Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.

beginning of content

Otitis media (middle ear infection)

3-minute read

Otitis media (another name for a middle ear infection) is very common in children. It often disappears by itself, but sometimes it may need treatment. Otitis media can also affect adults.

What causes otitis media?

Otitis media usually starts with a cold or a sore throat caused by bacteria or a virus. The infection spreads through the back of the throat to the middle ear, to which it is connected by the eustachian tube. The infection in the middle ear causes swelling and fluid build-up, which puts pressure on the eardrum.

Otitis media occurs in the middle ear when swelling and fluid build-up pressure the eardrum.

Otitis media symptoms

The first symptoms of acute otitis media are usually those of a cold — a sore throat, a runny nose and a temperature. When the infection spreads to the ear, and the pressure on the eardrum builds, other symptoms appear.

Older children will complain of pain — either an earache, a headache or even neck pain. Children who are too young to express themselves verbally might:

  • cry a lot
  • pull or rub their ears
  • have trouble sleeping

Sometimes, the pressure in the middle ear can cause the ear drum to burst or perforate. If it does, often the pain eases up straight away. A perforated eardrum usually heals by itself, but you should still get it checked by your doctor.

Diagnosis of otitis media

Making a firm diagnosis of otitis media is not easy. The eardrum is not easy to see, especially in younger children, and the signs of an infection are not always clear.

Your doctor or a nurse will examine your child with an otoscope, an instrument that has a light to allow them to see your child’s eardrum. Your child might also have a tympanometry test, which checks how much your child’s eardrum moves.

If they have had several ear infections, they will need a hearing test

Treatment of acute otitis media

If your child is in pain or has a fever, you should give them paracetamol. A warm (but not hot) compress to the ear can also help. Encourage them to drink plenty of water. Most kids will feel better within a day or two.

You should see a doctor if your child:

  • is still feeling unwell after 48 hours
  • has very bad pain
  • has a discharge
  • has diarrhoea, vomiting or a very high temperature
  • seems to have trouble hearing
  • keeps getting infections
  • is younger than 12 months

In general, doctors are discouraged from prescribing antibiotics since they often don’t make a difference, although they can be useful at times.

Don’t use antihistamines or decongestants since they do not work.

Otitis media prevention

If you smoke, quit. This will reduce the risk of your child getting otitis media.

If you have young children, it helps to:

  • continue breastfeeding past 6 months
  • get rid of a dummy, if you use one, at 6 months

Older children should:

  • wash their hands after blowing their nose or coughing
  • wear ear plugs while swimming

More information

The Women's and Children's Health Network and the Raising Children Network have more information on children and ear infections.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: May 2018

Back To Top

Need more information?

These trusted information partners have more on this topic.

Top results

Medicines and treatments for a middle ear infection - Choosing wisely

Middle ear infections (otitis media) usually get better on their own and dont need antibiotic treatment.

Read more on Choosing Wisely Australia website

Middle ear infections - Better Health Channel

Middle ear infections often happen during or after a child has a cold.

Read more on Better Health Channel website

Otitis Media (Middle Ear Infection) | Sydney Children's Hospitals Network

What is Otitis Media? Otitis Media is a common childhood condition which affects the ears

Read more on Sydney Children's Hospitals Network website

Middle ear infection: babies, kids & teens | Raising Children Network

Children with middle ear infections usually have pain or discomfort in the ear. If you think your child has a middle ear infection, it’s best to see a GP.

Read more on website

Otitis media in children -

Otitis media (middle ear infection) is a common childhood illness causing earache and fever. It usually gets better quickly with pain relievers but sometimes antibiotics are needed.

Read more on myDr website

Middle ear infection: should my child take antibiotics? | Australian Commission on Safety and Quality in Health Care

Middle ear infection: should my child take antibiotics? Downloads Middle ear infection: should my child take antibiotics? Publication year 2016 Resource type Fact sheet or brochure Topics Antimicrobial resistance, use and stewardship Health conditions, diseases and treatments Partnering with consumers

Read more on Australian Commission on Safety and Quality in Health Care website

Ear problems in children - Better Health Channel

Babies and young children are more likely to develop middle ear infections because they are still building up their immunity.

Read more on Better Health Channel website

Ear infections - Better Health Channel

It is estimated that around four out of five children will experience a middle ear infection at least once.

Read more on Better Health Channel website

Middle ear infection and grommets -

A grommet is a tiny tube inserted into the eardrum to allow air to enter the middle ear. Grommets can treat glue ear and recurrent middle ear infections.

Read more on myDr website

Ear infections in babies and children

Middle and outer ear infections are common in babies and young children, but there are ways you can manage your child's discomfort and help prevent infections.

Read more on Pregnancy, Birth & Baby website

Healthdirect 24hr 7 days a week hotline

24 hour health advice you can count on

1800 022 222

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Government of South Australia, health department logo Tasmanian government logo Government of Western Australia, health department logo