Download and print as a PDF (377kB pdf)
What is otitis media (OM)?
Otitis media, also known as middle ear infection, is a common infection in children and is usually caused by a viral bug.
In otitis media, infection in the middle ear, the small space behind the eardrum, causes inflammation and pus (infected fluid) build up. In some cases, the eardrum can burst causing release of the pus.
What are the symptoms of OM?
In most children the symptoms of middle ear infection develop quickly and get better in a few days.
You may notice your child:
- has earache
- has fever
- is pulling, tugging or rubbing the ear
- has pus discharge coming from the ear
- has temporary mild hearing loss
- has nausea (feeling sick) and may vomit.
What is the treatment of OM?
Most children get better by themselves within 3-5 days. Paracetamol or ibuprofen can be used to relieve pain whilst your child is unwell.
Antibiotics usually are not needed in OM. Over half of middle ear infections get better without antibiotics, and they always carry a risk of side effects. Your child may receive antibiotics if they:
- are under 2 years old and have infection in both ears
- have pus draining from the ear
- have symptoms that have present more than 3 days
Complications from OM are rare. Your child should see their GP if their
hearing hasn’t got better within a few days after the infection goes away as the fluid behind the ear drum can sometimes take time to drain away.
Rarely, otitis media can result in an infection in the bone behind
the ear (the mastoid bone). This is called mastoiditis and needs urgent
assessment and treatment in hospital.
Other, more serious complications such as meningitis are very rare.
What can I do for my child at home?
- Encourage your child to drink plenty of fluids, including breast or other milk feeds.
- If your child has earache or fever with discomfort, give them paracetamol and or ibuprofen according to the manufacturer instructions.
What should I look out for at home?
If your child:
- is getting worse, or has an illness that seems severe, or you are worried
- develops redness, pain and swelling behind their ear
- develops double vision or blurred vision
- has dizziness or loss of balance
- is refusing to drink or can’t keep any fluids down
- is not getting better after 3 days or has a fever for more than 5 days
- has pus draining from the ear.
Your child should see a nurse or doctor today. Please ring your child’s GP surgery or call NHS 111.
If your child has signs of a more serious infection, such as:
- breathing faster or harder than usual, or having pauses in their breathing or an irregular breathing pattern
- pale, blue or mottled skin and feels unusually cold to touch
- has a fit (seizure)
- complains of a severe headache, or is crying inconsolably despite distraction, is confused or very lethargic (difficult to wake)
- if your child has a stiff neck and vomiting
- develops a rash that does not disappear with pressure (the ‘Glass Test’)
- is under 3 months old with a temperature more than 38°C or under 36°C.
Phone 999 for an ambulance or go straight to the nearest Emergency Department.
Useful numbers
Practice Plus (Brighton walk-in centre / GP service)
Open 7 days a week including bank holidays
8:00 am to 8:00 pm
For Out of Hours GP service or advice ring NHS 111.
Royal Alexandra Children’s Hospital
Children’s Emergency Department
01273 696955
Ext. 62593
Be aware
Please be aware that CED staff will not be able to give you medical advice for your child over the phone but can direct you to an appropriate service to assist with your enquiry.
This information is intended for patients receiving care in Brighton & Hove.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.