Acute otitis media (AOM) is a painful type of ear infection. It
occurs when the area behind the eardrum called the middle ear becomes inflamed
The following behaviors in children often mean they have AOM:
- fits of fussiness and intense crying (in
- clutching the ear while wincing in pain (in toddlers)
- complaining about a pain in the ear (in older
What Are the Symptoms of Acute Otitis Media?
Infants and children may have one or more of the following
- pulling on the ears
- ear pain
- a headache
- neck pain
- a feeling of fullness in the ear
- fluid drainage from the ear
- a fever
- a lack of balance
- hearing loss
What Causes Acute Otitis Media?
The eustachian tube is the tube that runs from the middle of the
ear to the back of the throat. An AOM occurs when your child’s eustachian tube becomes
swollen or blocked and traps fluid in the middle ear. The trapped fluid can
become infected. In young children, the eustachian tube is shorter and more
horizontal than it is in older children and adults. This makes it more likely
to become infected.
The eustachian tube can become swollen or blocked for several
- a cold
- the flu
- a sinus infection
- infected or enlarged adenoids
- cigarette smoke
- drinking while laying down (in infants)
Who Is at Risk for Acute Otitis Media?
The risk factors for AOM include:
- being between 6 and 36 months old
- using a pacifier
- attending daycare
- being bottle fed instead of breastfed (in infants)
- drinking while laying down (in infants)
- being exposed to cigarette smoke
- being exposed to high levels of air pollution
- experiencing changes in altitude
- experiencing changes in climate
- being in a cold climate
- having had a recent cold, flu, sinus, or ear
Genetics also plays a role in increasing your child’s risk of
How Is Acute Otitis Media Diagnosed?
Your child’s doctor may use one or more of the following methods
to diagnose AOM:
Your child’s doctor uses an instrument called an otoscope to
look into your child’s ear and detect:
- air bubbles
- fluid in the middle ear
- perforation of the eardrum
During a tympanometry test, your child’s doctor uses a small
instrument to measure the air pressure in your child’s ear and determine if the
eardrum is ruptured.
During a reflectometry test, your child’s doctor uses a small
instrument that makes a sound near your child’s ear. Your child’s doctor can
determine if there’s fluid in the ear by listening to the sound reflected back
from their ear.
Your doctor may perform a hearing test to determine if your
child is experiencing hearing loss.
How Is Acute Otitis Media Treated?
The majority of AOM infections resolve without antibiotic
treatment. Home treatment and pain medications are usually recommended before
antibiotics are tried to avoid the overuse of antibiotics and reduce the risk of
adverse reactions from antibiotics. Treatments for AOM include:
Your doctor may suggest the following home care treatments to
relieve your child’s pain while waiting for the AOM infection to go away:
- applying a warm, moist washcloth over the
- using over-the-counter (OTC) ear drops for pain
- taking OTC pain relievers such as ibuprofen
(Advil, Motrin) and acetaminophen (Tylenol)
Your doctor may also prescribe eardrops for pain relief and other
pain relievers. Your doctor may prescribe antibiotics if your symptoms don’t go
away after a few days of home treatment.
Your doctor may recommend surgery if your child’s infection
doesn’t respond to treatment or if your child has recurrent ear infections.
Surgery options for AOM include:
Your child’s doctor may recommend that your child’s adenoids be
surgically removed if they’re enlarged or infected and your child has recurrent
Your doctor may suggest a surgical procedure to insert tiny
tubes in your child’s ear. The tubes allow air and fluid to drain from the
What Is the Long-Term Outlook?
AOM infections generally get better without any complications,
but the infection may occur again. Your child may also experience temporary
hearing loss for a short time. But your child’s hearing should return quickly
after treatment. Sometimes, AOM infections can cause:
- recurrent ear infections
- enlarged adenoids
- enlarged tonsils
- a ruptured eardrum
- a cholesteatoma, which is a growth in the middle
- speech delays (in children who have recurrent
otitis media infections)
In rare cases, an infection in the mastoid bone in the skull
(mastoiditis) or an infection in the brain (meningitis) can occur.
How to Prevent Acute Otitis Media
You can reduce the chances of your child having AOM by doing the
- wash hands and toys frequently to reduce your
chances of getting a cold or other respiratory infection
- avoid cigarette smoke
- get seasonal flu shots and pneumococcal vaccines
- breastfeed infants instead of bottle feeding them
- avoid giving your infant a pacifier