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We recently took our toddler to the Alps, and I was surprised when multiple people asked me if I was worried about her getting an ear infection due to the high altitude (the highest point was 2770 m). We checked with her pediatrician last year before visiting high altitudes when she was 7 months old, and he made no mention of possible ear infections due to altitude (slow acclimatization to prevent altitude sickness and lots of sunscreen, yes, but no other concerns).

In the end, she got an ear infection during our trip. Was it a coincidence? Is increased likelihood of an ear infection when visiting high altitude an old wives tale or is there some truth to it?

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    What an interesting question! Welcome to the site. – anongoodnurse Aug 24 '15 at 19:14
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    A quick look did find this article at the NIH website which shows altitude changes and cold as risk factors, but I don't understand the why behind it, so hopefully someone with more knowledge can elaborate. – JohnP Aug 24 '15 at 20:06
  • @Carolyn - Were your friends concerned with ear infection risk with flights, or did they specifically mention altitude of the destination? – anongoodnurse Aug 25 '15 at 5:29
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    In fact we were on foot, and arrived in the area by train, so no rapid changes in elevation were involved. We went from 1000 m to 2700 over the course of a couple days of hiking. It was well- meaning passers by that stopped us on the trail with their concern about her ears while at altitude, not about shifts in altitude. – Brusselssprout Aug 25 '15 at 5:33
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It is true that high altitudes can cause an increased risk of ear infection. JohnP mentioned in his comment that on the National Institutes of Health (NIH) website for acute ear infections, it says that "Changes in altitude or climate" can increase the risk of getting an ear infection. The reason for this is also explained on the NIH website. That page describes very succinctly what happens to your ears when you experience changes changes altitude (ie: going up a mountain, flying in a plane).

The air pressure outside of your body changes as altitude changes. This creates a difference in pressure on the two sides of the eardrum.

This difference in pressure can block your Eustachian tube, the tube that connects the back of your nose and upper throat to your middle ear, which can cause an ear infection. A blockage in the Eustachian tube can also lead to something known as ear barotrauma, which is just discomfort in the ear, not a full ear infection, but may look and feel similar to one if it is severe enough. It should also be noted that young children are at a much higher risk for their Eustachian tube to be blocked, which may also be a contributing factor to why your daughter got an ear infection.


NIH: Ear infection - acute

NIH: Ear - block at high altitudes

NIH: Ear barotrauma

WebMD: Blocked Eustachian Tubes

Healtline: Ear Barotrauma

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  • Hmm. This occurs on any plane ride that reaches regular cruising altitude (30-33K feet). I thought the question was more complex than that. Maybe I over-read. – anongoodnurse Aug 25 '15 at 5:26
  • @anongoodnurse It is most common for this to occur on plane rides. Other sources, such as Healthline, mention that both driving (which I would assume would include trains) and hiking (which is what the OP did) can also be a cause of ear barotrauma. Rapid altitude changes are the most likely causes, but almost any change in altitude can be a cause, most likely because the ear is usually not used to such pressures. Also, the person in the OP's family who got the ear infection was their young daughter, and children are more susceptible to this. – michaelpri Aug 25 '15 at 20:58

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