Why Do Kids Get So Many Ear Infections?
Wondering why kids get so many ear infections? Learn the causes, symptoms, risk factors, and when it may be time to consider ear tubes.
If you’re a parent, chances are you’ve spent a night or two up with a child crying from an earache. Ear infections are one of the most common reasons kids end up at the doctor — but why are they so frequent in children?
The Role of the Eustachian Tube
Inside each ear is a small passageway called the eustachian tube, which connects the middle ear to the back of the nose. Its job is to equalize pressure and allow fluid to drain out of the ear.
In kids, this tube is:
More narrow → easier for it to get blocked
More horizontal → harder for fluid to drain
Think of it like a pond with no outlet: when fluid sits stagnant, bacteria or viruses can grow. As children grow, the eustachian tube becomes larger and more vertical, so fluid drains more easily. That’s why most kids “outgrow” ear infections over time.
Symptoms to Watch For
Ear infections can be obvious, but they can also be surprisingly sneaky. Oftentimes children aren’t old enough to communicate that their ear hurts. Parents often notice:
Tugging or pulling at the ear
Fussiness or irritability, especially at night
Trouble sleeping
Fever
Trouble hearing, or saying “what?” more often
The Impact of Recurrent Infections
Frequent ear infections don’t just mean more antibiotics or more sleepless nights. They can also:
Cause kids to miss school (and parents to miss work)
Affect hearing, especially if fluid lingers behind the eardrum
Delay speech development if hearing is muffled during a critical learning stage
Create ongoing family stress from repeated illness and doctor’s visits
Why Some Kids Are More Prone
Not every child gets the same number of infections. Some factors that make ear infections more likely include:
Daycare or school exposure (more germs being shared)
Secondhand smoke (irritates and swells the eustachian tube)
Allergies (irritates and swells the eustachian tube)
Large adenoids (can physically block the eustachian tube)
Treatment Options If Infections Keep Coming Back
Most kids eventually outgrow frequent infections, but for children who keep struggling, ENTs have tools to help.
Ear tubes (tiny ventilation tubes placed in the eardrum) can be very effective. They:
Let fluid drain out, which improves hearing.
Remove trapped infected fluid, curing the infection.
Provide ventilation, which reduces the chance of future infections.
Allow drainage you can see, so infections are recognized earlier.
Enable antibiotic ear drops instead of oral antibiotics, delivering medicine directly to the problem site at much higher concentrations without whole-body side effects.
For some children, especially those with large adenoids blocking the eustachian tube, an adenoidectomy may also be recommended. Removing the adenoids can improve airflow and drainage, further reducing infections and congestion.
Bottom line: Kids get ear infections more often than adults because of their short and horizontal eustachian tubes. If your child is getting recurrent ear infections (≥3 in 6 months or ≥4 in 12 months) and getting treated with multiple rounds of antibiotics, it may be time to consider tubes.