Throat and ear infections in children

Throat and ear infections are the most common reasons for a child to become unwell. These include tonsillitis and otitis media (middle ear infection). Most of these infections are not dangerous and do not respond to antibiotics. There are things that can be done to help and some important things to know.

What causes infections of the throat or ears?

Most of these infections are caused by viruses, which are similar germs to those that cause colds. These germs are passed on from other people, especially when they have direct contact.

Is it normal for children to get lots of infections?

It is a normal part of early childhood to get quite a lot of viral infections. As long as each infection goes away, leaving the child growing normally and without long term symptoms, it is very unlikely that they have any problems with their immune system.

Does my child need antibiotics?

Studies have shown that in most circumstances antibiotics are very unlikely to help ear or throat infections. Because antibiotics can cause upset stomachs, vomiting, diarrhoea and occasionally dangerous allergic reactions, the best thing is to avoid antibiotics.

What treatment does work?

Simple medicines such as paracetamol and ibuprofen are the most effective treatments for throat and ear infections. As well as treating fever, these medicines are very good at treating the pain that makes children with throat and ear infections reluctant to drink. If your child is drinking less or seems subdued or in pain, give paracetamol or ibuprofen (if they are allowed to have these medicines normally), even if they don’t have a fever.

How long will the infection last?

The time that these infections take to go away varies a lot. The illness can take around a week to settle but the worst part of the illness usually only lasts a few days.

If a few days have passed and your child is getting worse then this is one reason to seek a medical assessment.

What should I expect my child to be like?

Your child will be a bit miserable but alert and interactive. When the fever comes back, they may be a bit worse but they should improve within 1 hour of taking paracetamol or ibuprofen. It is normal during a viral illness to have a fever, a cough, vomiting and diarrhoea. Many children find it too uncomfortable to eat but should manage to drink if their discomfort is controlled by medicines. Make sure that they have little bits to drink often. If they are not eating then try to make sure that what they are drinking gives them energy. Avoid sugar-free drinks and prolonged periods of drinking only water.

When do I need to worry?

When a child has a viral infection, there is always a small possibility that they could develop another infection, so if something changes they may need further assessment. There are certain things that suggest that an infection is not a simple viral illness including:

• looking significantly unwell despite paracetamol or ibuprofen
• pale or floppy episodes
• passing very little urine

More detail about signs of serious illness can be found in the Emergency Department resource Advice for the management of a feverish child.

Who should I contact if I need advice or think my child needs to be seen?

In most cases, calling NHS 111 or seeing the GP (including the out of hours GP or walk in centre) will be the most appropriate way to get advice. If you feel that the situation is more serious, you should attend the Emergency Department.

Further information

Healthier Together website on earache

Healthier Together website on sore throat

NHS.uk website on coughs colds and ear infections in children