read my new blog on family webicine on the new guidelines for treating ear infections in children. most children with middle ear problems improve by age six so you have two more years. i don't know if he is a candidate for tubes or not but middle ear fluid lasting more than three months is very problematic. he may need to see an ent specialist at this point. he is likely in pre-school or pre-k where he is being exposed. keeping him home would reduce his exposure to other children with colds but the benefits of preschool outweigh this risk. never smoke around a child. if he has allergies try and get them controlled. hopefully he is immunized against pneumococcal disease and influenza - the new treatment guidelines stress the vaccines as a preventative. don't know if this is helpful or will even apply to your son but my nephew used to get ear infections all the time. his mom let him go to sleep all the time with a bottle of milk and once she stopped doing that the ear infections stopped. you said he is 4 so i doubt he still has a bottle but thought i'd mention it anyway. hope he gets better soon.
how to prevent ear infections in toddlers? . my 4 year old son keeps getting ear infections after a bout of cold. he has been on antibiotics every month for the past 3-4 months.