Middle ear infection is a common complication of a cold in children. The middle ear space lies behind the eardrum and contains three tiny bones that transmit sound to the nerve endings of the inner ear. The Eustachian tube ventilates the middle ear space into the back of the throat. Swelling and congestion due to a cold may obstruct the Eustachian tube and allow fluid to fill the middle ear space. This fluid may then become infected.

Indications of middle ear infection include irritability, sleeplessness, earache and fever. Infants may or may not tug or rub the ear. Infants may also have vomiting or diarrhea associated with an ear infection.

The pain of a middle ear infection can often be relieved with acetaminophen (Tempra, Tylenol) and heat applied to the external ear with a heating pad or warm compress. If there is no ear canal discharge, numbing drops, such as Auralgan or Otocaine, may be used. Ear pain will usually subside after a few hours but the infection will remain. The child should be checked within a day after onset of symptoms. Note: Numbing drops should not be given to a child who has tubes in the eardrum.

Middle ear infections are generally treated with an oral antibiotic. If a child has not shown improvement within 2-3 days, the ears should be checked again. Regardless, the child should be checked a few days after completing the antibiotic to be sure the infection and fluid have resolved.