Three out of four kids have had at least one by the time they're three. How do parents know when a common problem has become something more? Our channel six pediatrician has the answer.

One-year-old Alexander Andres has plenty to say but he's not able to tell his mom when his ears hurt.

Sandy Andres says, "At the beginning, I just knew he wasn't sleeping, wasn't eating, bottles, just not acting normally. He was fussy a lot and he's not fussy. So I brought him in and that's when she said this is what's wrong."

Alexander has had two infections. For other children, it's a lot more. Some kids just pick up colds easier and colds trigger ear infections.

It's the same with seasonal allergies. Then there's family history. Face shape affects the way the ears drain or don't drain.

Recurrent ear infections can lead to problems with hearing and speech. That's why Dr. Clancy McNally sometimes recommends a specialist.

She says, "Usually if a kid's had one ear infection that just won't go away after multiple rounds of antibiotics including antibiotic injections we'll have him go see an ear, nose, and throat doctor, or if they have multiple ear infections within a six month time period."

Tubes provide drainage to the eardrum Instead of building up causing pain and eventually an infection, the fluid can get out.

Alexander has been given the all-clear from Dr. McNally and his mom hopes they can keep it that way.

Sandy says, "It's pretty important to him that his ears don't hurt and he'll let you know, so yeah, it is a pretty big disruption when something like that is going on."