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How To Tell If Infant Has Ear Infection

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How To Know If Your Baby Has An Ear Infection Or Just Teething

How to tell if your baby is teething or has an ear infection

Did you know that teething can be confused with an ear infection in babies?

While these two things might seem completely different concerns, the signs and symptoms can often overlap. For example, when your baby starts tugging on their ear, you may assume thats a clear sign that they have an ear infection. While this is possible, pulling on the ear could also mean your baby is teething because as the tooth erupts, the perforation can cause inflammation in the gum and subsequent pain that radiates to the adjacent ear.

In addition to pulling on their ears, other shared signs and symptoms include:

  • Waking more frequently in the night

  • More fussing than usual during the day

  • Flushed cheeks

  • Reduced appetite or pushing food away

  • Rubbing their cheeks

So, how can you tell the difference between teething and an ear infection?

Symptoms that would suggest your baby is teething include:

  • A low fever

  • Swollen, red gums

  • Wanting to chew on hard things

On the other hand, if an ear infection is to blame, your child may have the following symptoms:

  • A fever of up to 40 °C

  • Cold symptomsear infections are almost always preceded by a cold

  • Discharge from the ear

  • Complaining of ear pain or hearing loss

  • Not reacting to auditory cues

  • Loss of balance

What should you do if you suspect your baby is teething?

What should you do if you suspect your baby has an ear infection?

In summary:

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Baby Ear Infection: Causes Symptoms Treatment

Your baby has been battling a cold. Now theyre tugging at their ears and acting fussy. Last night they didnt sleep so well, either. Of course, they cant tell you what is wrong, but you cant 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.

Lets 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 placeand most importantly, what can be done so that your little one feels better.

How To Determine If Your Infant Has An Ear Infection

This article was co-authored by Laura Marusinec, MD. Dr. Marusinec is a board certified Pediatrician at the Children’s Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care. This article has been viewed 52,161 times.

Ear infections are pretty common among babies, but it can still be a tough experience for both you and your infant. Luckily, we can help you be prepared by knowing what signs and symptoms to watch for so you can get your baby to their doctor and get the infection cleared up.

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How Is An Ear Infection Diagnosed

Ear exam

Your healthcare provider will look at your or your childs ear using an instrument called an otoscope. A healthy eardrum will be pinkish gray in color and translucent . If infection is present, the eardrum may be inflamed, swollen or red.

Your healthcare provider may also check the fluid in the middle ear using a pneumatic otoscope, which blows a small amount of air at the eardrum. This should cause the eardrum to move back and forth. The eardrum will not move as easily if there is fluid inside the ear.

Another test, tympanometry, uses air pressure to check for fluid in the middle ear. This test doesnt test hearing. If needed, your healthcare provider will order a hearing test, performed by an audiologist, to determine possible hearing loss if you or your child has had long lasting or frequent ear infections or fluid in the middle ears that is not draining.

Other checks

Your healthcare provider will also check your throat and nasal passage and listen to your breathing with a stethoscope for signs of upper respiratory infections.

How Common Are Ear Infections In Toddlers

Fun With Otoscopes

Children between the ages of 6 months and 2 years are more susceptible to ear infections than toddlers and older children. Childrens eustachian tubes are shorter, and they have a weaker immune system, which accounts for their susceptibility.

For toddlers, one way they might be more at risk of getting an ear infection is group child care. Children in group settings are more likely to be exposed to colds, which could lead to an ear infection, as both viruses and bacteria cause infections.

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How To Tell If A Child Has An Ear Infection

If a child has a bothersome cold for a week. Her nasal discharge turns a little green and her cough starts to keep the family all up at night. Then one night she is up every hour extremely fussy with a fever.

Ear infections are one of the most worrisome illnesses for both parents and children to go through, especially if they frequently recur. They also are the most common reason for antibiotic prescriptions. Heres a guide to help understand why ear infections occur, how to best treat them, and most importantly, how to prevent them from happening too often.


If a child has 2 or more of these symptoms it is likely she has an ear infection:

  • Cold symptoms keep in mind that ear infections are almost always preceded by a cold. Often a clear runny nose will turn yellow or green before an ear infection sets in.
  • Fussiness during the day or night.
  • Complaining of ear pain or hearing loss.
  • Night-waking more frequently.
  • Fever usually low grade or there may be no fever at all.
  • Sudden increase in fussiness during a cold .
  • Ear drainage if there is blood or puss draining out of the ear, then it is probably an infection with a ruptured eardrum. DONT WORRY! These almost always heal just fine, and once the eardrum ruptures the pain subsides.

  • Teething Baby thinks the pain from sore gums is coming from the ears.

  • Note: Teething does not cause a runny nose, only drool.
  • Are Antibiotics Absolutely Necessary To Treat Ear Infections

    No, they are not absolutely necessary, but they are helpful for several reasons:

    • Antibiotics will help your child feel better faster by eliminating the bacteria, which in turn reduces the fever and ear pain more quickly. Children generally feel better after one or two days of antibiotics.
    • Allowing an ear infection to heal on its own usually subjects a child to four to seven days of fever and ear pain.
    • Antibiotics help prevent the very rare, but possible, complications of an ear infection spreading into the brain or bone surrounding the ear.
    • New research is suggesting that 80 percent of uncomplicated ear infections will resolve within 4 to 7 days without antibiotics. Parents who choose not to use antibiotics can treat the pain and fever with Auralgan anesthetic ear drops and ibuprofen or acetaminophen, or can try using Xlear® nasal spray as mentioned above.

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    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.


    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

    Know The Signs Of Ear Infections In Infants

    How do I know if my child has an ear infection?

    Its incredibly important to recognize the signs of ear infections in infants. Although an ear infection is a common occurrence and nothing to worry about, its still something that needs to be treated as early as possible to avoid complications.

    If you have any suspicions your child is suffering from an ear infection, dont waste any time. Get them to a doctor or a top-notch urgent care clinic right away.

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    Baby Ear Infection Treatment

    Ear infection in babies typically resolves on its own within a few days, so the strategy should be to keep baby comfortable in the meantime. The common baby ear infection treatment plan, Burgert says, is pain relievers, patience and hugs. While its a common condition thats rarely dangerous, an infection still calls for an evaluation by a doctor, to avoid any potential complications. Talk to your pediatrician about which over-the-counter pain meds, like Tylenol or Motrin, would be best to usebut steer clear of homeopathic ear drops, which arent effective, Burgert says.

    Even after the symptoms have disappeared, stop by the doctors office to make sure the ear infection has fully cleared up. You want to make sure that theres no fluid hanging around or scarring in the ear, says Katherine OConnor, MD, a pediatric hospitalist at the Childrens Hospital at Montefiore in New York City.

    For a more severe baby ear infection, your doctor may recommend one of the following treatments:

    Inserting tubes in the ears. For recurring ear infections, some doctors will recommend surgery to insert tubes into babys ears. These small tubes are placed through the eardrum to help equalize the pressure, Brown explains. This helps to allow fluid to drain and to prevent ear infections from developing in the first place. This also enables your doctor to place antibiotics into the ear canal and treat the infection at its source, Brown explains.

    What Can Parents Do

    Watch for signs of an ear infection and get your child to a doctor if symptoms dont go away or get worse. Here are a few things you can do to help prevent ear infections:

    • Breastfeed for 6 to 12 months if you can to boost your childs immune system
    • Limit your childs exposure to second-hand smoke
    • Wash your hands often to prevent the spread of infection
    • Keep your child up-to-date on all immunizations

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    Fluid Or Pus Draining From Your Child’s Ear:

    While not very common, this is a definite sign of infection, so call the doctor right away. Yellow, white, or green drainage from the ear can signal a perforated eardrum, a condition that can develop if the fluid in the middle ear puts so much pressure on the eardrum that it bursts.

    Although a burst eardrum may sound scary and can be very painful for your child, the hole is not serious and will usually heal by itself. And the good news is that your child may start to feel better as fluid drains and pressure decreases.

    What Should I Expect If I Or My Child Has An Ear Infection

    How To Tell If Baby Has Ear Infection

    Ear infections are common in children. Adults can get them too. Most ear infections are not serious. Your healthcare provider will recommend over-the-counter medications to relieve pain and fever. Pain relief may begin as soon as a few hours after taking the drug.

    Your healthcare provider may wait a few days before prescribing an antibiotic. Many infections go away on their own without the need for antibiotics. If you or your child receives an antibiotic, you should start to see improvement within two to three days.

    If you or your child has ongoing or frequent infections, or if fluid remains in the middle ear and puts hearing at risk, ear tubes may be surgically implanted in the eardrum to keep fluid draining from the eustachian tube as it normally should.

    Never hesitate to contact your healthcare provider if you have any concerns or questions.

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    Who Is Most Likely To Get An Ear Infection

    Middle ear infection is the most common childhood illness . Ear infections occur most often in children who are between age 3 months and 3 years, and are common until age 8. Some 25% of all children will have repeated ear infections.

    Adults can get ear infections too, but they dont happen nearly as often as they do in children.

    Risk factors for ear infections include:

    • Age: Infants and young children are at greater risk for ear infections.
    • Family history: The tendency to get ear infections can run in the family.
    • Colds: Having colds often increases the chances of getting an ear infection.
    • Allergies: Allergies cause inflammation of the nasal passages and upper respiratory tract, which can enlarge the adenoids. Enlarged adenoids can block the eustachian tube, preventing ear fluids from draining. This leads to fluid buildup in the middle ear, causing pressure, pain and possible infection.
    • Chronic illnesses: People with chronic illnesses are more likely to develop ear infections, especially patients with immune deficiency and chronic respiratory disease, such as cystic fibrosis and asthma.
    • Ethnicity: Native Americans and Hispanic children have more ear infections than other ethnic groups.

    What Else Do You Need To Make Your Decision

    Check the facts

    • Sorry, thats not right. Most ear infections clear up on their own.
    • Youre right. Most ear infections clear up on their own.
    • It may help to go back and read Get the Facts. Most ear infections clear up on their own.
    • Sorry, thats not right. Antibiotics do not relieve ear pain immediately. Your child may need to take an over-the-counter medicine for pain.
    • Thats right. Antibiotics do not relieve ear pain immediately. Your child may need to take an over-the-counter medicine for pain.
    • It may help to go back and read Get the Facts. Antibiotics do not relieve ear pain immediately. Your child may need to take an over-the-counter medicine for pain.
    • Thats right. Antibiotics can have bothersome side effects, such as vomiting, diarrhea, and an allergic reaction.
    • No, thats not right. Antibiotics can have bothersome side effects, such as vomiting, diarrhea, and an allergic reaction.
    • It may help to go back and read Compare Your Options. Antibiotics can have bothersome side effects, such as vomiting, diarrhea, and an allergic reaction.

    1.How sure do you feel right now about your decision?

    3.Use the following space to list questions, concerns, and next steps.

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    How Long Will It Take My Child To Get Better

    Your child should start feeling better within a few days after visiting the doctor. If its been several days and your child still seems sick, call your doctor. Your child might need a different antibiotic. Once the infection clears, fluid may still remain in the middle ear but usually disappears within three to six weeks.

    How Does A Doctor Diagnose A Middle Ear Infection

    ASK UNMC! How can I tell if my child has an ear infection?

    The first thing a doctor will do is ask you about your childs health. Has your child had a head cold or sore throat recently? Is he having trouble sleeping? Is she pulling at her ears? If an ear infection seems likely, the simplest way for a doctor to tell is to use a lighted instrument, called an otoscope, to look at the eardrum. A red, bulging eardrum indicates an infection.

    A doctor also may use a pneumatic otoscope, which blows a puff of air into the ear canal, to check for fluid behind the eardrum. A normal eardrum will move back and forth more easily than an eardrum with fluid behind it.

    Tympanometry, which uses sound tones and air pressure, is a diagnostic test a doctor might use if the diagnosis still isnt clear. A tympanometer is a small, soft plug that contains a tiny microphone and speaker as well as a device that varies air pressure in the ear. It measures how flexible the eardrum is at different pressures.

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    Does My Baby Have An Ear Infection

    Take this quick quiz to find out just how much you know about ear infections.

    Q. Are all children at risk for ear infections?

    A. Ear infections are common in kids, especially babies between ages 6 and 18 months. One reason may be simple anatomy. The tube that drains fluid from inside each ear is much shorter in children than in adults.

    In children, ear infections often follow a cold virus. One study in Pediatrics found that 30 percent of upper respiratory infections in kids younger than age 3 led to an ear infection. Other factors, such as being around smokers, can raise the risk for ear infection.

    Q. How do I know if my baby has an ear infection?

    A. Young ones may cry and tug at their ears. Theyll seem irritable and wont feel like eating or sleeping. They also may have a fever.

    Q. Does my little one need antibiotics?

    A. It depends on your childs age. Most ear infections in older babies and kids go away after a week or two without antibiotics. Taking these medicines when they arent needed can make it harder for your child to fight off future infections.

    The American Academy of Pediatrics recommends antibiotics for babies younger than 6 months with ear infections. If your child is between 6 and 24 months and the ear infection isnt serious, antibiotics may offer little benefit. After age 2, an antibiotic is recommended only for a severe ear infection.

    Online Medical Reviewer: Desrosiers, Florence MD

    Date Last Reviewed: 4/2/2010

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