Kids and Ear Infections

An ear infection is an acute inflammation of the middle ear caused by fluid and bacteria behind the eardrum. “Usually it starts with a cold, so the child will have a runny nose and a cough. Colds can lead to  ear infections in susceptible children,” says Dr. Nguyen Pham, an ear, nose and throat specialist at CHOC  Children’s. “Older kids will pull on their ears and tell you their ears hurt. For infants, symptoms can include  fever, irritability, or changes in their eating and sleeping patterns. A pediatrician can look at the eardrum  to diagnose an ear infection.” Generally, ear infections are treated with oral antibiotics.

“The best thing families can do is to have really good hand hygiene,” says Dr. Pham. “Everyone should wash hands constantly. Encourage children to not touch their faces with their hands or rub their eyes,” he says. Colds and the flu can frequently lead to ear infections, so children should be protected against colds and get a flu vaccine, Dr. Pham advises.

“An acute ear infection can lead to temporary hearing loss because of the fluid behind the eardrum. That type of hearing loss will get better over several weeks. If it doesn’t get better, that’s the time to go to the pediatrician or a specialist,” says Dr. Pham. If you suspect your child has hearing loss, ask for an audiogram,  which is a formal hearing test. A pediatrician can perform this test or refer the child to a specialist such as  an audiologist or otolaryngologist.

Children who have four or more ear infections per year meet the criteria to have ear tubes inserted into the  eardrum. Ear tubes create a drainage pathway for bacteria behind the eardrum to get out, so infections don’t  form. This is a commonly performed surgery in the U.S. and is very effective in preventing ear infections.


  • Number of babies born in the U.S. with permanent hearing loss: 3 in 1,000
  • Percentage of children in the U.S. with some hearing loss: 10%
  • Percentage of children who will have at least one ear infection by their second birthday: 90%

View the full feature on Kids and Ear Infections

Dr. Nguyen Pham
Dr. Nguyen Pham
CHOC Ear, Nose and Throat Specialist


Dr. Pham specializes in pediatric otolaryngology – head and neck surgery. Dr. Pham completed his residency at the  UC Davis Medical Center and a fellowship at Stanford University. He practiced advanced surgical techniques in airway reconstruction, otological surgery and the treatment of congenital defects at Stanford’s Lucille Packard Children’s Hospital. Dr. Pham has participated in many humanitarian endeavors, including a medical mission to perform cleft lip and palate surgeries in the Philippines and helping patients in New Orleans after Hurricane Katrina. Dr. Pham speaks fluent Vietnamese.

Dr. Pham’s philosophy of care: “My philosophy is to truly listen to my patients and to provide compassionate  care based on the best possible scientific evidence.”

UC Irvine School of Medicine


More about Dr. Pham

This article was featured in the Orange County Register on February 24, 2014, and was written by Amy Bentley.

Don’t Let Flying be a Pain in the Ear for your Family!

If your summer vacation includes a plane ride, read up on tips for avoiding ear pain as a result of changes in air pressure…

While flying, air pressure decreases as you go higher and increases as you go lower. If the pressure isn’t equalized, the higher air pressure pushes on one side of the eardrum and causes pain. That explains why so many babies cry during those last few minutes of the flight, when the air pressure in the cabin increases as the plane prepares to land.

But the pain is only temporary — it won’t cause any lasting problems for kids and usually will subside within a few minutes.

Some simple things to try during air travel can help equalize the air pressure in your child’s ears and eliminate, or at least decrease, ear pain.
• Drink plenty of decaffeinated fluids (water is best) throughout the flight. Drinking a lot is very important, not only because it encourages swallowing (which makes the eustachian tubes open), but also because airplane air is dry, which thickens nasal mucus, making it more likely for the eustachian tubes to become clogged.
• Take acetaminophen or ibuprofen about a half hour before takeoffs or landings if you know your child has ear pain when flying.
• Chew gum or suck on hard candy (only if your child is over 3 years old).
• Take a bottle or pacifier or breastfeed. If you bottle-feed, make sure your baby is sitting upright while drinking.
• Yawn frequently (if your child can do this intentionally).
• Stay awake for takeoff and landing. During sleep, we don’t swallow as often, so it’s harder to keep the air pressure in the middle ear equalized.
• If your child is taking medications that contain antihistamines or decongestants, talk to your doctor about whether to continue them during the flight.

In some cases, a child may continue to have ear pain for longer periods (up to several hours) if the ears don’t “pop.” You can continue to give your child pain relievers according to the package directions until the pain eases. If it continues for more than several hours, call your doctor for advice.

With a little patience and some simple precautions, though, you can make your next family flight less stressful and more comfortable for both you and your child.

Related articles:

    CHOC docs see increase in “swimmer’s ear”

    With kids hitting the pools and beaches to beat the summer heat, some of our pediatricians are seeing an increase in otitis externa, or “swimmer’s ear.”  This is caused by excess water entering the ear canal resulting in redness, swelling, pain and itching.  It can also be caused by use of ear plugs, headphones inserted into the ear, harsh cleaning of the ear canal, or soaps, shampoos and bubble baths.

    Parents can help prevent “swimmer’s ear” by using rubbing alcohol on a cotton applicator to gently clean their children’s ear canals following time in the water.  Use of non-prescription ear drops, which contain half-strength vinegar, can help prevent an infection.  Parents should also check chlorine levels in public pools; keep their kids away from dirty water areas;  limit their children’s time in the water; and make sure to dry their kids’ ears after time in the pool or ocean.