Ear infections in babies

Ear infections (otitis media) are very common in toddlers and babies, and it’s normal for your little one to develop one at some point in their childhood. If you’re wondering how to tell if your baby or toddler has an ear infection, what can be done to treat and prevent them, and the causes of ear infections, read on to find out more.

How Common Are Ear Infections in Babies and Toddlers?

Most children get an ear infection in their first few years of life, most frequently between 6 and 15 months of age. Moreover, 1 in 4 children have had an ear infection by the time they turn 10 years old. An infection of the inner or middle ear, also known as otitis media, is the most common type of ear infection in children.

Signs and Symptoms of an Ear Infection in Your Baby or Toddler

So, you may be wondering how to tell if your baby or toddler has an ear infection? It’s not easy to figure this out with babies (toddlers will often tell you when they have ear pain), but there are some signs you can look for. Here are some common signs of an ear infection in your baby or toddler:

  • You may see your baby or younger child pulling at their ear. An older child may tell you their ear hurts

  • Trouble sleeping or irritability

  • Decreased appetite

  • High temperature or fever

  • Poor balance

  • Difficulty hearing in toddlers or unresponsive to quiet sounds in babies due to the fluid build-up. This may also cause inattentiveness in your child

  • Drainage from the ear that's either pus or fluid. This may indicate your child’s eardrum has developed a small hole due to the infection.

What Causes Ear Infections in Babies and Toddlers?

You may be wondering how babies and toddlers get ear infections. There are quite a few situations that can lead to your child developing otitis media (ear infection), including:

  • Your child previously had a cold. A cold can cause a build-up of mucus in the ear which can lead to an infection if the tube between the ear and back of the nose (Eustachian tube) becomes blocked and swollen.

  • Underdeveloped Eustachian tubes. Since children are still growing and developing, their Eustachian tubes are smaller and shorter than in adults, making them more susceptible to blockages and infections.

  • Your child attends nursery or preschool. Children under 1 year old who attend day-care or nursery tend to get more ear infections than those who are cared for at home, since they’re exposed to more viruses through contact with other children.

  • Certain conditions. Conditions such as a cleft palate or Down’s syndrome can increase the risk of ear infections.

  • Second-hand smoke. If your child breathes in tobacco smoke or is in a smoky environment, it can increase their risk of getting an ear infection.

How to Prevent Ear Infections in Babies and Toddlers

There are a few ways you can help to lower your baby and toddler’s chance of getting ear infections:

  • Breastfeeding your baby. Antibodies that you pass on to your baby in breast milk are known to promote a lower rate of ear infections in breastfed babies.

  • Always bottle-feeding your baby in an upright position. Feed your baby so their head is above the level of the stomach to prevent the Eustachian tubes from getting blocked by the fluid

  • Avoiding smoky environments

  • Ensuring your child has received their latest vaccinations

  • Avoiding contact with other children who may be unwell

  • Reducing your child’s use of a dummy after 6 to 12 months old

  • Avoiding sticking anything in the ears, such as cotton wool buds or fingers.

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Treatment for your Baby or Toddler’s Ear Infection

Ear infections usually clear up on their own within a few days. If your baby or toddler has an ear infection, try the following home treatment strategies to ease their discomfort:

  • For fever and pain, ask your doctor what pain-relief medicine is suitable for your child

  • Place a warm or cold flannel over your child’s ear to help manage the pain

  • Wipe away any discharge using cotton wool

  • If your child has a fever, keep them cool by turning down your central heating and avoid over or underdressing them

  • Ensure your child drinks plenty of fluids.

In some cases, your baby’s ear pain may be caused by teething or toothache, a build-up of earwax, a foreign object stuck in the ear, or tonsillitis, rather than an ear infection. If you’re unsure, check in with your doctor.

When to See a Doctor

Ear infections don’t usually need special treatment or antibiotics, as they often clear up by themselves within a few days. However, you may need to contact your doctor if

  • your baby or toddler has a very high temperature

  • the ear infection or pain is still present after 3 days

  • your child suffers from frequent ear infections

  • your child has a weakened immune system

  • they have a long-term medical condition or illness

  • you notice fluid coming out of your child’s ear

  • your child has hearing loss

  • there is swelling around the ear

  • your child is less than 2 years old and has an infection in both ears.

The doctor may look inside your little one’s ear using a small light and may also blow a small puff of air into each ear using an otoscope, to check for blockages. Depending on the cause of your child’s ear infections and the risk factors associated, your doctor may prescribe ear drops and/or antibiotics. For recurring ear infections that are often severe in your baby or toddler, your doctor may recommend ‘grommets’. Grommets are tiny tubes that are inserted into the eardrum and help to drain fluid. The grommets are usually left in for 6 to 12 months, and naturally fall out once the ear drum is healed. The procedure of inserting grommets usually takes about 15 minutes, is painless and done under general anaesthetic. For more information on grommets, or if you have any concerns about your child’s ear infection, ask your doctor or health visitor.

Should You Limit Your Child’s Activities During an Ear Infection?

We recommend checking with your doctor before your child takes part in any activities or mixes with other children. If your little one has an ear infection caused by a contagious cold or flu virus, it is highly recommended that they avoid attending nursery or mixing with others, as it can be easily spread. If your baby or toddler participates in swimming, it may be OK for them to swim while recovering from an ear infection as long as they avoid getting water into their ears. They can prevent this by wearing a swimming hat over their ears or using earplugs. Check with your doctor first, to be on the safe side. If you need to travel by airplane with your baby or toddler, check with your doctor first to ensure it’s ok. Flying is usually fine, but your child may experience pain from the pressure changes. This can be remedied by breastfeeding or bottle feeding your baby or offering them a dummy, as the sucking and swallowing can ease the discomfort.

In Summary

Contact your child’s doctor if you think your baby or toddler has an ear infection. In the meantime, you can treat their fever and keep them comfortable. At the appointment, the provider may prescribe an antibiotic or eardrops for your child. You don’t need to keep your child home from nursery or school during their recovery unless they have a virus.

FAQS AT A GLANCE

  • Your child may have an ear infection if you notice the following:
    • Pulling at their ears or complaining of ear pain
    • Trouble sleeping or irritability
    • Decreased appetite
    • High temperature
    • Poor balance
    • Difficulty hearing

  • If your baby has an ear infection, you can
    • give them an age-appropriate dose of ibuprofen or paracetamol
    • place a warm or cold flannel over their ears
    • keep them cool if they have a fever
    • wipe away any fluid drainage
    • make sure they drink plenty of fluids.

  • Ear infections can be caused by
    • a cold or flu virus- more easily contracted in day care
    • smaller Eustachian tubes can get blocked more easily
    • smoky environments
    • conditions such as cleft palate or Down’s syndrome.

The Bottom Line

Ear infections, also known as otitis media, are very common in babies and toddlers. Being exposed to colds and other childhood illnesses in a day care setting can increase the chance of your child also getting an ear infection. Smoking around your baby or bottle-feeding in a lying position can also increase the chance of them getting an ear infection. Ear infections can be accompanied by fever and ear pain. Until you’re able to have your child seen by their doctor, you can keep your little one comfortable by using a pain-relieving medication or a warm compress. Your child may need antibiotics to completely recover from the ear infection, depending on the cause and risk factor. During this time, your child can go about their days as normal—there’s no reason to keep them home from nursery or preschool. Most ear infections tend to be minor and clear up on their own without causing your child problems, so take heart that your little one will soon recover from their ear infection and be back to their usual self.

How We Wrote This Article
The information in this article is based on the expert advice found in trusted medical and government sources, such as the National Health Service (NHS). You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.