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Q: My son is 18 months old and gets chronic ear infections. What causes ear infections and what can we do to avoid them?

Ear infections are one of the most common childhood infections, with around 31 million cases each year worldwide, so you’re not alone! An ear infection can occur with a bacterial or viral infection when fluid accumulates in the middle.

Children who get ear infections in the first few months of life tend to get more ear infections later. And there's a genetic component—if you had ear infections as a child, your son may be more likely to get them as well. Other factors include allergies, secondhand smoke, swimming in dirty water, and going to daycare—kids who spend time in close quarters with other children are more likely to pick up colds that can lead to an ear infection (the same goes for siblings who may bring a virus home).

While you may not be able to change your son's genetics, there are still some things you can do. If your son still uses a bottle, avoid letting him drink from it while lying down—the sucking action and flat position can make it hard for the ear to drain. Make sure your son is being treated for any potential allergies he might have, and help him practice good hygiene, like washing hands, to avoid picking up colds and germs. If the infections continue, you can have his physician check him. Rarely, cholesteatomas—benign growths in the ear partially caused by ear infections—can also contribute to the problem.

If untreated, ear infections can lead to more serious problems like hearing loss, so it's important that you stay on top of it. Your physician will be able to help treat the problem, if necessary by inserting tubes to help drain and ventilate the middle ear while it heals.

David S. Crow, MD


David S. Crow, MD
71 Kanoa St., Suite 101
Wailuku, HI 96793