Ear Infection Health Center

Some factors that increase the risk for middle ear infection (acute otitis media) are out of your control. These include:

• Age. Children ages 3 years and younger are most likely to get ear infections. Also, young children get more colds and upper respiratory infections. Most children have at least one ear infection before they are 7 years old.
• Birth defects or other medical conditions. Babies with cleft palate or Down syndrome are prone to ear infections.
• Weakened immune system. Children with severely impaired immune systems have more ear infections than healthy children.
• Family history. Children are more likely to have repeat middle ear infections if a parent or sibling had repeat ear infections.
• Allergies. Allergies may be a risk factor for ear infections. Allergies cause long-term stuffiness in the nose that can affect how the eustachian tube works. Blocking this tube, which connects the back of the nose and throat with the middle ear, can cause fluid to build up in the middle ear.

Other factors that increase the risk for ear infection include:

• Repeat colds and upper respiratory infections. Most ear infections develop from colds or other upper respiratory infections.
• Exposure to cigarette smoke. Babies who are around cigarette smoke are more likely to have ear infections than babies who are not. Also, ear infections seem to last longer in babies who are near cigarette smoke.¹
• Bottle-feeding. Babies who are bottle-fed are more likely to develop ear infections within the first year of life than are babies who are breast-fed. Also, bottle-fed babies may be more likely to get ear infections if they drink their bottles lying down rather than being held in an upright position.²
• Child care centers. Children who are around many other children, such as in child care centers, are more likely to have repeat ear infections than children who are not exposed to many other children.
• Pacifier use. A young child who uses a pacifier is more likely to get ear infections.

Factors that increase the risk for repeated ear infections also include:

• Ear infections at an early age. Babies who have their first ear infection before 6 months of age are more likely to have other ear infections.
• Persistent fluid in the ear. Fluid behind the eardrum that lasts longer than a few weeks after an ear infection increases the risk for repeated infection.
• Prior infections. Children who had an ear infection within the previous 3 months are more likely to have another ear infection, especially if the infection was treated with antibiotics.