Ear infections are very common in small children. It is common for small children to have multiple ear infections per year, even up to one every month. There are two types of ear infections: middle ear infections (otitis media) and outer ear infections (otitis external). In the case of middle ear infections, there can be a build up of fluid behind the eardrum that doesn’t clear, this is called glue ear. Glue ear can present with hearing problems, ear pain, sleep disturbances, irritability or even problems with balance. Occasionally some cases of glue ear require a minor operation to insert ventilation tubes, ‘grommets’ to allow the fluid to drain out.Middle ear infections are often caused by viruses and therefore do not require antibiotics. Antibiotics do not treat infections caused by viruses. Exposure to cigarette smoke from household contacts is a known risk factor for middle ear infections. Decongestants, anti-histamines and corticosteroids are not effective in middle ear infections.Outer ear infections almost always need treatment with antibiotic drops.