Demographics

Infection of the outer ear is common. In the United States, it is more
common in the summer months and in the warmer and more humid parts
of the country and is more likely to affect adolescents and young adults
than very young children.
Infection of the middle ear, however, is much more common in young
children than in older children or adults. There are two reasons for this.
First, the immune systems of young children are less well developed than
those of older children; second, the Eustachian tubes in young children
enter the upper throat at a lower angle than in older humans. This difference
makes it easier for disease organisms to stay in the tubes and cause inflammation
and swelling rather than being carried downward into the throat.
Infections of the middle ear are very common in children between
six months and three years of age. According to the National Institutes
of Health (NIH), 50 percent of all children in the United States have
at least one episode of otitis media by the time they are a year old, and
80 percent have an episode by three years of age. The costs of treating
these infections and their complications come to $4 billion each year.
Otitis media is more common in the fall and winter months in the
United States. It is somewhat more common in boys than in girls and
is more common in Native Americans than in children of other racial
groups. The reasons for these differences are not known.

Factors that increase a child’s risk of middle ear infections include:
  • Heredity. Repeated infections of the middle ear are known to run
    in some families, although no specific genes have been linked to
    otitis media.
  • Having a cleft palate.
  • Day care. Children in day care settings are exposed to common colds
    and other upper respiratory infections that can lead to otitis media.
  • Exposure to tobacco smoke or air pollution.
  • Feeding position. Babies who are fed from a bottle while lying down
    are at greater risk of ear infections than those who are held upright.
  • Family history of frequent ear infections.
  • Use of a pacifier.
  • History of allergies.

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