Adults with a middle ear infection may describe sound as being muffled - the result of the fluid there. If the pressure is greater than the tympanic membrane can handle, the eardrum will rupture and the fluid will drain out. The child will then feel better although still with an ear infection. Health care providers give antibiotics to clear up the infection and then there must be a waiting time for the tissues to heal, the eustachian tube to open, and air to refill the area. There are no laboratory tests that are easily available to clinicians to help them make the diagnosis.
Children have several reasons for more ear infections.
Anatomy has a lot to do with it. The child's eustachian tube is shorter, flatter, and actually wider. It allows fluid and bugs to enter the middle ear more easily. Another reason is that children are immune to fewer bacteria than adults are and their frequent use of day care means they are exposed to lots of bugs in a population not used to using kleenex, covering sneezes, washing hands, etc. Third, is to not feed babies lying down which allows milk to pool at the eustachian tube opening.