How to Tell if Your Baby Has an Ear Infection (and What to Do to Prevent Ear Infections)

Other than well-baby visits, ear infections are the most common reason why parents take their infants to the pediatrician. Ear infections account for nearly half of all antibiotic prescriptions for young children. Ear infections are justifiably a source of great concern for parents. But there are things that can be done to prevent them, and to know if a visit to the doctor is truly warranted, or if your baby may be dealing with a lesser, harmless ailment. The ear structure is divided into three sections: outer ear, middle ear, and inner ear. Most infections in babies and young children occur in the middle ear. There are two reasons for this: First, a baby’s immune system is not yet fully developed. Second, the eustachian tube is shorter in babies, so it can get blocked more easily. This tube is a structure that connects the middle ear to the throat; it often becomes inflamed during an ear infection, trapping fluid — and bacteria — in the middle ear. As a child gets older, the eustachian tube gets longer, and rises upward more, making it harder for bacteria to “climb up” and reach the middle ear; this partly explains why ear infections become more rare as children get older. The typical ear infection in a baby is called otitis media, and there are two types of common  middle ear infections that are causes for concern:
  • Acute otitis media: it can cause mild to severe pain, fever, and a bulging, red ear drum
  • Otitis media with effusion (OME): the middle ear does not drain properly, and fluid is trapped behind the ear drum. Ears may discharge thick, yellowish fluid, pus or even blood. All three of these discharges are an indication that the inflammation has burst the ear drum; however, a ruptured ear drum is no cause for great alarm. It will heal on its own, and its rupturing alleviates the pain from the inflammation
Signs that your baby may have an ear infection Ear infections often follow a cold, throat infection or allergy attack: these can cause the eustachian tubes to become inflamed, trapping fluid in the middle ear, including discharges from the upper respiratory tract, and thus encouraging bacterial growth. If your baby has a cold, a cough, or has had an allergic reaction, look for the following symptoms, to indicate a possible ear infection (one or more of these may be present):
  1. Baby is unusually fussy from his or her cold
  2. Baby is irritable during the day or at night
  3. Baby has trouble sleeping
  4. Fever (may or may not be present in an ear infection)
  5. Fluid draining from ears
  6. Baby pulls or flaps outer ears
Most ear infections will go away on their own after a week or so. If the symptoms are not severe, you may want to wait 48 hours before seeking out an antibiotic prescription from your pediatrician. Ear aches can be treated at home by placing a heating pad on baby’s ear, with rest, and with doctor-prescribed ear drops. You can also give your infant a pain and fever reducer such as Tylenol (safe for babies two months old and up), and for babies older than six months, you can also use Motrin (follow recommended doses on product packages). If you take your baby to your pediatrician, and an ear infection is diagnosed, your doctor may decide to put your baby on antibiotics, especially if the child is under two years of age. This is because babies and young toddlers run a higher risk for potentially serious complications, such as progression of the bacterial infection to the neighboring, porous mastoid bone; deafness; and the spread of infection to the spinal fluid that surrounds and cushions the brain (a condition known as meningitis). Therefore, antibiotics are an important modern-day tool for treating more severe ear infections. Your baby is also more likely to be placed on antibiotics if he or she is running a fever higher than 101 F, or if your baby has had a number of previous ear infections, as more frequent infections may damage hearing. Some Important Ways to Prevent Ear Infections in Your Infant:
  • Babies who are cared for in larger day cares are more susceptible to ear infections; if your baby attends one such day care, consider finding a smaller, home day care setting
  • Help avoid colds by washing baby’s hands often
  • Breastfeeding is a great tool for preventing ear infections. Medical research has clearly shown that the longer a baby is breastfed, the more the chances of ear infections will be decreased. In addition to germ-fighting organisms in the mother’s milk, the breastfeeding position allows for better normal fluid drainage from baby’s ears as he or she nurses
  • If baby is bottle-fed, hold baby in an upright position. Letting baby lie down with bottle increases the chances of ear infections
  • Do not let your baby fall asleep while drinking from a bottle often; milk in a baby’s mouth increases the risk of chronic ear infections (and it also promotes tooth decay)
  • Drain a runny nose with a suctioning device (and disinfect device frequently)
  • Do not smoke cigarettes around your baby, as the smoke irritates the baby’s nasal passages, and this can damage the middle ear structure
As a final note, keep in mind that certain symptoms, such as fussiness and even a low fever (less than 101 F) may simply be the result of teething. But with teething, there should be no cold symptoms or high fever; the baby may have a lot of drool from the mouth, but no runny nose.