Middle ear infections are common in children under 3. The tiny tube that connects the middle ear to the throat and nose gets blocked. Fluid then becomes trapped from the blockage. The ear becomes infected by either bacteria or viruses.

Otitis media refers to inflammation in the middle ear area. There are different forms of otitis media. Typically, when the doctor refers to an ear infection, he or she is most likely talking about "acute otitis media" (although there's also the common ear infection called swimmer's ear, or otitis externa).

Acute otitis media is the presence of fluid, typically pus, in the middle ear with symptoms of pain, redness of the eardrum, and possible fever.

Other forms of otitis media are either more chronic in nature (meaning that there's fluid in the middle ear for 6 or more weeks) or there's fluid in the middle ear that's temporary and isn't necessarily infected (this is called otitis media with effusion).

The reason that doctors try to distinguish between the different forms of otitis is because it affects treatment options. Not all forms of otitis need to be treated with antibiotics.

Causes

Children develop ear infections more frequently in the first 2 to 4 years of life for several reasons:

• Their eustachian tubes are shorter and more horizontal than those of adults, which allows bacteria and viruses to find their way into the middle ear more easily. Their tubes are also narrower and less stiff, which makes them more prone to blockage.
• The adenoids, which are gland-like structures located in the back of the upper throat near the eustachian tubes, are large in children and can interfere with the opening of the eustachian tubes.
• Children's immune systems aren't fully developed until the age of 7. Therefore, they have more trouble fighting infections.

There are also a number of other factors that contribute to children getting ear infections. The more common ones are exposure to cigarette smoke, bottle-feeding, and day-care attendance.

Ear infections also occur more commonly in boys than girls, in children whose families have a history of ear infections, and more often in the winter season when upper respiratory tract infections or colds are most frequent.

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