As the weather warms up, so do outdoor activities like swimming, trips to the river, and beach vacations. But for some kids, these fun adventures can lead to a painful condition known as swimmer’s ear. While swimmer’s ear can be uncomfortable, it’s just one of two common types of ear infections that affect children. Knowing the difference between otitis media (middle ear infection) and otitis externa (swimmer’s ear) can help you take the right steps if your child develops ear pain.
Understanding Ear Infections
Ear infections are one of the most common reasons children are prescribed antibiotics. In fact, five out of six children will experience at least one ear infection by the time they turn three.
The most common type is acute otitis media, which occurs behind the eardrum in the middle ear. Children with this type of infection often experience prolonged ear pain, fever, difficulty hearing or sleeping, and fluid draining from the ears. They may also prefer sitting upright or complain of headaches.
Middle ear infections typically begin with a viral upper respiratory infection, such as the flu or common cold. Bacteria or viruses from the nose and throat can travel into the middle ear, leading to inflammation and increased fluid buildup.
“When there is fluid in the middle ear, the eardrum cannot vibrate,” explains Michael Abdelmisseh, MD, a pediatrician with West Tennessee Medical Group Primary Care in Dyersburg. “The first symptoms you may notice are a feeling of fullness and a decrease in hearing. If the fluid sits still, bacteria and viruses can multiply and cause infection.”
What Is Swimmer’s Ear?
Unlike middle ear infections, swimmer’s ear is an infection of the outer ear canal, usually caused by bacteria in trapped water after swimming. It causes inflammation of the external ear canal and is especially common in children due to their narrower ear canals.
Swimmer’s ear symptoms include:
- Itchiness
- Redness
- Pain when touching or pulling the outer ear
- Fluid drainage
- Difficulty chewing
- Temporary hearing loss due to swelling or pus
While swimming in lakes or rivers with higher bacteria levels increases the risk, swimmer’s ear can also result from skin irritation caused by dry skin, eczema, scratching the ear, or inserting objects like cotton swabs or bobby pins.
Diagnosing and Treating Ear Infections
Any ear pain that lasts more than a day or is accompanied by fever should be evaluated by a doctor.
“Treatment depends on how severe and painful the infection is,” says Dr. Abdelmisseh. “Antibiotics may be prescribed if fluid is visible behind the eardrum or if the child has a fever and pain. However, not all cases require antibiotics. Many ear infections clear up on their own, and over-the-counter pain relievers like acetaminophen can help ease discomfort.”
Preventing Swimmer’s Ear
Prevention is often the best medicine. To reduce the risk of swimmer’s ear:
- Keep ears dry after swimming
- Have your child tilt their head to each side to help drain water
- Gently dry the outer ear with a towel
- Use ear plugs while swimming if recommended
When to See a Doctor
If your child’s symptoms persist for more than two to three days, worsen, or are not managed with pain relievers, it’s time to see a provider.
West Tennessee Medical Group has experienced pediatricians ready to diagnose and treat your child’s ear pain.
Updated: July 16, 2025
