So your baby has an ear infection. Now what?

Children's Health

by Johelin De Freitas Hernandez, MD

Oct 19, 2020

Has your child started pulling, tugging or rubbing his or her ears? Maybe your baby can’t sleep and has kept you up crying and fussy all night? Most likely your child has ear pain from an infection. 

Ear infections are one of the most common reasons for acute visits to the pediatrician in children between six and 24 months of age. It is estimated that 80% of children will have at least one episode of otitis media (ear infection) by their third birthday.

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 baby’s 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.

Related: 5 learnings about lice every parent should know

Signs your child has an ear infection

Identifying an ear infection can be challenging for parents because this disease is more common in children that are barely starting to talk, and symptoms often mask other normal child behaviors. Are they just exploring their ears? Is it a self-comforting habit? Or teething? How can I know whether my child has an ear infection? 

You should suspect an ear infection if your child is: 

  • Having sudden episode(s) of fever
  • Touching or rubbing his or her ears
  • Crying and fussy more than usual 
  • Having trouble eating, drinking or sleeping (Chewing and laying down usually cause painful pressure in the middle ear)
  • Having fluid coming out of the ears (Sometimes parents find a liquid stain on the pillow after a rough fussy night)

Treating an ear infection 

If you notice the above signs, especially after having few days of cold symptoms, you should call your pediatrician. During this appointment your doctor will check inside your child’s ears with a lighted instrument. Depending on how the eardrum looks and severity of symptoms, we will give you advice on how to get your child and whole family back to sleeping comfortably all night.  

Although this is an infection, either caused by viruses or bacteria, most of the time ear infections can get better on their own.

Keep in mind that antibiotics do not work on viruses. 

You and your child’s doctor can adopt a “wait and see” approach for couple of days. During this time, there are a few things you can do to help your child get well and stay comfortable.

  • Over-the-counter pain relievers (as safely directed by your pediatrician)
  • Suction the nose frequently
  • Feed in an upright position
  • Make sure the baby sleeps with the head elevated to decrease pressure on the ear and relieve pain

Related: Are my child’s growing pains normal?

Recurring ear infections

What happens if a child has recurring ear infections? This trapped fluid in the eardrum prevents sound from getting transmitted and causes a temporary decrease in hearing ability. Some children can face speech delays, especially those with recurring ear infections during the first year of life. 

Fortunately, there are ways to help reduce the risk and recurrence of ear infections, including:

  • Breastfeeding for at least 6 months help to prevent early episodes of ear infection. If your child is bottle fed, avoid feeding while laying the child down. 
  • Don’t smoke around your child — it can increase the frequency and severity of ear infection. 
  • Wash your hands and your child’s hands frequently to stop the spread of germs. 
  • Keep your child up-to-date on immunizations. 

Although ear infections are common, teething, ear wax and foreign objects in the ear can also cause ear pain. Call your pediatrician and schedule an appointment to help get your child back to feeling healthy and happy.

Find a doctor near you or explore our virtual care options.

About the Author

Johelin De Freitas Hernandez, MD, is a pediatrician on the medical staff Baylor Scott & White Clinic – Round Rock 425 University. Schedule an appointment with Dr. De Freitas today.

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