One of the hardest parts of caring for a little one is seeing them in pain and feeling powerless to help. They might not be able to talk, but they’re communicating their distress loud and clear. Crying, restlessness and disrupted eating habits are all signs something is wrong. But what exactly is the matter? It could be an ear infection.

Ear infections in babies are incredibly common. About 75% of children get one before their third birthday, and an unlucky 25% will get them more than once.

Read on to learn more about baby ear infection symptoms, as well as possible causes, treatment options and when your baby should see a doctor.

Type and causes of ear infections in babies

An ear infection happens when fluid containing bacteria or viruses gets trapped in your ear. Over time these “trapped germs” can grow into an infection. Viral infections typically go away on their own within a week or so, but bacterial infections may need antibiotics to be cured.

Your child’s doctor can help determine whether your child may have a viral or bacterial ear infection, and the location of the infection. The type of ear infection is determined by where fluid builds up: outer ear, inner ear or middle ear.

The most common type of ear infection that babies get is a middle ear infection, also known as “otitis media.” Middle ear infections happen when fluids build up due to a cold, allergies or the flu. So it’s not uncommon for a little one to suffer from one of these conditions, then soon after develop an ear infection.

Why does it seem like you and your child get the same cold, but your kiddo develops symptoms of an ear infection, and you don’t? It comes down to size and anatomy.

Babies have smaller ears, with smaller and more level eustachian tubes – the tubes that drain fluid away from the ears. Because of their size and position, eustachian tubes can’t drain as easily in children as they do in adults, so ear infections are more likely to happen. Babies also lack the fully developed immune systems that healthy adults have. As a result, they are much more susceptible to infections.

Baby ear infection symptoms

Your baby can’t tell you what’s wrong, but they’ll give you plenty of clues by displaying the following symptoms:

  • Disrupted sleeping
  • Crying and fussiness
  • Rubbing or pulling at their ear
  • Rubbing the side of their head
  • Trouble hearing
  • Fluid draining from their ear
  • Blood in their ear
  • Fever

Every child is different, so they likely won’t have all the above symptoms. And while fevers are common with ear infections, the thermometer doesn’t tell the whole story. Babies can have an ear infection without running a fever.

If you think your child has an ear infection, a great first step can be contacting your care provider’s nurse line. If you’re a HealthPartners patient or insurance plan member, you can call our CareLine at 800-551-0859 or 952-993-4665 to speak with a nurse 24/7. They’ll listen to your child’s symptoms and offer suggestions to help manage them. They can also help you decide when and where to seek care.

Is it an ear infection or just teething?

It can be difficult to tell if your baby is aggravated by a new tooth coming in or if it’s an ear infection. Teething can cause some pain but typically not as much pain as ear infections cause. Symptoms of teething include:

  • Increased saliva
  • Drooling
  • An increased desire to chew on firm objects

Fever and trouble sleeping are rarely associated with teething, so be sure to look out for these differentiators. Additionally, if your baby’s hands are going to their mouth more than their ear or side of their head, it’s a good indication that baby may be teething.

When babies should be seen by a doctor for ear infection symptoms

While many ear infections can be treated at home, some need medical attention. Watchful waiting is the recommended course of action for children over 2. For babies, you’ll want to see a doctor or clinician if:

  • Your baby has a fever, especially if they are younger than 3 months old, or if your older baby’s temperature is above 102 degrees Fahrenheit.
  • The ear infection symptoms aren’t getting better after a couple of days.
  • There’s fluid draining from the ear.
  • Your baby is experiencing changes or loss of hearing.
  • Your baby is experiencing a lot of pain or discomfort.

Ear infection treatment for babies

When it comes to treating ear infections in babies, doctors will make recommendations based on several factors, including symptom severity and the age of your child.

For children under 2 years old, antibiotics are often the treatment of choice. That’s because their young immune systems often need a little help to fight off ear infections. Older children with no health complications may be able to fight the infection without the use of antibiotics.

However, if a baby’s symptoms are mild and an ear exam isn’t worrisome, a doctor may recommend watchful waiting for 48-72 hours from the onset of symptoms. During this time symptoms can improve, and the infection may resolve itself.

Whether antibiotics are prescribed or not, your doctor will likely recommend infant acetaminophen or ibuprofen (depending on their age and weight) to help baby be more comfortable.

Babies are resilient, so it’s possible that your little one will be back to normal within 24 hours of beginning antibiotic treatment. However, it’s important that you continue to give your baby the prescribed dosage of antibiotics to make sure the infection is cured – and prevent it from coming back. If your baby’s symptoms don’t improve within 72 hours, call your doctor.

What happens if baby’s ear infection is left untreated?

Ear infections can often go away on their own. And while it’s possible that untreated ear infections can lead to complications like meningitis or permanent hearing loss, it’s very rare. It’s important to always seek medical care if you suspect an ear infection in your child and they’re experiencing worse or worrisome symptoms.

Are there home remedies for baby ear infections?

Home remedies for baby ear infections like warm compresses and over-the-counter pain relievers formulated for infants can help manage symptoms. While they don’t cure the infection, these remedies can help your little one feel more comfortable while their body fights it off – with or without the help of antibiotics. Of course, giving your baby plenty of snuggles can help them get through it, too.

Preventing ear infections in babies

Most babies will experience an ear infection in their young lives, but there are ways to prevent it from happening more than necessary. The following are some precautions to take to make sure you’re doing everything possible to help your baby avoid ear infections:

  • Wash your hands – It’s a classic prevention tip because it works. The more germs you can keep away, the healthier your baby will be. Since ear infections are often the result of a head cold or flu, reducing baby’s risk for these will prevent ear infections.
  • Avoid exposing your baby to cigarette smoke – Secondhand smoke has been found to increase instances of ear infections in babies.
  • Keep your baby away from sick people – Again, this will reduce their risk of catching anything that might cause an ear infection down the line.
  • Don’t let your baby fall asleep with a bottle – Fluids can become trapped and may lead to ear infections.
  • Vaccinate your baby – Help keep ear infections at bay by following the childhood immunization schedule and receiving other vaccinations that protect your baby from the flu or other ailments.

Recurrent ear infections

Sometimes there’s no way to avoid ear infections for your baby. When chronic ear infections happen, it might be time to talk to your doctor about ear tube surgery. During this common procedure, tiny tubes are placed in your child’s ear. These will help fluid drain and reduce the chance of ear infections. This is a common procedure that makes a big difference for many children.

Ear infections for breastfed babies

There is evidence to suggest that breastfed babies have a lower chance of developing ear infections. Some studies indicate that babies who are exclusively breastfed for the first year of life are half as likely to develop an ear infection as babies who are formula fed.

Get your baby the care they need

When your little one is sick, all you want to do is help them feel better. When baby ear infection symptoms first appear, a great first step is calling your care provider’s nurse line. For HealthPartners patients and members, our CareLine is available 24/7 at 800-551-0859 or 952-993-4665.

But depending on your baby’s symptoms and age, it may be best to get in-person care. Whatever you need, we’re here for you.