We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Ear Problems in Children FREE

Denise M. Goodman, MD, MS, Writer; Cassio Lynm, MA, Illustrator; Edward H. Livingston, MD, Editor
JAMA. 2013;309(21):2284. doi:10.1001/jama.2013.4428.
Text Size: A A A
Published online

Two common ear conditions may affect children. Acute otitis media (AOM) is an infection that usually involves fever, pain, and evidence of middle ear (behind the eardrum) inflammation with effusion (fluid). Otitis media with effusion (OME) is fluid in the middle ear without signs of infection. The eustachian tubes drain fluid from the ears to the back of the throat. When these tubes are swollen or clogged, fluid can build up in the ear, causing these conditions. Risk factors for AOM or OME include exposure to cigarette smoke, allergies, respiratory infections, and drinking while lying on one's back. Avoiding these risks may help prevent these problems. The pneumococcal vaccine prevents one of the most common types of ear and respiratory infections.


The diagnosis of AOM or OME requires a physical examination by a health care professional who will look inside the ear to find fluid or inflammation. Making the diagnosis can be difficult because children's ear canals are small and are sometimes obstructed by wax.


Pain: Treat pain with analgesic eardrops or an over-the-counter medication such as acetaminophen.
Otitis media with effusion: Routine use of antihistamines, decongestants, and antibiotics is not recommended. Children should have a hearing test if OME lasts longer than 3 months or when there are suspected hearing, language, or learning problems.
Acute otitis media: Antibiotics are given to children younger than 6 months because these children have immature immune systems and are less able to fight infections. Between ages 6 months and 2 years, children may be given antibiotics depending on age, certainty of diagnosis, and severity of the infection. Children with nonsevere illness and an uncertain diagnosis may be watched for 48 to 72 hours without antibiotics. Most children do well, but if they do not improve in 48 to 72 hours, they may be given antibiotics.
Tympanostomy tubes are inserted when OME lasts longer than 3 months, there is recurrent AOM (3 episodes over 6 months or 4 in 1 year), or there is significant hearing loss.

Fluid may remain in the middle ear even after an infection resolves. Fluid can also develop without any signs of infection. Children with OME may have no symptoms and do not usually look sick, and most episodes resolve on their own. Even if fluid is present for several months, most otherwise healthy children have no long-term hearing damage or problems with language development. Children with medical problems such as developmental disorders, memory or thinking problems, or speech or motor issues may need early treatment.

Sources: National Library of Medicine, American Academy of Otolaryngology–Head and Neck Surgery, American Academy of Pediatrics, Healthy Children, Agency for Healthcare Research and Quality
Smith N, Greinwald J. Curr Opin Otolaryngol Head Neck Surg. 2011;19(5):363-366.
Schraff SA. Curr Opin Otolaryngol Head Neck Surg. 2008;16(5):406-411.
Spector ND, Kelly SF. Curr Opin Pediatr. 2004;16 (6):706-722.



To find this and previous JAMA Patient Pages, go to the Patient Page index on JAMA 's website at www.jama.com. Many are available in English and Spanish.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Spanish Patient Page: Problemas auditivos en los niños

Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Collections
PubMed Articles