Reducing Your Risk of Middle Ear Infections
by Alayne Ronnenberg, ScD
Viruses can pass easily from person to person, especially children. This can make ear infections hard to avoid. Some steps that may help include:
Avoid Irritants or Allergens
Smoke and allergens can irritate the airways. It can cause swelling and increased fluids. This can make it easier for germs to settle in or travel to ear. To decrease these risks:
Consider Breastfeeding Your Baby for at Least the First 6 Months
Breast milk can make your baby's immune system stronger. This may mean fewer illnesses in first few years.
If You Bottle-feed Your Baby, Keep Your Baby’s Head as Upright as Possible
Fluid can travel from the back of the throat, up to the ear. This happens more often in babies because of short tubes between the throat and ear. Keep your baby's head upright when bottle feeding. This will let fluid flow down to stomach instead of up to the ear. Angled bottles may also help.
Never lay your baby down flat in bed with a bottle.
Preventive Care for High Risk
Some children may have many infections in the ear. There may also be problems with fluid that increase the risk of new infections. Long-term antibiotics may be given to prevent a new infection.
The tube between the ear and the back of the nose is shorter in all children. In some this tube may be causing more fluid buildup and infections. A surgery called myringotomy may help. It places a tube inside the ear. Most tubes will fall out or be removed within 6 months to 1 year.
Limit Pacifier Use
Regular use of pacifiers increase the use of ear infections. It may be best to use them only when going to sleep. Try to wean your child from the pacifier by the time they are 1 year old. When in use, set rules for when the pacifier can be used. Wash the pacifier and/or replace it often. This is most important after a cold, sore throat, or other infection of airways.
Wash your hands often. Teach your children to do the same. If your child chews on toys, keep those toys separate. Wash them well before they are played with again.
Cover your mouth with a disposable tissue or elbow when they cough or sneeze. Throw the tissue away after use. Teach your child to do the same.
Check Snoring Out
Snoring in children may be caused by large adenoids. Adenoids sit at the back of the nose. If they are too big they may block the tube from the ear to the back of the throat. This will make it hard for fluid to drain from the ear and increase the risk of infections. The doctor may recommend that your child have their adenoids removed. The surgery may not stop middle ear infections. It can help to get rid of fluid buildup in the ear.
Acute otitis media (AOM) in Adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-otitis-media-in-adults. Updated September 4, 2019. Accessed December 5, 2019.
Acute otitis media (AOM) in Children. EBSCO DynaMed website. Available at: https://www.dyname.... Updated September 4, 2019. Accessed December 5, 2019.
Ear infections in children. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at:
...(Click grey area to select URL)
Updated May 12, 2017. Accessed December 5, 2019.
Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013 Mar;131(3):e964-99
Middle ear infections. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Middle-Ear-Infections.aspx. Updated February 22, 2013. Accessed December 5, 2019.
12/16/2011 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance https://www.dyname...: Azarpazhooh A, Limeback H, Lawrence HP, Shah PS. Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev. 2011;11:CD007095.
3/31/2014 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance https://www.dyname...: Vernacchio L, Corwin MJ, et al. Xylitol syrup for the prevention of acute otitis media. Pediatrics. 2014;133(2):289-295.
Last reviewed December 2019 by EBSCO Medical Review Board Nicole Meregian, PA