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Jennifer L.W. Fink
Registered Nurse

Ear Infection In Babies

Your baby is likely to get an ear infection (or several!) in her early years. We’ve got answers to all your questions about ear infections.

What are ear infections in babies?

The most common kind of ear infection is an infection of the middle ear, the part of the ear that’s located behind the eardrum. Sometimes, germs get in there and multiply, causing a painful infection.

What are the symptoms of ear infections in babies?

Ear pain is the most common symptom of an ear infection. Young kids might tug at their ears; they might also be fussier than usual or have a hard time sleeping. A fever may or may not accompany an ear infection.

Are there any tests for ear infections in babies?

Your doctor will look in your child’s ear with a special tool called an otoscope. Fluid and/or redness behind the eardrum are signs of an ear infection.

How common are ear infections in babies?

Extremely common! According to the American Academy of Pediatrics, about 90 percent of kids will have at least one ear infection before they start school; most will occur between the ages of six months and four years.

How did my baby get an ear infection?

Young kids are prone to ear infections because their Eustachian tubes, the tubes that connect the ears and the back of the throat, are smaller and more horizontal than they are in older kids and adults. That means that fluid is more likely to pool in babies’ and toddlers’ Eustachian tubes — and pooled fluid is a perfect place for an infection to take hold. The location of the tubes also makes it really easy for mucus (from a cold, for instance) to back up into the tubes and cause infection.

What’s the best way to treat baby’s ear infection?

Antibiotics used to be prescribed routinely for ear infections, but the American Academy of Pediatrics now recommends a watch-and-see approach. That’s because many ear infections will clear up without medical treatment — and because overuse of antibiotics may have contributed to the rise of antibiotic-resistant germs.

If baby is otherwise healthy and not in too much pain, your doctor may recommend watchful waiting for two to three days. If baby doesn’t get better during that time, your doc may then prescribe antibiotic treatment.

Antibiotics may be given if your child is under six months old, if she has a high fever or if she’s in a lot of pain. Numbing eardrops can be ordered to ease the pain, but the copay for that med is usually pretty high (often around $50), so most docs don’t order it. You can give oral acetaminophen or ibuprofen instead.

Be sure to return to your doctor’s office for follow-up as ordered. “You want to make sure that there's no fluid hanging around, or scarring in the ear,” says Katherine O’Connor, MD, a pediatric hospitalist at The Children’s Hospital at Montefiore in New York City.

If a child has persistent fluid in the ear or frequent ear infections, he may be referred to an ear, nose and throat specialist. Sometimes, ear tubes are placed to facilitate drainage of the ears.

What can I do to prevent my baby from getting an ear infection?

Most ear infections follow colds, so try to keep baby healthy. Wash your and baby’s hands frequently, especially during cold and flu season. Discourage sharing of cups and eating utensils. Fully immunizing your child may also help prevent ear infections, by preventing other illnesses that can lead to ear infections.

You should also stop smoking, or at least smoke far away from your child; kids of smokers are more prone to ear infections. Breastfed babies appear to get fewer ear infections, so breastfeeding may also protect baby.

As baby gets older, taking away her pacifier may also help. Kids who use pacifiers after one year of age are more likely to develop ear infections than their peers.

What do other moms do when their babies have ear infections?

“My daughter is currently on meds for an ear infection. I will tell you I had no idea she had one. But now that I look back, these are the signs we had: She wasn't sleeping very well at night, had a cold for about three weeks and wasn't eating very well. For two days, the day care staff told me she was fussy. The day we took her to the doctor, she was messing with her ears at day care (I just thought she’d found her ears!). But while we were at the pediatrician’s office, my husband told me she was all smiles and laughing. So I think every baby is different. If you think your child has one, then I would take her in.”

“When Kenley had an ear infection, she would scream if I offered her a bottle. She took her solids just fine, and her pacifier didn't seem to bother her, but the sucking/swallowing of the bottle evidently hurt her. She ran a fever and would NOT sleep unless I was holding her. [If you suspect your baby has an ear infection] I’d probably have her checked out, just to be on the safe side, because they can start spiking a pretty high fever once the infection sets in.”

“We're on the third type of antibiotic to get rid of my son’s ear infection. He had a horrible cough with his too. He didn't pull on his ears until after the first round of antibiotics didn't work. At this point our doctor told us it was one of the worst ears" she'd ever seen... I did read that when ear tugging is the primary symptom, it's rarely an ear infection. Usually, it's just the child ‘finding’ their ears, but it’s worth seeing a doctor [if you think it could be an ear infection].”

Are there any other resources for ear infections in babies?

American Academy of Pediatrics’

Plus, more from The Bump:

Ear Problems in Babies

Excessive Crying in Babies

Nasal Congestion in Babies

The Bump expert: Katherine O’Connor, MD, a pediatric hospitalist at The Children’s Hospital at Montefiore in New York City

PHOTO: Getty Images