Matthew Miller, MD is an Ear, Nose and Throat Specialist at St. Peter’s Health. He is board certified by the American Board of Otolaryngology – Head and Neck Surgery.
February 23, 2026
Ear infections are very common in children. The medical name for this type of infection is otitis media. It happens when fluid builds up behind the eardrum. Sometimes the fluid is just there, making sounds seem muffled. Other times it gets infected and can cause pain. In rare cases, it can even cause the eardrum to burst or allow the infection to spread.
Who Gets Otitis Media?
Babies and toddlers under age 2 are most likely to get ear infections. This is because their eustachian tube — the small passage that drains fluid from the middle ear — sits at a flatter angle when they are little. As children grow, this tube shifts into a better position and drains more easily.
Things that cause nasal swelling can make ear infections more likely. These include:
Going to bed with a bottle
Exposure to cigarette smoke
Air pollution
Having pets at home
As children get older, allergies, acid reflux and swollen adenoids can also lead to more ear infections.
When Is Otitis Media a Problem?
Most ear infections go away on their own, and most children will have at least one in their lifetime. Doctors may use antibiotics if the fluid gets infected. Nasal sprays can sometimes help fluid drain.
Ear infections become a concern when:
Fluid stays behind the eardrum for three months or more and causes hearing loss.
A child has three or more infections in six months or four in one year.
An infection does not get better after three rounds of antibiotics, including shots.
What Happens Next?
If your child meets these criteria, your primary care provider may refer you to an ear, nose and throat (ENT) specialist.
At the ENT visit, the doctor may:
Check hearing
Recommend watching and waiting
Suggest nasal sprays
Talk about placing ear tubes if fluid is thick, infected or causing hearing problems
What Are Ear Tubes?
Ear tubes are tiny, hollow tubes placed into a small opening in the eardrum. They let trapped fluid drain out through the ear canal instead of getting stuck behind the eardrum. They also make it possible to treat infections with ear drops, which can deliver much stronger medicine than oral antibiotics.
How Are Tubes Placed?
For many years, children needed general anesthesia in the operating room to get ear tubes. This is still true for older kids who may need additional procedures.
But for many younger children, tubes can now be placed in the clinic without fasting or a long hospital stay. The procedure usually takes less than five minutes and causes very little discomfort.
Do Adults Ever Need Ear Tubes?
Yes. Adults can also have trouble with the eustachian tube, especially when flying, driving in the mountains or dealing with allergies. Doctors will try medical treatments first, but tubes can help adults when other options don’t work.
The Bottom Line
If you or your child is dealing with frequent ear infections or ongoing hearing changes, talk with your provider. An ENT evaluation may help you find answers and relief.
