Recently parents have been asking me an earful of questions about why their children get so many ear infections — and if anything can be done to prevent them.

Well, let me try to lend an ear on this topic by providing some guidelines from the American Academy of Pediatrics regarding treatment of ear infections.

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What causes an ear infection?

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Eighty percent of ear infections in children are caused by viral germs which get better simply with tincture of time.

The rest are caused by bacteria that need an antibiotic. Since these are in the minority as a cause, the American Academy of Pediatrics now suggests not treating ear infections in children over six months of age automatically with an antibiotic — but helping to treat the pain with the hope that the viral germ will go away in a day or two.

If not, then antibiotics might be considered. This is being recommended to prevent overuse of antibiotics which can make the bacterial germs resistant to common antibiotics and more difficult to treat.

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What if it won’t go away?

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If there is no improvement and recurrent infections continue to occur, sometimes an ear nose and throat specialist may be needed to put tubes into the ear. These tubes will help fluid in the ear drain so that germs do not grow.

Just because we may not prescribe antibiotics immediately does not mean we will not treat the pain with ibuprofen or acetaminophen.

Warm compresses against the ears (not hot), an extra pillow for children who have outgrown cribs, or sitting your child up to lessen pressure in the ear will also help.

What can we do to prevent them?

Of course, the best way to deal with an ear infection is not to let that happen.

– The best way to do this is to teach your children good handwashing. This is especially important if they have been around other children with colds.

– In addition, breastfeeding your baby for at least the first six months, avoiding exposure to cigarette smoke, and making sure their immunizations are up to date, including flu vaccination, decreases the risk of ear infections occurring.

– Keeping children away from environmental tobacco smoke will make it easier for viruses to get out of the nose so they do not move up into the ear canal and cause an infection.

Hopefully, tips like these (and I don’t mean Q-tips) will give you the information you need so an infection is ear today and gone if not tomorrow, at least in a few days.

Lewis First, MD, is Chief of Pediatrics at The University of Vermont Children’s Hospital and Chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.