How to Tell if Your Child Has an Ear Infection: Signs and Symptoms

If you’re a parent, you probably won’t be surprised to learn that ear infections are the most common reason children visit their doctors. In fact, according to the National Institutes of Health, five out of six children will have at least one ear infection by their third birthday.

Here’s what you need to know about middle ear infections, or otitis media, in children, including how to spot the symptoms and keep your child comfortable when an ear infection strikes.

What Causes Ear Infections?

Ear infections are caused by trapped fluid behind the eardrum, not a backup of nasal mucous in the ear as is commonly believed. Inner ear fluid typically drains into the throat through the Eustachian tubes. When inflammation occurs in these tubes due to a bacterial or viral infection (such as a cold), the exit tract of the inner ear can swell shut. This causes ear fluid to back up, offering the perfect breeding ground for bacteria to multiply and create an infection.

Why Are Children More Susceptible to Ear Infections?

It’s very common for young children and babies to get ear infections, with otitis media most often occurring in children between ages three months and three years of age. This is because children’s Eustachian tubes are shorter, and have less of a slope for drainage, allowing them to clog more easily. 

While ear infections are typically more common in children through the age of eight, older children and adults can also get ear infections.

What Are the Symptoms of an Ear Infection?

While the most obvious symptom of an ear infection is pain in the ear, a very young child likely won’t be able to verbalize this. Other signs and symptoms of ear infections include:

• Tugging or pulling at the ear
• Fussiness and crying
• Trouble sleeping
• Loss of appetite
• Fever (especially in infants and younger children)
• Yellow, brown or white fluid draining from the ear
• Trouble hearing or responding to quiet sounds

If your child is experiencing bothersome ear pain or exhibiting these symptoms, it’s important to schedule an appointment with their provider for an ear exam.

How Are Ear Infections Treated in Children?

Treatment for ear infections varies depending a number of factors including your child’s age, the severity of the infection, and if it’s a new or ongoing infection. Mild ear infections may get better on their own as your child’s immune system fights the infection. Because of this, their provider may recommend waiting a few days and monitoring the infected ear before prescribing antibiotics.

If your child’s provider prescribes an antibiotic, it’s important to complete all of the doses to ensure the infection doesn’t return. In many cases, your child’s ear pain will start to feel better after a few days of treatment. Your child’s provider will let you know if a follow-up visit is required to reevaluate their ears.

In the meantime, over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can help keep your child’s fever down, and relieve discomfort or pain. Consult with your child’s health-care provider for specific dosage instructions—and remember, babies younger than 6 months of age should not take ibuprofen.

How Do I Know if My Child Needs Ear Tubes?

If a younger child has recurrent ear infections or hearing-related issues caused by fluid buildup in the ear, their provider may refer them to an Ear, Nose and Throat (ENT) specialist. After an evaluation, your child’s specialist may recommend performing a tympanostomy, or tube insertion. This short surgical procedure is the most common childhood surgery performed in the U.S., and takes on average eight to 15 minutes.

During this outpatient procedure, small tubes are placed into the eardrums which help prevent the buildup of fluid and improve air flow. For most babies and young children, this procedure is highly effective at treating and preventing chronic ear infections and is most common for children between ages one and three.

Can Ear Infections Be Prevented in Children?

While there isn’t a way to directly prevent ear infections, keeping your child as healthy as possible can certainly help them avoid getting sick. A few things you can do to help reduce their risk of illness include:

• Proper hygiene: Encourage older children to bathe and wash their hands frequently. Teach young children good hygiene and hand washing habits.
• Vaccines: Keep your kids up-to-date with their vaccines. Studies show that children who have had the proper vaccinations experience fewer ear infections.
• Avoid secondhand smoke: Smoking is a big contributor to illnesses in children. It’s important to keep your child away from secondhand smoke to keep them healthy.
• Breastfeed: Infants that breastfeed for the first year of life receive protective antibodies through their mother’s breastmilk. If bottle feeding, ensure all bottles and pump parts are washed and sanitized thoroughly to avoid the spread of bacteria.

We know ear infections are incredibly frustrating—for you and your child. Fortunately, many children experience less ear infections as they get older. If you have questions or concerns about ear infections and your child, it’s important to schedule an appointment with their provider.