Ear Infection Symptoms in Babies and Toddlers

From fever to drainage, learn the signs of an ear infection in toddlers and infants so you can nip this common childhood ailment in the bud.

Baby Ear Infection Crying
Photo: Dayna Moore/Shutterstock.com

Recently, I noticed my 8-month-old son tugging on his right ear. That, combined with his unusual crankiness, got my attention. Was he teething? Just discovering his ear? Or could he be signaling that he was suffering from an ear infection? He was just getting over a cold, so I decided to call the pediatrician's office. The nurse suggested bringing him in for a quick peek at his ears.

The verdict: no ear infection! While I was relieved, the incident did get me thinking. Did I have to drag him in every time he pulled at his ear? That seemed a little extreme. But what if I was too laid back and missed a real ear infection? I decided it was time to learn a little bit more about this common childhood ailment.

"Next to the common cold, ear infections are the most common disorder in children," says Margaretha Casselbrant, MD, PhD, chief of the division of pediatric otolaryngology at Children's Hospital of Pittsburgh. But ear infections are not always easy for a parent to diagnose because the symptoms can be vague and mimic those of a regular cold or flu. In fact, ear infections often start as a cold with a cough and a runny nose.

While it's certainly tricky, there are still signs that are specific to ear infections. Here's how to tell if it's an ear infection, mom.

Signs It's an Ear Infection

Because infants and toddlers don't yet have the language skills to let you know how they're feeling, detecting an ear infection is especially hard.

Despite what you may think ear tugging is not a reliable sign, according to experts. So what should parents be on alert for?

"In general, a fever above 102 degrees is one of the hallmarks of an ear infection in a nonverbal child," says Max M. April, MD, chair of the committee on pediatric otolaryngology for the American Academy of Otolaryngology - Head and Neck Surgery.

The following signs also may indicate your child is suffering from an ear infection:

Pain in the ear:

Ear infections are painful, so your infant or toddler's tears or increased irritability may be a symptom. Also, if your baby becomes more upset when she's lying down, an ear infection may be to blame, because that position puts pressure on the eustachian tubes.

Difficulty falling or staying asleep:

This is due to the pain from pressure building in the ears. Sometimes active, busy kids will complain more about pain when things quiet down at the end of the day or when it's time for sleep.


A sign that her immune system is at work fighting off infection, your child's temperature may range from 99 F. to 104 F., taken rectally.

Trouble hearing:

Fluid buildup in the ear may block sound so she may not respond to sounds around her as she normally would. Rest assured — her hearing will come back once the infection is gone and her ear is free of fluid.

Decreased appetite:

The ear infection itself shouldn't cause problems swallowing, but your child may lose his appetite because he just doesn't feel well. Vomiting and diarrhea may also crop up.

Fluid or pus draining from your child's ear:

While not very common, this is a definite sign of infection, so call the doctor right away. Yellow, white, or green drainage from the ear can signal a perforated eardrum, a condition that can develop if the fluid in the middle ear puts so much pressure on the eardrum that it bursts.

Although a burst eardrum may sound scary and can be very painful for your child, the hole is not serious and will usually heal by itself. And the good news is that your child may start to feel better as fluid drains and pressure decreases.

Still Not Sure? Head to the Doc

The only way to be sure that your child has an ear infection is to visit your pediatrician. Take a baby younger than age 2 to the doctor if a cold and apparent discomfort don't go away in two or three days, or if a fever doesn't go away in one or two days. (If your infant is less than 4 months old, notify your doctor of any fever immediately.)

When your physician peeks in your child's ear to check for signs of an infection, she's looking at the eardrum to see if it is red, thick, or bulging.

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