Risk Factors for Middle Ear Infections

A risk factor is something that increases your chance of an illness.

It is possible to get an ear infection without the risks below. The more risks you have, the better the chance of getting an ear infection. Talk to your doctor about ways to lower your risk.


Ear infections are common in children. It is much more common in children aged 6 months to 6 years than adults.

Daycare Attendance

Ear infections are often linked to viruses like colds. These types of viruses spread quickly in places where people gather, especially children. Kids who go to daycare or nursery school have a higher risk of ear infections.

Exposure to Cigarette Smoke

Cigarette smoke can irritate airways. This can increase the risk of infections of airways. This can increase the risk of infections in ears. This holds true for smokers and children who live with smokers.


Children who live in polluted areas have a higher rate of ear infections.


Ear infections are most common during the fall and winter.

Other Health Issues

The risk of ear infections may be higher for people with health issues such as:

  • Allergies or asthma seem to increase the risk of ear infections most often when pollen counts are high
  • Illnesses that lower immune system such as AIDS
  • Health issues present at birth that make it hard for the ear to drain well such as cleft palate, Down syndrome, or fetal alcohol syndrome

Daily Habits

  • Children drinking from a bottle while lying down. May allow fluid to get into ears.
  • Regular use of pacifier.

Family History

Ear infections may run in families. A child may have a higher risk of ear infections if older brothers or sisters had them.



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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, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013 Mar;131(3):e964-e999
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.
Last reviewed September 2019 by EBSCO Medical Review Board Marcie L. Sidman, MD

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