Troublesome Young Ears
It's not unusual for babies and toddlers to get ear infections. Ninety percent of children have at least one by the time they're 2 years old, according to one study. Anatomy is the main reason little ones are afflicted with ear troubles. The eustachian tubes are angled less steeply in children than in adults, which makes it harder for fluid to drain from the middle ear. And kids' tubes are also shorter, which makes it easier for germs in the throat to work their way up into the middle ear. The muscles that open the tubes and allow fluid to drain (this is what you flex when swallowing to relieve ear pressure) are also not as well developed in babies and toddlers. Plus, young children have a less-mature immune system, so they can't fight off infections as well as adults can. As a result, they're more susceptible to the upper respiratory infections (colds and flus) that can lead to ear infections.
Fortunately, the rate of ear infections declines after age 3, which is when a lot of these factors start to change. However, there are some things that put your child at a greater risk for ear infections even beyond age 3. Frequent ear infections tend to run in families. In the same way that blue eyes or athletic ability is inherited, how well your ear muscles open and close is also passed on. When I have a patient who has had several ear infections, I ask his parents if they also had ear problems as children. Most moms and dads don't remember, but they're often reminded of their ear troubles after talking with their own parents. It's likely that they outgrew the problem by adulthood, and they are relieved to learn that their child probably will too.
Children with allergies are also prone to ear infections. The congestion caused by exposure to dust or pollen blocks the eustachian tubes so they can't drain. This can quickly lead to an ear infection when germs invade. Babies who are born with a cleft palate or Down syndrome are also more likely to get ear infections. The differences in their anatomy make it harder for their eustachian tubes to function properly.