Ear Infection and Sore Throat

Ear infection

Ear infection is a viral or bacterial infection of the middle ear, which is the area just behind the eardrum. Ear infections frequently occur after a cold. The infection causes swelling that blocks off the eustachian tube, which is the passage connecting the middle ear to the back of the throat, and infected fluid gets trapped within the middle ear cavity. The infected fluid puts pressure on the ear drum, causing it to bulge. This can be very painful. Sometimes the ear drum can burst, allowing pus to flow out of the ear.

Ear infections are very common in children between the ages of six months and two years, and most children will have at least one ear infection. About one-quarter of children have repeat ear infections. About 5% to 10% of children experience a burst, or ruptured, ear drum.

Treating ear infections

Here are some ways that you can help your child:

  • If your doctor prescribes antibiotics, make sure that your child takes all the doses and finishes the complete course of medication. Even if your child feels better in a few days, continue to give the antibiotic until it is completely gone. This will keep the ear infection from flaring up again.
  • If your child has a fever above 38.5 °C (101 °F), try giving acetaminophen or ibuprofen according to the directions on the package. These medications usually control the pain within one to two hours.
  • Bring your child back to the doctor in two to three weeks to make sure that the infection has cleared up and more treatment is not needed. This is especially important if your child has experienced a burst ear drum.

If your child develops a stiff neck or acts very sick, bring him to the doctor right away. Also bring your child to the doctor if his fever or pain does not go away after taking antibiotics for 48 hours.

Preventing ear infections

Here are a few ways to prevent ear infections:

  • Breastfeed your baby in the first year. Breastfeeding provides the baby with antibodies to fight infections.
  • If you bottle feed, avoid propping up the bottle or feeding your baby in a horizontal position. This can cause the milk to flow back into the eustachian tube and lead to an ear infection.
  • Do not allow smoking in your home or around your child. Second-hand smoke increases the severity of ear infections.

Sore throat

A sore throat is a symptom of an illness such as a cold. Babies with a sore throat are not able to communicate what the problem is, but they may refuse to eat or begin to cry during feedings. The throat will appear bright red if you shine a light on it.

Most sore throats are caused by viruses. Sore throats caused by viral illnesses usually last about three to four days. Sometimes a sore throat may be caused by tonsillitis, where the tonsils at the back of the throat are swollen.

Bring your child to the doctor if he has had a sore throat for more than 24 hours, especially if he also has a fever. A throat swab should be done if sore throat is the only symptom the child is experiencing. However, if sore throat is accompanied by croup or a cough, a throat swab may not be necessary.

Treating sore throat

About 10% of sore throats are caused by Streptococcus bacteria, hence the name strep throat. If left untreated, strep throat can be serious. Strep throat can be diagnosed using a throat swab, and it is treated using penicillin or another antibiotic. After taking the antibiotic for 24 hours, strep throat is no longer contagious, and the child can return to daycare if he has no fever and is feeling better.

If your baby has a sore throat, here are a few ways that you can help him:

  • Give him acetaminophen or ibuprofen​ according to the directions listed on the package.
  • Remember that most sore throats are caused by viruses, and therefore antibiotics are not effective. Only sore throats caused by Streptococcus should be treated with antibiotics.
  • Do not give your child leftover antibiotics from siblings or friends.
  • Avoid “rapid” strep throat tests that are performed in shopping malls or at home. They tend to be inaccurate. Your baby’s doctor can administer a reliable throat swab to test for strep throat.

If your baby starts drooling excessively, has great difficulty swallowing or breathing, or is acting very sick, bring him to the doctor right away.

Douglas Campbell, MD, FRCPC

Andrew James, MBChB, MBI, FRACP, FRCPC