Otitis media — commonly known as a middle ear infection — is practically a rite of passage for infants and toddlers. The primary reason for little ones’ vulnerability: Their developing ears are more prone to fluid buildup and conducive to invasion by germs than those of adults. The eustachian tube, the ear-to-nose drainage passage for fluid from the middle ear, is shorter in children. If bacteria or viruses infect the tube due to a cold or allergies, it can become inflamed, as can the nearby adenoid glands. Fluid may become trapped in the swollen middle ear, causing pain.

Know Your Child’s Risk

If your child reaches age 3 without having had an ear infection, he’s an exception to the rule — most children have had at least one ear infection by this age. If he’s had an infection, he’s more likely to have another one. Many other factors can increase his risk, including allergies, bottle-feeding, exposure to cigarette smoke and history of respiratory illness.

Fall and winter are the times of year to be especially vigilant against ear infections. As we enter cold and flu season, these illnesses can be precursors to an ear infection. Be alert if your child attends day care or playgroups, where she is vulnerable to catching a respiratory infection.

Keep Your Eyes and Ears Open

Determining whether your child has an ear infection can be a challenge, especially if she hasn’t yet begun talking. Discharge from the affected ear sometimes occurs, usually when the eardrum ruptures from the pressure of pent-up fluid behind it. More reliable symptoms can be easy to miss or misinterpret, unless you’re keenly attuned to your child’s mood and body language.

If your child seems to have developed a preoccupation with her ear — perhaps she can’t stop touching, tugging or rubbing it — she may be experiencing pain she can’t verbalize. Children who talk may complain of feeling as if water is in their ears or that everything sounds too quiet. An ear infection may affect the way your child usually behaves, potentially turning a happy toddler who eats and sleeps well into a grumpy, reluctant eater and fitful sleeper.

If you feel sure your little one has an ear infection, take him to his pediatrician for confirmation. Treating the infection may be as simple as letting your child’s immune system do its job; if that doesn’t work, or if the infection is severe, the pediatrician will likely prescribe antibiotics to get your child back to his smiling, pain-free self.