Female Speaker: Eight month old Jack is making his first visit to Boston Common Park. This stroll through the park comes just three weeks after his first trip to an emergency room. Carol Thornton remembers that sleepless night. Carol Thornton: He woke up in the middle of the night pulling his ear, crying, wanting his bottle, and I couldn't console him and I had to take him to emergency room the next morning because he was so miserable and he is not normally a crying baby and the doctor looked at him and said, "No wonder he is so sad, his ears are inflamed, he has an earache. So here he is, eight months old, already on antibiotics. Female Speaker: What cause this sudden and painful attack? Jack had picked up a cold and doctors say this lead to the ear infection. The same thing happened to 16 month old Jerome. What began as a common cold ended in a trip to the doctor? The diagnosis, infection of the middle ear, also known as otitis media. Each year, parents in the U.S. will make about 30 million trips to the doctor's office for middle ear infections. Most of these visits are during cold and flu season beginning in the early fall and continuing through the spring. Experts say the anatomy and physiology of young children's ears make them vulnerable to infection. The ear has three parts, the inner ear, the outer ear and the middle ear. For infants and toddlers of the tube that leads from the nose to the middle ear, the eustachian tube is different from that of an older child or an adult. It's horizontal and wider and shorter than the adults. This makes it easier for germs to travel into the middle ear when the tube is blocked, say from the congestion of a cold, fluid that normally drains from the middle ear cannot exit. The combination of blocked fluid and the entrance of a bacteria are sometimes a virus can create an infection. It's the fluid birching on the ear drum that causes pain. The younger a child is when he has his first ear infection, the more likely he will be to have repeated infections. Some kids are genetically at risk for more ear infections, it can run in families. Kids with allergies usually have more congestion and swelling in the nasal passages which can lead to year round ear aches. And boys tend to get more ear infections than girls. Here are some symptoms to watch for. Ear pain and tugging on the ears. Irritability and crying, head shacking, especially with a fever, problem sleeping because lying down can make ear pain feel worse. And since sucking and swallowing can worsen ear pain, child may have trouble eating. And with infants sometimes irritability may be the only clue. Even that is not always present. Healthcare providers use an instrument called an otoscope to diagnose middle ear infection. With the otoscope, a doctor can see the ear drum and determine if there is inflammation of the middle ear. A tympanometer can be used to check for the accumulation of fluid. Fluid in the middle ear or inflammation signals a problem. Dr. Jerome Klein, professor of pediatrics at Boston Medical Center has reviewed thousands of cases. Most kids will be between six months and three years of age and these infections can cause lasting problems. Dr. Jerome Klein: Whenever a fluid is present there is some loss of hearing. The average loss is 25 decibels. That's the equivalent of putting a plug is your ear.