Ear Infection Vs Teething
Because ear infections often have some of the same symptoms as teething – fussiness, night waking, tugging at the ears, low-grade fever – it can be hard to tell the two apart. Teething pain generally kicks in when your baby is around 4 months old and will return at intervals until all her teeth, including the two-year molars, appear. If your baby has not had a cold or upper respiratory infection in the last couple of weeks, or if there’s drool but no runny nose, it’s likely to be teething. If you’re unsure, call your doctor to discuss your child’s symptoms.
Ear Infection Signs And Symptoms
The telltale sign of an ear infection is pain in and around the ear. Young children can develop ear infections before they are old enough to talk. That means parents are often left guessing why their child appears to be suffering. When your child can’t say “my ear hurts,” the following signs suggest an ear infection could be the culprit:
- Tugging or pulling the ear
- Crying and irritability
- Fever, especially in younger children
- Fluid draining from the ear
- Loss of balance
- Difficulty hearing or responding to auditory cues
Signs that require immediate attention include high fever, severe pain, or bloody or pus-like discharge from the ears.
Johns Hopkins Pediatric Otolaryngology
Our pediatric otolaryngologists are committed to providing compassionate and comprehensive care for children with ear, nose, and throat conditions. As part of the Johns Hopkins Children’s Center, you have access to all the specialized resources of a children’s hospital. Your child will also benefit from experts who use advanced techniques to treat both common and rare conditions.
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, its likely they will have you come in for an exam. There is no harm in getting things checked outthe worst that will happen is that your baby doesnt have an ear infection and you can feel some relief.
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Why Teething Symptoms May Be Confused With Cold Symptoms
Research has pointed out that teething begins around six months of age. This is the same time when an infants immunities they received from their mother, via the placenta, are diminishing. This means that the infants own immune system is becoming established. During this time, infants become vulnerable to minor infections. Because these two changes are taking place, the symptoms of teething can be confused with a minor illness or cold and visa versa. This explains why only 70-80 percent of parents reported teething symptoms of their infant its very likely that parents of the remaining 20-30 percent associated the symptoms to a minor illness or cold.
Signs It’s An Ear Infection
Because infants and toddlers don’t yet have the language skills to let you know how they’re feeling, detecting an ear infection is especially hard.
Despite what you may think ear tugging is not a reliable sign, according to experts. So what should parents be on alert for?
“In general, a fever above 102 degrees is one of the hallmarks of an ear infection in a nonverbal child,” says Max M. April, MD, chair of the committee on pediatric otolaryngology for the American Academy of Otolaryngology – Head and Neck Surgery.
The following signs also may indicate your child is suffering from an ear infection:
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How Can You Help
Okay, you looked at the symptoms, and you determined it’s not teething but an ear infection. Cool. Consult your pediatrician to find the best treatment option for your child. Here are some common options, according to the Mayo Clinic:
- Wait and see
- In milder cases, it’s best for the infection to heal on its own
If Your Child Has Chronic Ear Infections See A Specialist
Pediatricians typically refer a child to an otolaryngologist an ear, nose, and throat specialist when he’s had three infections in six months or four within a year, but this isn’t set in stone.
“Kids who have frequent infections spend a lot of time feeling ill, and if fluid in their ears doesn’t clear between infections it can interfere with hearing and language development,” says Nancy Young, M.D., head of otology at Children’s Memorial Hospital, in Chicago.
When an ENT examines your child, she’ll discuss whether it’s a good option to insert a tympanostomy tube to reduce the risk of infections and improve hearing. Although there’s no maximum or minimum age for tubes, children usually get them between 1 and 3 years old.
With about 500,000 kids a year undergoing the procedure, it’s the most common surgery with anesthesia performed on children. The surgeon makes a tiny cut in the eardrum, suctions out the fluid, and then inserts a cylinder the length of an infant’s pinkie nail into the hole to keep it open. Once the tubes are in, you won’t be able to see them, but they allow air to flow into the middle ear and fluid to drain out.
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How Can I Tell If Its An Ear Infection Or Just Teething
Are you tired of taking your fussy baby to the doctor to check her ears, only to be told its probably just teething? To help you decide, with teething:
- The pain usually starts at 4 months old and will come and go until the 2-year molars are in
- Tugging or digging at the ears with no cold symptoms or fever
- Fussiness or night waking with no cold symptoms or fever
- May have low fever less than 101º
- Teething does not cause a runny nose, only drool
Medical Prevention For Chronic Or Frequent Ear Infections
If your child is having frequent ear infections, more aggressive prevention may be indicated. There are different opinions as to the definition of chronic ear infections. How many is too many?
- More aggressive doctors may choose to begin medical prevention if your child has more than three ear infections in six months or more than four in one year.
- Less aggressive doctors may allow your child to have more infections before recommending medical prevention We lean more in this direction.
- Other factors such as hearing loss and speech delay may warrant more aggressive treatment.
There are three forms of medical prevention:
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Preventing Ear Infection In Babies
Its important to remember that your child will get sick. You can follow every preventative measure in the book and the child could still get sick. Thats not necessarily a bad thing, as it will help your child build the antibodies required to fight the infection next time it comes around. But if you want to try and prevent your child from getting an ear infection, there are a number of ways that may help out.
Whats The Difference Between An Ear Infection And An Earache
An earache is just one symptom of an ear infection. But just because your child has ear pain doesn’t necessarily mean he has an ear infection.
Earaches may have a number of causes besides ear infection, including a sore throat, fluid behind the eardrum, a buildup of earwax, a sinus infection or a tooth infection. They could also be caused by soap or shampoo residue in the ear or by using a cotton-tipped swab.
Because ear infections are so common in young children, call your doctor if you notice an earache along with other symptoms of an ear infection.
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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, its important to give it for the full prescription course, usually 7 to 10 days. Its 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 Do Ear Infections In Children Occur
Heres an anatomy lesson
The ear is divided into three parts: the outer ear canal, the middle ear space where infections occur, and the inner ear where the nerves and balance center are. A thin, membranous eardrum divides the outer and middle ear. The middle ear space contains the small bones that conduct the vibrations of the eardrum to the brain and is also connected to the back of the nose via the Eustachian tube.
Immature Eustachian tube
In infants and young children, this tube is much shorter and is angled. It is therefore much easier for bacteria to migrate from the nose and throat up into the middle ear space. As the child grows, this tube becomes more vertical, so germs have to travel upward to reach the middle ear. This is one-reason children outgrow ear infections.
Colds
When your child has a cold, the nasal passages get swollen and mucus collects in the back of the nose. This environment is a breeding ground for the bacteria that normally live in the nose and throat to begin to overgrow. Mucus is also secreted within the middle ear space just as it is in the sinuses.
Bacterial invasion
Germs migrate up through the Eustachian tube and into the middle ear space where they multiply within the mucus that is stuck there. Pus begins to form and soon the middle ear space is filled with bacteria, pus, and thick mucus.
Ear pain
Diminished hearing
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What Causes Ear Infections
As your child’s immune system is developing, her eustachian tubes, which connect the upper throat to the middle ear, are shorter and straighter than those of adults and are particularly susceptible to ear infections. Eustachian tubes, which are generally closed, open periodically to allow air into the middle ear for ventilation and to help the ears respond to changes in outside air pressure.
Your child also has larger adenoids than adults these can also become swollen and inflamed and lead to ear infections.
Eustachian tubes also allow mucus to drain out of the middle ear and into the back of the throat, but if the passage is blocked – perhaps from a buildup of mucus or the swelling of its lining following a cold or upper-respiratory virus – proper ventilation or drainage may not occur, and fluid may collect in the middle ear.
Bacteria can then get trapped and breed in the middle ear, leading to an infection. The resulting buildup of pus can put pressure on the eardrum and prevent the middle ear bones from moving freely, which can cause difficulty hearing, pain and possibly a ruptured eardrum .
What Causes Our Babys Stuffy Nose
As stated above, when we have a cold or something similar, our noses get inflamed. The tissues, blood vessels, and nasal polyps inside your nose become swollen with extra fluid and it creates that very âfullâ or âstuffyâ feeling. With our little babes, their noses are so tiny! So a little inflammation for us is very different compared to their tiny baby congested nose. And does it seem like your baby is more congested at night? This isnât just to spite you poor, hard working parents! Our bodies react differently to allergens at night and as much as we need gravity, it is not helpful when it comes to a babyâs stuffy nose at night. Mucus builds up and has nowhere to go, increasing nasal congestion.
âYou know whatâs really common beginning at 6 months of age? The common cold. You know what else? Teething. Great, I know. Another mystery of wondering what ailment your little one is dealing with. So, do babies get stuffy noses while theyâre teething? Usually not. Teething can sometimes be related to a runny nose due to inflammation of the mouth and gums, but if what youâre seeing in your infant is nasal congestion, itâs likely the common cold. The good news is that neither of these are cause for alarm or a reason to see the pediatrician, unless other symptoms arise that weâll discuss shortly.
Our babies can have a stuffy nose with no other symptoms but oftentimes, our babyâs stuffy nose can come with other symptoms.
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Your Baby Has Itchy Skin
Your baby might just be scratching an itch when theyre pulling or rubbing at their ears. Babies can get dry skin for many reasons, just like adults. Some causes of dry, itchy skin are mild and go away on their own.
The delicate skin around your babys ears and head can also get dry. Your baby might sometimes have slightly dry or itchy skin due to the following:
- heating
- difficulty sleeping or feeding
Cheek Rubbing And Ear Pulling
This is caused by pain in the gums, which can travel to the cheek and ear, especially when the molars are erupting. Infants will rub those areas. Keep in mind that ear pulling or rubbing can also be a sign of an ear infection, please contact your infants pediatrician if this symptom continues or is accompanied with a high fever.
How to help your infants cheek rubbing and ear pulling: Try rubbing and massaging the gums with a clean finger for one to two minutes to help with the discomfort.
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Keep Your Babys Face And Mouth Dry
All that drool coming from your babys mouth has to go somewhere. If you leave it on those chubby cheeks and cute outfits, theres a good chance your baby will develop skin irritation. If you dont want to change their clothes often, invest in teething bibs. These bibs can catch the drool and are easy to remove and replace throughout the day. Skin products such as Vaseline and Aquaphor can also be used on their skin to create a moisture barrier and prevent irritation.
How Do I Know If My Child Has An Ear Infection
Ear infections in kids can be patently obvious , but they can be harder to identify with babies after all, it’s not like your baby can tell you what’s wrong. But there are a few common symptoms to watch for:
- Frequent tugging at the ears
- Trouble sleeping
- Failure to respond to sounds
- Increased irritability
- A fever of 38°C or higher
- A thick clear or yellowish, sometimes bloody, fluid draining from the ears.
These symptoms often show up a few days after your child has had a cold or upper-respiratory infection. But ear infections can be stealthy, and pain can range from mild to severe. And some kids who have ear infections show no signs of it at all.
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Why Are Babies Prone To Ear Infections
The most common ear infection is called otitis media. Otitis media is the swelling of the eardrum due to accumulation of fluid behind it. But why is this more common in early life? There are several reasons contributing to it:
- Immature anatomy: In children, the eustachian tube which connects the middle ear with the nose/mouth is shorter, floppy and more horizontal compared to adolescents and adults.
- Constant upper respiratory illness: All that fluid from their nose travels easily to the middle ear and can get trapped in the eardrum.
Contrary to popular belief, ear infections are not caused by getting a babys ears wet during a bath. I get this question a lot from parents, but the truth is that fluid is coming from the back of the nose instead of the outer ear.
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 . But some babies may be more at risk for ear infections than others. Here are some risk factors that may increase your babys 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 babys 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 doesnt pool in their ear passages.
- Making sure your baby doesnt fall asleep while drinking a bottle can also decrease their likelihood of getting an ear infection.
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