Acute otitis media (or AOM) is one of many types of ear infections, that can be associated with hearing loss. AOM refers to inflammation and infection of the middle ear, which is the space behind the ear drum.^1,2,3

Although AOM typically resolves on its own, it can sometimes persist and require medical attention or treatment.^2,3

Did you know?

• AOM is most common in children aged 6-18 months, but it can also affect adults^3,4

• 75% of children will experience at least one episode of AOM by school age⁴

When the middle ear becomes infected, some fluid collects behind the ear drum and usually clears itself as the infection resolves.^1,3 Some children may experience ‘glue ear’ as a result of repeated infections - where the fluid stays behind the ear drum for many weeks or months.^1,3 This can be painful for a child, and also make it difficult to hear properly.^1,3

So…is AOM just an ear infection?

Not quite. AOM is a complex condition associated with both illness and hearing loss.²

Hearing loss from AOM may result in long-term developmental problems: impaired language skills, decreased school performance, speech disorders, as well as anxiety and depression.^2,5,6,7 Due to the potential life-long impact that hearing loss can have in children, it is important to be aware of AOM, how to help prevent it and when to seek medical attention.

Common symptoms of AOM are similar to symptoms of a cold (such as a sore throat, runny nose, fever) in addition to ear pain.^1,3

The ear pain is caused by fluid collection behind the ear drum during an infection.^1,3 In some cases, the ear drum may burst from the pressure and ooze a yellow discharge. Fortunately, a burst ear drum normally heals itself, but it’s best to have it checked by the doctor.^1,3

Older children may also notice the following symptoms:⁵

• Decreased alertness

• Boredom

• Watching others for cues

• Poor concentration

• Behavioural problems

Babies and younger children may have trouble communicating how they feel, and instead may:^3,5

• Cry a lot

• Rub or pull on their ears

• Have trouble falling asleep

• Become irritable

• Lose their appetite

It is also important to know the signs and symptoms of ‘glue ear’ (which can follow episodes of AOM) – these may include:¹

• Pressure or pain in the ear

• Irritability

• Problems sleeping

• Problems with balance

Children who have ‘glue ear’ may have problems with their hearing, so they may talk more loudly, listen to the television loudly, or ask to have things repeated to them more often than usual.¹

Episodes of AOM are typically caused by another illness, such as a cold or a sore throat.^3,6

Bacteria or viruses are able to spread from the back of the throat to the middle ear, through a connecting tube known as the Eustachian tube.^1,3,6

The infection in the middle ear causes swelling and fluid build-up, which then puts pressure on the eardrum.³

In the general population, babies and young children experience more episodes of AOM than older children and adults. This is because they have much smaller Eustachian tubes - making it easier for germs to travel from the throat to the middle ear to cause an infection.^1,3,6

Other known risk factors of AOM include:^6,7

• Group childcare and overcrowding

• Poor air quality

• Bottle feeding (especially with the infant lying down)

• Seasonal factors – ear infections are most common during winter and autumn

In Aboriginal and Torres Strait Islander children, middle ear infections are a significant cause of hearing loss.^5,8 Aboriginal and Torres Strait Islander children may experience AOM earlier in their lives. Ear infections may be more severe, frequent and persistent, compared to non-Indigenous children.^5,8 Aboriginal and Torres Strait Islander children are reported to have one of the highest rates of AOM around the world.^2,8 This can negatively impact their educational and social development, and contribute to various mental health problems including anxiety and depression.²

The doctor may examine your child with a device called an otoscope, which allows them to see the eardrum.³

The doctor may also ask questions about the type and duration of symptoms your child has been experiencing. Children who have had several infections may also need a hearing test.³

AOM is often caused by viruses, and most cases will resolve without the need for treatment.^1,4 However, a doctor may prescribe antibiotics in very young or very unwell children, if there is a risk of bacterial infection.^1,4 If your child has pain, discomfort or a fever, speak to the doctor or pharmacist about the suitability of over-the-counter medicines (such as paracetamol) for pain and fever relief.^3,4

For children who develop glue ear but are not bothered by it, treatment may not be needed, as glue ear usually clears up by itself over time.¹ If your child still cannot hear properly several months after a middle ear infection, seek advice from a doctor or specialist.³ In some cases, surgery may be required to help drain fluid from the middle ear.¹

It is important NOT to insert anything into your child’s ears, unless advised by a healthcare professional.⁵

There are several actions you can take to help prevent AOM from occurring in the first place:^3,5,6,9

• Ensure children receive all their recommended vaccinations on time

• Keep children clean - including regularly washing their face and hands (especially after blowing their nose or coughing)

• Quit smoking or avoid smoking around children

• Breastfeed if possible and continue past 6 months

• If bottle-feeding, hold the infant in an upright position

• Avoid using dummies or pacifiers at 6 months

You should see a doctor if you think your child may have an ear infection and your child:^1,3,4,6

• Is younger than 6 months

• Is of Aboriginal or Torres Strait Islander heritage

• Has symptoms lasting longer than 24 hours

• Has trouble hearing weeks after the initial infection

• Has severe ear pain

• Has pus or bloody discharge leaking from the ear

• Has frequent ear infections