Fort Worth, Texas,
10:24 AM

7 ear infection myths every parent should know

Hear what The Doc Smitty says about ear infections

1. All ear pain is an ear infection.

Ear pain can be caused by many different factors. Often kids just play with or point to their ears. If the child is otherwise cranky, sick or not sleeping well, parents will assume there is an ear infection. However, a study from 1998 showed that parents only identified 70 percent of their children with ear infections and when they suspected an ear infection, it was only present 50 percent of the time. (Translation-they could have just flipped a coin rather than trying to guess.)

This is why getting an antibiotic called in when your child has ear pain is a bad idea - whether it is from your doctor or from one of the new insurance nurse lines that many people are using. Every exposure to antibiotics is a potential risk for allergy or side effects. Unnecessary exposure is not worth it.

2. All ear infections have fever.

Studies are all over the place about what percentage of ear infections have fever. They generally fall between 1-2 out of 3. Regardless, that means a lot of kids with ear infections won’t have fever.

3. Having your child in the wind or under water causes ear infections.

The location of an ear infection is behind the ear drum way back in the inner ear. External exposure like wind and water don’t affect that area. Grandma will have to come up with another reason for their grandbaby to put on a hat when it is cold outside.

What are risk factors?

  • Age (6 months-2 years)
  • Family history
  • Day care
  • Not breastfeeding
  • Smoke exposure
  • Pacifier use (small effect)

4. You can’t go swimming if you have an ear infection.

Related to the previous myth, there is no reason to avoid swimming if you have an ear infection. Unless the ear drum has ruptured the space where the ear infection is located is walled off from the water. Don’t skip the swim party! If the child feels discomfort or pain while swimming, they can play in the shallow end or just have a snow-cone.

5. All ear infections need antibiotics.

Many children with ear infections will get better without antibiotic treatment. The latest treatment guidelines give the following advice for treating ear infections:

  • Children of any age with severe pain, fever or ear drainage should receive antibiotics.
  • Children 6 months-2 years with both ears infected should receive treatment.
  • Children 6 months and up with 1 ear infected and with mild symptoms can be watched for 2-3 days to see if symptoms improve or worsen prior to starting antibiotics.

6. Amoxicillin is not strong enough for ear infections.

Many studies have looked to compare different antibiotic treatments for ear infections. The bottom line is this, there is nothing better at getting rid of infections than amoxicillin. Other antibiotics may work as well, but they are typically more broad spectrum - meaning they cover more different types of infections that those that typically cause ear infections. Because of this, we should reserve those antibiotics for those situations in which they are necessary. Amoxcillin is cheap, well tolerated by most kids and effective. Therefore, except in penicillin allergic patients, it should be used unless the child has been on the medication in the last 30 days.

7. If your child gets tubes, their ear infections are guaranteed to stop.

After a few ear infections, some parents are eager to move forward with placement of tubes. Tubes can be a life saver with kids who have had multiple ear infections and can prevent recurrence of ear infections, but they aren’t perfect. They are a surgical procedure and the inherent risk associated with anesthesia need to be fully explained to a parent. Continued ear infections occur in about 20 percent of children even after they have had tubes placed.

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Comments 1 - 7 (7)
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My baby just turn 1 almost 2 weeks ago she has 2 ear infection and a fever for over 5 days. Is it bad to drive with the windows open if it’s in the 30s out side the mom is telling me she has a reason for it.. do you know of any Beneficial reasons
Melinda Irvine
Dr Smith thank you, this was so helpful. My adopted son is turning 11 next week and desperately wants to swim at his birthday party on the weekend. He was malnourished and lived in extreme poverty until the age of 7, and has had a lot of ear infections in the past 2-3 years (plus for the last 6 months he's been on adult doses of medication for active tuberculosis). (note: we live in the Philippines). A few days I took him for his regular checkup (liver test etc for the TB meds) and his Ped told me one of his ears was red (ear drum intact but an injection there) and not to let him swim at his party. He's not in any pain and has no other discomfort and my heart tells me we need to work on boosting his immune system instead of filling his body with even more medication. Anyway thank you I have decided I will let him swim, or at the very least splash around in the little pool with a swim cap on. Mel.
Justin Smith
Hello Ashley,

It’s possible that there were different strains of bacteria in each ear, the right being resistant to amoxicillin. Ear infections are caused mostly by internal factors, wind and water from the outside are not the cause. Hope this helps.
My 2 1/2 year old daughter was diagnosed with an ear infection in both ears, she was put on amoxicillin for 10 days and only her left ear became better within a few days. She is now on antibiotics again for her right ear still being infected. So my question is how could this happen, and should I try to avoid water getting waters in her ears during bath time??
Erica F
Thank you so much for providing this information. It was very helpful!
This was very helpful, thank you!!
Jenny Riddle
Dr. Smith is the only resource I could find that answered the question if a child can go swimming with a middle ear infection. Thank you for the thorough information. Enjoyed the read.