How to Spot the Signs of an Ear Infection in Baby

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It's the middle of the night, and your child is lying awake crying. It could be an ear infection, but how can you tell?

Children between the ages of six months and two years are more prone to ear infections than older children and adults because of their undeveloped immune system and the size and shape of their eustachian tubes. Ear infections are caused by a bacteria or virus and lead to fluid buildup in the eustachian tubes, which prevents them from draining normally from the middle ear. Ear infections often occur when a child has a cold, sinus infection or allergies.

Babies and toddlers don’t have the language skills to verbally communicate their ear hurts, so Andrew Sims, DO, UnityPoint Health explains common ear infection signs.

Ear Infection Signs

Tugging at the Ear

Ear infections cause ear pain and discomfort. In an attempt to alleviate the pain, children will pull on their ear. Babies under the age of one might hit their ear, because they have difficulty locating and connecting the pain to the ear.

Difficulty Sleeping or Lying Down

When a child with an ear infection lies down, it causes a shift in pressure in the middle ear. The change in pressure is painful and uncomfortable, which makes sleeping or lying down flat difficult for children.

Ear Drainage

A sure sign of an ear infection is fluid or pus draining out of a child’s ear. Although not all children experience it, this thick, yellow or bloody fluid is the result of a ruptured eardrum. Don’t be concerned about a ruptured eardrum; it'll heal on its own in a few weeks.

Crying More Than Usual

Due to pain and pressure caused by ear infections, a child may cry, fuss or be more irritable than usual. 

Difficulty Hearing

Fluid builds up and sits in the middle ear when a child has an ear infection, which may cause a temporary loss of hearing. For infants and toddlers unable to speak, they may be unresponsive to sounds. Older children may ask, “What?,” more frequently throughout the duration of their ear infection.


A fever is a noticeable sign the body is working hard to fight off an infection. When a child has a temperature of 100 F, it's important to be observant of other common symptoms as their body could be trying to fight off the infection in the ear. 

Loss of Balance

The center of balance is located in the inner ear. Pressure and fluid buildup from an infection in the ear may cause dizziness, unsteadiness or clumsiness.

Diarrhea, Vomiting, Reduced Appetite

The virus that causes the ear infection also affects the gastrointestinal tract, upsetting the stomach. Children may experience diarrhea, vomiting or reduced appetite while they're sick. Ear infections also make it difficult to chew and swallow because of the changes in pressure. If you notice a decrease in your child’s appetite, look for additional signs that may indicate they have an ear infection.

Ear Infection Treatment

Most ear infections go away without the use of antibiotics. Symptoms typically improve after a couple of days, with full recovery after one to two weeks. However, call your doctor if symptoms don't improve after a day or two. Your doctor will advise you on a treatment plan or prescribe an antibiotic to help heal the infection. "It’s never wrong to have your child checked out, if you're concerned about an ear infection. We have tools most parents don’t have at home that allow us to see the ear drum more clearly. Young children can’t typically tell us what's causing their pain and less concerning issues, such as teething, can only be diagnosed once we rule out an ear infection." says Dr. Sims. 

If your child displays the symptoms of an ear infection that don’t go away, schedule an appointment to see their primary care provider