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Canadian Paediatric Society

Paediatricians continue to encourage watch-and-wait for ear infections

Feb 5 2016

OTTAWA – Paediatricians continue to encourage doctors to ‘watch and wait’ before treating most ear infections with antibiotics in healthy children over six months of age. An updated statement released today echoes previous recommendations for doctors to look for signs that the infection is relatively severe before prescribing antibiotics, which are not needed or effective for mild ear infections.

“Doctors should look for definitive signs that it is a severe ear infection,” says Dr. Joan Robinson, co-author of the updated CPS statement and chair of the CPS Infectious Disease and Immunization Committee. “It’s important to be looking for a bulging eardrum rather than just a red eardrum before prescribing antibiotics. Even then, many children will get better just as quickly with pain relief as with antibiotics.  Side effects are common with antibiotics.”

Ear infections are extremely common, especially in children between six months and three years of age. They are usually not serious and aren’t contagious. Most ear infections happen when a child has already had a cold for a few days. Symptoms include unexplained fever, difficulty sleeping, tugging or pulling at the ears, and overall irritability.

“Most children will have relief with just acetaminophen or ibuprofen,” says Dr. Robinson. “However, the message to parents is, if your child has a cold and then develops signs of an ear infection that do not improve with pain relief, take them to the doctor to check it out.”

The statement lists several ways to help prevent children from getting an ear infection, including:

  • breastfeeding babies,
  • avoiding bottle feeding a baby who is lying down,
  • refraining from using a pacifier too often,
  • avoiding exposure to cigarette smoke, and
  • vaccinating children with the influenza and pneumococcal conjugate at the recommended age.



About the Canadian Paediatric Society

The Canadian Paediatric Society is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,300 paediatricians, paediatric subspecialists and other child health professionals across Canada.

Last updated: Feb 5 2016