yoon.

And, if you’re tempted to try any essential oil ear products or other remedies you see online, just be sure to speak with your child’s healthcare provider first. “The eustachian tube and all of that are behind the ear drum, so anything you put in the ear canal is not going to treat ear infections,” Yoon says.

Of course, even if you follow these guidelines perfectly, your child may still wind up sick. If your child is dealing with chronic ear infections, or any related delays in speech or development, your pediatrician will probably start talking to you about ear tubes.

Do ear tubes prevent ear infections?

Ear tubes don’t always prevent infections, Messner says, but they certainly make them fewer and farther between. “In general, kids will get fewer ear infections with the tubes,” she says. “It is still possible to get ear infections. The difference is, if you have ear tubes in place, you will see the fluid drain out of the ear instead of building up inside, and the symptoms are a lot more mild. We can treat them with antibiotic ear drops instead of oral antibiotics.”

If your child is having constant ear infections, you might have looked up the criteria for getting ear tubes, or started talking to friends and family about them. Messner says a child who is a candidate for ear tubes will have had three ear infections in six months, or six infections in a year. However, not every child who fits that description should automatically receive tubes. In addition to how many ear infections they’ve had, Messner says, you should talk with your pediatrician about whether the fluid in your child’s ears actually drains between infections, and how they respond to antibiotics.

If you feel like you’re stuck in a constant cycle of missing work, doctor visits, and fevers, just know that whether you manage to prevent your child’s ear infections or not, this stage of being sick all the time won’t last forever. “As kids get older they get better and better,” says Messner. “As they mature and their immune systems and eustachian tubes mature, the ear infections typically do go down drastically in frequency.”

Experts:

Dr. Brian Kulbersh, pediatric ENT at Children’s of Alabama

Dr. Anna Messner, FACS, FAAP, division chief of otolaryngology/head and neck surgery at Texas Children's Hospital

Dr. Patricia Yoon, pediatric otolaryngologist, associate medical director of the Bill Daniels Center for Children’s Hearing at Children’s Hospital Colorado, and associate professor of otolaryngology at the University of Colorado School of Medicine