Q: My 12-month-old has had an ear infection for a month and it spread to both ears. Should we go to a university hospital?
Updated: Sep 7
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My 12-month-old baby has been struggling with an ear infection for a month. Initially, we took medication for nearly two weeks, and it seemed to clear up. However, a few days later, my baby developed a cough with phlegm. We went back to the clinic and were diagnosed with pneumonia and another ear infection, so we’ve been on medication for over 10 days now. Today at the clinic, we were told the ear infection has spread from one ear to both ears. We currently go to a large children's clinic, but we see a different doctor every time.
Should we just continue with the medication? I read online that if an ear infection lasts more than a month, we should visit a larger hospital. Does that mean we need to go to a university hospital? Currently, there is no runny nose or fever, just some phlegm and an occasional cough.
Answer:
You have been through a lot dealing with your baby's ear infection for almost a month.
Here is a quick summary of your baby's current situation:
• Initial ear infection → Improved after 2 weeks of medication
• Relapse a few days later with pneumonia and ear infection → On medication for over 10 days
• Today's update: Infection spread from one ear to both ears
• Current symptoms: Phlegm and occasional cough; no runny nose or fever
Key Point:
For a 12-month-old infant, a recurrent or persistent ear infection lasting more than 4 weeks requires an evaluation of their response to antibiotics and a check for other underlying causes.
What to Do Now:
Consult Your Current Doctor First
Discuss the following with the pediatrician you are currently seeing:
• "We have been treating this for 4 weeks, and it has spread to both ears. Do we need to change the type of antibiotic?"
• "What is the condition of the eardrums? Is there still fluid (effusion) left in the middle ear?"
• "Is it time to get a referral to an Ear, Nose, and Throat (ENT) specialist?"
When to Consider an ENT Referral
Based on your pediatrician's judgment, an ENT referral may be discussed if any of the following apply:
• No improvement even after changing antibiotics 2 to 3 times
• Fluid in the middle ear persists for more than 3 months
• Suspected hearing loss (decreased response to sound, delayed speech development)
• Recurrent ear infections (3 or more times within 6 months, or 4 or more times within a year)
Regarding "Large Hospitals / University Hospitals"
• The proper step is to first get an ENT consultation or a referral letter from your current clinic.
• University hospital ENT departments are typically for when surgical procedures, such as an eardrum incision (myringotomy) or ear tube insertion, become necessary.
Home Care Tips
• Use saline nasal drops or a gentle saline wash (2–3 times a day) to help reduce postnasal drip and phlegm.
• Maintain indoor humidity at 40–60%.
• Slightly elevate your baby's upper body during feeding and sleeping to relieve congestion and prevent reflux.
When to Seek Immediate Medical Attention:
• Sudden onset of high fever (38.5°C / 101.3°F or higher)
• Constant crying from ear pain or frequently pulling at the ears
• Discharge or pus draining from the ear
• A noticeable decrease in response to sounds
• Difficulty breathing or bluish discoloration of the lips/skin (cyanosis)
In summary, since the infection has spread to both ears after 4 weeks of treatment, please ask your current pediatrician about the need to switch antibiotics and whether an ENT consultation is required at this stage. Consistent follow-up is the best way to ensure your baby fully recovers.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
