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About half of all ear infections resolve themselves without antibiotics. However, your doctor is more likely to prescribe antibiotics if your baby is under six months old, or if your baby is older but your doctor is sure that it is an ear infection. Your GP will recommend which course of treatment to take - watchful waiting or prescription medicines.

In the over-twos, many doctors prefer not to prescribe antibiotics if the infection is not severe, such as where there's fluid in the ear but no sign of fever or infection.

Many GPs are exercising caution these days because more and more bacteria are becoming resistant to antibiotics. So you can also help by not requesting antibiotics for every ear infection as your baby gets older. 

What comfort measures can I offer my baby? 

You can give her a dose of infant paracetamol suspension - to help reduce fever, and ease her pain and discomfort. You can also use ibuprofen, but ask your doctor for advice if your baby is less than three months old, as the dose will depend on your baby's weight.

Is there anything I can do to prevent ear infections?

There are several factors that can help prevent ear infections, including:

• breastfeeding

• if you are bottle feeding your baby, try to keep your baby in an upright position during feeds

• if your baby uses a dummy, use it only for settling your baby to sleep

• not smoking near your baby

There is no need to avoid taking your baby swimming, as there is some evidence that swimming can be good for your baby's inner ears. 

How should recurring ear infections be treated?

See your doctor if your baby keeps getting ear infections, as your baby may need to be referred to an ear, nose and throat specialist.

If your baby's prone to recurring ear infections, she may develop "glue ear", which is a build up of thick fluid in the Eustachian tube (the tube that connects the middle ear to the back of the nose and throat). Glue ear can affect your baby's hearing and may cause delays in speech development as well as behavioural problems. In this case, you may want to ask your GP what he thinks about grommets. These are small ventilation tubes which are fitted into your baby's ears during a surgical operation.

The procedure can be uncomfortable for a baby, and some doctors don't agree with it, but it can help in certain instances. Grommets help drain fluid from the inner ear, which will decrease the chance of ear infections and improve your baby's hearing. The grommets are removed when the Eustachian tubes mature, (around a child's fifth birthday) when fluid build-up isn't as much of a problem.

Doctors often recommend grommets when a child has a problem with fluid in the middle ear over a period of at least three months along with impaired hearing. Babies born with Down's syndrome or a cleft palate are closely monitored for ear problems as they are particularly susceptible to them and from an earlier age than most children. 

Does alternative medicine make a difference?

Homeopathic remedies use minute amounts of naturally-derived substances to stimulate the immune system. Some parents and their children find these remedies and other complementary therapies helpful.

However, homeopathic remedies and other complementary treatments, such as acupuncture, and cranial osteopathy are not recommended by experts for treating ear infections, because there is a lack of evidence that they are effective.

Reviewed April 2008