A board-certified pediatrician speaks to the nuances of ear infections, and ways to minimize their discomfort and risks.
Are Ear Infections Contagious? An Expert Doctor Explains
Published on Mar. 18, 2025
About the expert
Shannon Godsil, MD, is a board-certified pediatrician at Children’s Nebraska in Omaha. She earned her medical degree from Creighton University School of Medicine in 2013 and completed her residency at the University of Nebraska Medical Center.
Highlights
- Ear infections aren’t contagious, but the viruses that cause them are.
- Kids are more prone to ear infections than adults due to their ear structure.
- Most ear infections clear up on their own, but some need treatment.
- Breastfeeding and vaccination are two factors that help prevent ear infections. Secondhand smoke can prompt them.
Each year, an estimated 20 million cases of acute middle ear infections occur in the United States, according to data shared by the National Institutes of Health (NIH). It’s also been reported that the annual cost of treating this common condition exceeds $4 billion. Given their prevalence—and the potential discomfort before treatment sets in—a doctor speaks to the transmissibility of viruses related to ear infections.
“Acute otitis media (also known as an ear infection) happens when bacteria or viruses infect the small space behind the eardrum, known as the middle ear,” explains Shannon Godsil, MD, a board-certified pediatrician at Children’s Nebraska in Omaha. This type of infection differs from otitis externa, or swimmer’s ear, which affects the ear canal rather than the middle ear.
You may already know that ear infections can cause the following uncomfortable symptoms:
- Ear pain or pressure
- Fluid drainage from the ear
- Hearing difficulties
- Fever
- Irritability, especially in young children
Ahead, Dr. Godsil shares her expert insights on whether ear infections are contagious, as well as strategies to treat and prevent them. If you or your little one are experiencing these symptoms, keep reading.
What causes an ear infection
“A small passageway called the eustachian tube connects the middle ear to the back of the nose and throat,” explains Dr. Godsil. “When the eustachian tube becomes blocked, usually due to a cold or allergies, fluid can build up in the middle ear and will not drain through this tube.” This trapped fluid creates an ideal breeding ground for bacteria or viruses, which can lead to infection.
The most common bacterial culprits behind ear infections include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Viral infections, such as those caused by respiratory syncytial virus (RSV), rhinovirus (which causes the common cold), influenza virus, and adenovirus, can also contribute to ear infections.
Dr. Godsil says certain factors can increase the risk of developing an ear infection:
- Colds, flu, or allergies: Congestion and sneezing can lead to fluid buildup in the ear.
- Frequent exposure to germs: Kids who spend time in group settings, such as daycare or school, are more likely to catch respiratory illnesses that can trigger ear infections.
- Bottle feeding while lying down: Drinking from a bottle while reclining—especially during naps or overnight—can contribute to fluid collecting in the middle ear.
- Secondhand smoke: Being around people who smoke or in environments where smoking occurs increases the risk of ear infections.
Are ear infections contagious?
Ear infections themselves are not contagious, Dr. Godsil confirms. “Your child can’t catch an ear infection from others,” she says. That means once they start feeling better, kids can return to school or daycare while recovering.
However, many ear infections begin with colds, which are caused by viruses that often spread easily from person to person.
Here’s why kids can get ear infections so often
Dr. Godsil explains that children are especially prone to ear infections because their immune systems are still developing, making it harder for them to fight off infections caused by viruses or bacteria.
Specifically, there’s a part of the child’s ear that’s significantly different than an adult’s. “The eustachian tube that connects a child’s middle ear to the back of their throat is shorter, narrower, and more horizontal than an adult’s,” she adds. This structure makes it more difficult for fluid to drain properly, creating an environment where fluid can build up and allow bacteria to grow, increasing the risk of infection.
Should you stay home with an ear infection?
If you or your child have a high fever or feel too sick to go about daily activities, it’s best to stay home and rest. This allows time to recover and helps children get back to their normal eating and sleeping routines.
“Ear infections can be very painful for kids,” says Dr. Godsil. “We do recommend treating the pain and fever that ear infections can cause with antipyretics (acetaminophen or ibuprofen).” Always consult your doctor to ensure the correct dosage.
How to treat an ear infection
“When it comes to safely treating a child’s ear infection, studies show that less is more,” says Dr. Godsil. That’s why doctors often take a wait-and-see approach, holding off on antibiotics for 48 to 72 hours.
About 80% of childhood ear infections clear up on their own, and unnecessary antibiotic use can contribute to antibiotic resistance—making it harder for the body to fight off future infections, including serious ones.
A doctor’s strategies to prevent an ear infection
Preventing ear infections starts with strengthening the immune system and minimizing exposure to potential triggers. Dr. Godsil shares some key strategies:
- Breastfeeding provides early protection: Breast milk contains antibodies that support a baby’s developing immune system, helping to defend against infections, including those in the ears.
- Vaccinations lower the risk: Immunizations can help prevent illnesses that may lead to ear infections, such as pneumonia and meningitis. The flu vaccine also reduces the chances of related complications in children.
- Healthy habits strengthen immunity: Frequent handwashing, a nutritious diet, and other immune-boosting practices can lower the risk of recurrent ear infections.
- Keep ears dry: Trapped moisture creates a favorable environment for bacteria, so it’s important to gently dry ears after swimming or bathing.
- Avoid secondhand smoke: Exposure to smoke can increase inflammation and make ear infections more likely.
- Manage allergies and sinus issues: Treating congestion and allergies can help prevent fluid buildup in the ears, reducing the risk of infection.
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