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How can families stop the spread of germs that cause otitis media (OM)?

Many infectious illnesses such as the common cold or the flu can lead to OM. Parents should keep babies and children away from other children and adults who are sick. People can spread germs that cause OM by sneezing, coughing and touching each other. Children need to be encouraged to wash and dry their hands after coughing. Bad germs also live in the nose so it is important that children blow their noses regularly and throw away dirty tissues in the bin. Having children sleep in their own bed and washing every day with soap also helps prevent OM spreading among children.

What important things should parents know about detecting OM in their child? 

It is not always easy to tell if a baby or a young child has an ear infection. A child with an ear infection may not always have ear pain. Parents should be aware that ear infections can occur in Indigenous babies in the first months of life and that regular visits to the health centre for ear checkups is recommended. Parents need to be aware that ear infections often occur when a child has a cold, runny nose, chest infection or cough. It is important that families understand that most children with OM will have some hearing loss and to be aware of the typical signs of hearing loss in babies and children (see Signs of hearing loss in the Hearing and education section).

What are some practical ways health services can improve the prevention of OM?

Health services can help raise awareness among families and schools about the risk factors of OM. Recognising the early signs of OM and hearing loss is also important. It should also be emphasised that OM can occur in children that appear to be well and that children need to visit the health centre regularly for ear check-ups. Health services can also provide advice to families and teachers about ways to improve communication with children with hearing loss. This can help prevent problems with language and speech development in early childhood.

What are the main risk factors of OM?

A risk factor of a disease is something that can increase or decrease a person’s chance of getting a disease. There are several risk factors associated with OM. If families take action to address these problems they may be able to prevent their child from getting OM. 

Personal hygiene 

Nasal discharge (snot) and sputum carry viruses and bacteria that cause OM. These bacteria can be spread from person to person. To avoid spreading the bacteria children should wash and dry their hands with soap after blowing their noses or coughing. Children’s faces should also be kept clean of discharge. Children should be encouraged to wash their hands regularly throughout the day.


The bacteria and viruses that cause OM can be passed from person to person so can spread very easily in houses with a lot of people. To reduce the spread of the bacteria children should sleep in their own beds and try to avoid contact with sick children and adults.


Breastfeeding helps to strengthen the immune system of an infant so it is healthy and able to fight infections, like the infection that causes OM. It is recommended that infants are breastfed for at least 6 months.

Bottle feeding

Infant formula does not have the same immune strengthening properties as breast milk, so infants that are fed formula may develop OM more easily than infants that are breastfed. If an infant is bottle-fed it is best to hold them in an upright position with the bottle instead of lying them down with it. Feeding while lying down can cause formula and other fluids to flow back into the Eustachian tubes (the tubes that connect the back of the throat to the middle of each ear) and lead to an infection of the middle ear – OM.


Eating a healthy diet helps children build strong immune systems. Children with strong immune systems are less likely to get OM. To stay healthy children should eat less junk food and more fresh healthy foods. A healthy diet contains lots of fruit and vegetables, wholegrain breads and diary, and not very much salty and sugary food like fast food and soft drink.

More information about healthy eating can be found at the following link: The Aboriginal and Torres Strait Islander guide to healthy eating.


Smoking around babies and children weakens their immune systems so they are less able to fight diseases such as OM. Smoke also irritates the Eustachian tubes (the tubes that connect the back of the throat to the middle of each ear) and can cause them to swell. Exposure to smoke even makes the bacteria that cause OM stick inside the tubes more easily. These things make it much easier for OM to develop. Parents and family members should not smoke around babies and children.


Using a pacifier (dummy) makes it easier for bacteria from the nose to move to the middle ear, increasing the risk of developing OM. It is recommended that pacifiers are only used until the baby is 6 months old.


Swimming has a lot of health benefits for babies and children but can sometimes make OM worse. If swimming is known to have caused OM or is making it worse in a child it is okay to tell parents to stop their child from swimming to keep their ears dry. Swimming is still very good for health overall though so should not be completely discouraged to all parents.


Pneumococcal vaccination (Prevnar 13) can help prevent OM. Influenza vaccination given just before the flu season may also help prevent OM. Recommendations for when to vaccinate children may vary between the different states in Australia.

Find out more information about additional vaccinations recommended for Indigenous Australians at the Immunise Australia program: Aboriginal and Torres Strait Islander website, and check the Australian immunisation schedules website for local immunisation schedules.


Couzos S, Metcalf S, Murray RB (2001) Systematic review of existing evidence and primary care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations. Canberra: National Aboriginal Community Controlled Health Organisation and Commonwealth Department of Health and Aged Care

Darwin Otitis Guidelines Group (2010) Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations. Darwin: Menzies School of Health Research

© Australian Indigenous HealthInfoNet 2013 
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    Last updated: 7 March 2013
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