Baby Ear Infection: Causes, Symptoms, Treatment

baby ear infection

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Your baby has been battling a cold. Now they’re tugging at their ears and acting fussy. Last night they didn’t sleep so well, either. Of course, they can’t tell you what is wrong, but you can’t help thinking they might have an ear infection. Could it be true? If so, how serious are ear infections in babies? And what should you do next?

The good news is that ear infections are very common among children under the age of two, and they are also generally very treatable.

Let’s take a look at how ear infections affect babies, what causes them, what symptoms to look for, when you should take your baby to the doctor, how to prevent them in the first place—and most importantly, what can be done so that your little one feels better.

What Causes Ear Infections in Babies?

Ear infections, medically known as acute otitis media, are infections of the middle part of the ear. They are caused by either a viral infection (like the common cold) or a bacterial infection. These infections cause fluid to build up in the middle ear, as well as inflammation. In some cases, the eustachian tubes (the small tubes between the nose and middle ear) show signs of infection as well.

Adults can get ear infections, too, but babies and young children are most prone to them, especially children under the age of three. Five out of six children will have had an ear infection by the time they turn three,and 25% of children will experience repeat ear infections.

The reason babies and young children are more prone to ear infections include:

  • Babies’ ear passages are different than adults: they are shorter, narrower, and more horizontal in orientation
  • Babies are more likely to get colds and other viruses, which make them more prone to ear infections
  • Babies’ immune systems are less developed than adults, so their reactions to virus are usually more intense—leading to complications such as ear infections

Risk Factors for Baby Ear Infections

The majority of children will get at least one or two ear infections in their first few years of life (so if this is happening to your baby, don't fret!). But some babies may be more at risk for ear infections than others. Here are some risk factors that may increase your baby’s susceptibility:

  • If you have a family history of ear infections, your baby may be more likely to get them.
  • Your baby is more likely to get an ear infection with the more colds and other viruses they pick up.
  • Babies who have allergies are more likely to have ear infections because of the swelling and inflammation that allergies can cause.
  • Babies with chronic illnesses are more likely to experience ear infections, especially if they have respiratory diseases such as cystic fibrosis and asthma.
  • Being exposed to secondhand smoke can increase your baby’s risk for ear infections.
  • Babies who are bottle-fed are more likely to experience ear infections than breastfed babies; however, you can minimize the risk by bottle feeding your baby in an upright position, so that milk doesn’t pool in their ear passages.
  • Making sure your baby doesn’t fall asleep while drinking a bottle can also decrease their likelihood of getting an ear infection.

Symptoms of Baby Ear Infections

Many parents will notice their baby tugging on their ear or simply acting fussy and assume that they have an ear infection.

However, while ear tugging and fussiness are sometimes signs of ear infections, they can also be the signs of teething, or just general crankiness.

Let’s look at all the possible signs of baby ear infections, and how to know whether it’s time to contact your pediatrician.

Early Signs of Infection

The symptoms of ear infections usually come on suddenly and are first experienced as discomfort, pressure, and pain. Of course, your baby can’t describe what they are feeling, which makes it hard to know what’s wrong.

At first, your baby may just generally be more fussy and inconsolable. Soon after, you may notice your baby tugging on their ear, or having trouble sleeping. Lying down often causes the pressure and pain in the ear to worsen, so you may notice that your baby can’t sleep for very long stretches during this time. They may also have trouble breastfeeding or bottle feeding, as suckling and swallowing can also sometimes worsen their pain.

As the ear infection progresses, they may develop a fever or experience drainage from their ears.

Symptoms of Ear Infections in Babies

There are many symptoms that may indicate an ear infection. Again, just having one of these symptoms doesn’t always mean your baby has an ear infection. But if your baby has several of these symptoms together—and especially if they have recently had a cold or other virus —you can suspect that they may have an ear infection.

  • Crankiness and fussiness due to discomfort and pain
  • Trouble sleeping or lying down flat
  • Pulling at the ears from pain
  • Fever (not all babies have fever with an ear infection, but many will have a fever between 100 degrees F and 104 degrees F)
  • Decreased appetite due to fever, pain, or discomfort while swallowing or suckling
  • Digestive discomfort
  • Clumsiness due to ear balance issues
  • Yellow or brownish fluid draining out of your baby’s ear
  • Difficulty hearing or responding to the sound of your voice—this is due to fluid build up in the ear and should resolve after the ear infection is over

Treatments for Baby Ear Infections

Ear infections can be upsetting for both babies and their parents, but most are treatable, and mild infections may diminish on their own without medicine. Either way, if your baby is experiencing an ear infection, your doctor will discuss remedies to help ease their pain and discomfort.

Should I Take My Baby to the Doctor?

Even if you are unsure if your baby is experiencing an ear infection, it's better to err on the side of caution and call your doctor.

If they do not believe there is an issue, they may tell you to stay home. However, since baby ear infections are so common, it’s likely they will have you come in for an exam. There is no harm in getting things checked out—the worst that will happen is that your baby doesn’t have an ear infection and you can feel some relief.

What Will Happen at the Doctor’s Office?

If your doctor thinks your baby may have an ear infection, they will certainly examine your baby’s ear canal, but they will also likely look at other possible symptoms.

Here’s what will happen during the visit:

  • Your doctor will ask you what viral or infection symptoms your baby has had recently.
  • Your doctor will ask you what symptoms your baby has been experiencing, and will check your baby’s vital signs.
  • Your doctor will take your baby’s temperature.
  • Your doctor will listen to your baby’s lungs for signs of respiratory distress.
  • Your doctor will examine the inside of your baby’s ears.

 Here’s what an examination of your baby’s ear canals may entail:

  • Your doctor will view your baby’s middle ear using an instrument called an otoscope. They will be looking for signs of redness and inflammation. Babies usually don’t like this, but the procedure is not painful.
  • If your doctor wants to check for fluid buildup in the ear, they will use a pneumatic otoscope. This will blow a small amount of air inside your baby’s ear. This is not harmful or painful, but again, your baby may not like it very much.
  • If neither of these procedures offer your doctor a definite answer, they may use a tympanometer to examine your baby’s ear. This uses air pressures and sound tones to measure the pressure inside your baby’s ear.

What Medications Are Used to Treat Baby Ear Infections?

Traditionally, ear infections were treated with antibiotics like amoxicillin. However, in more recent years, doctors have adopted a “wait and see” approach to prescribing antibiotics, at least for kids 2 years old and up. Most of the time, babies under 2 need an antibiotic

If your baby is prescribed an antibiotic, it’s important to give it for the full prescription course, usually 7 to 10 days. It’s likely that your baby will start to feel better within a few days, but if you stop the medication before the course is done, you risk the infection returning.

Many pediatricians recommend giving your baby probiotics while they are taking antibiotics. In doing their jobs, antibiotics kill both “good” and “bad” bacteria, and the depletion of “good” bacteria can sometimes cause digestive discomfort. Probiotics can replenish the “good” bacteria your baby needs, and ease any digestive upset.

How To Treat Ear Infections at Home

Whether your baby is prescribed antibiotics or not, you will want to decrease your baby’s pain and discomfort as they recover from an ear infection.

Here’s what you can do:

  • Depending on your baby’s age, you can give your baby pain relieving medication such as acetaminophen and ibuprofen. Again, check with your doctor on what pain reliever is appropriate for your baby as well as dosage. Never give your baby aspirin, as this can cause a dangerous condition called Reye's syndrome.
  • In addition, your doctor may recommend ear drops that reduce pain as well as simple at-home remedies like warm washcloths or heating pads for comfort.

Can Baby Ear Infections Be Prevented?

Ear infections are very common. In most cases, there’s not much parents can do to prevent them—and you shouldn’t feel guilty if it happens to your baby! However, there are a few things you can do to reduce the likelihood that your baby will come down with an ear infection:

  • Breastfeeding—you don’t have to breastfeed full-time to reap benefits
  • Reducing your baby’s exposure to secondhand smoke
  • Practicing good hygiene such as frequent hand washing to reduce the chances of your baby picking up a viral infection that may lead to an ear infection
  • Keeping up with your baby’s vaccines and getting an annual flu shot

What To Do If Your Baby Has Repeated Ear Infections

It can be very stressful if your baby has repeated ear infections, though this is also common in childhood. If the infections are very frequent or if they are causing temporary hearing loss for your baby, your doctor may want to intervene.

The most common intervention for repeated ear infection are small tubes (tympanostomy tubes) that are placed in your baby’s eardrum. These tubes are left in for six to nine months and decrease the fluid buildup as well as improve air flow quality. Frequent check ins with your doctor are necessary if your baby has ear tubes.

If tubes don’t help solve the problem, sometimes doctors will suggest surgically removing your baby’s adenoids, especially if they are swollen, enlarged, and seem to be contributing to your baby’s ear infections.

A Word From Verywell

It’s always distressing when your baby is uncomfortable or in pain, and it’s common for parents to become very worried, even from something as common as an ear infection. You should know that so many other parents have been there too, up all night with a cranky, sleepless, and feverish little one suffering from an ear infection.

Again, if you suspect that your baby may be suffering from an ear infection, it’s always better to be safe than sorry. Call your pediatrician for advice or for an appointment. Chances are, your sweet baby will be feeling better in no time.

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Article Sources
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  1. National Institute on Deafness and Other Communication Disorders. Ear Infections in Children. Updated May 12, 2017.

  2. Cleveland Clinic. Ear Infection (Otitis Media). Updated April 16, 2020.

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