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Column originally published Dec 27, 2016

Colds And Ear Infections

Question: Our four-year-old son has been sick several times already since the fall. He gets one cold after another. He has the usual fever and running nose. Within a few days, he complains of earache. He has taken several courses of antibiotic for ear infections already. I am concerned about so much antibiotics. Is there anything that I can do when he gets sick again? Would it help if he gets the flu shot?


It is not uncommon for young children to have a number of colds during fall and winter. Most of the time, symptoms of cold last for a few days, with fever, running nose, sore throat, and some cough. Swelling and congestion in the nose can lead to blockage of sinuses and Eustachian tubes. These are the tubes that connect the back of the nose to the middle ear, behind the ear drums. This can lead to sinusitis and ear infections.

Although ear infection is a common complication of colds in young children, and likely the most common reason that they are given antibiotics, it can be prevented fairly easily. Topical nasal decongestant like Otrivin can be given as drops or sprays in the nostrils. It can reduce swelling of nasal mucosa and mucus production, allow drainage of sinuses as well as Eustachian tubes, thereby prevent both sinus and ear infections.

The key is to begin using this over-the-counter medicine shortly after the onset of a virus infection, when you notice an increase in nasal congestion and running nose. For younger children, parents can use Otrivin as nasal drops when they are laying down, put one to two drops in each nostril. Keep the child laying down so that the drops can go to the back of the nose to work.

Since your son is four already, you can use one spray for each nostril. Try to direct the spray outwards instead of towards the septum of the nose. If your son can sniff the medicine in after you spray, that would work well. Otherwise, lay him down after you spray, so that the medicine can run into the back of his nose instead of running out. Most children don’t like Otrivin because it tends to sting the nose and tastes quite bad, but it is very effective.

Use the Otrivin two to three times a day for three to five days without stopping. You can use additional saline drops or sprays in between Otrivin to soften the mucus inside the nose. However, saline does not reduce swelling of nasal passage or Eustachian tubes. Therefore, it doesn’t prevent sinus or ear infections.

It is always a good idea to get the flu shot. However, you have to understand this: flu shot only prevents influenza infection, it doesn’t prevent colds caused by other viruses. There are hundreds of respiratory viruses that can infect children. He will be exposed to them in daycare and when he plays with his friends. There is just no way to avoid them. Getting virus infections help children to build up their immune system.

Influenza is a more serious respiratory virus that can cause complications like pneumonia. That is why doctors recommend children and seniors (as well as those who have chronic conditions) to get flu shot once a year to prevent these serious complications. He will still get his share of colds.