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What is an ear infection?

If your baby is fussy, cries more than usual, and tugs at their ear, they may have an ear infection. Five out of six children will have an ear infection before their 3rd birthday, according to the National Institute on Deafness and Other Communication Disorders.

An ear infection, or otitis media, is a painful inflammation of the middle ear. Most middle ear infections occur between the ear drum and the eustachian tube, which connects the ears, nose, and throat.

Ear infections often follow a cold. Bacteria or viruses are usually the cause. The infection causes inflammation and swelling of the eustachian tube. The tube narrows and fluid builds behind the eardrum, causing pressure and pain. Children have shorter and narrower eustachian tubes than adults. Also, their tubes are more horizontal, so it’s easier for them to get blocked.

Approximately 5 to 10 percent of children with an ear infection will experience a ruptured eardrum, according to the Children’s National Health System. The eardrum usually heals within one to two weeks, and rarely causes permanent damage to the child’s hearing.

Symptoms of an ear infection

Earaches can be painful and your baby can’t tell you what hurts. But there are several common signs:

  • irritability
  • pulling or batting at the ear (note that if your baby has no other symptoms this is an unreliable sign)
  • loss of appetite
  • trouble sleeping
  • fever
  • fluid draining from ear

Ear infections can cause dizziness. If your baby has reached the wobbling stage, take extra care to protect them from falls.


For years, antibiotics were prescribed for ear infections. We now know that antibiotics are often not the best option. A research review published in The Journal of the American Medical Association notes that among average-risk children with ear infections, 80 percent recover in about three days without the use of antibiotics. Using antibiotics to treat an ear infection may cause the bacteria responsible for ear infections to become resistant to antibiotics. This makes it harder to treat future infections.

According to the American Academy of Pediatrics (AAP), antibiotics cause diarrhea and vomiting in approximately 15 percent of children who take them. The AAP also notes that up to 5 percent of children prescribed antibiotics have an allergic reaction, which is serious and can be life-threatening.

In most cases, the AAP and the American Academy of Family Physicians recommend holding off on starting antibiotics for 48 to 72 hours because an infection may clear up on its own.

However, there are times when antibiotics are the best course of action. In general, the AAP recommends prescribing antibiotics for ear infections in:

  • children age 6 months and younger
  • children age 6 months to 12 years who have severe symptoms

What you can do

Ear infections can cause pain, but there are measures you can take to help ease the pain. Here are six home remedies.

Warm compress

Try placing a warm, moist compress over your child’s ear for about 10 to 15 minutes. This may help reduce pain.


If your baby is older than 6 months, acetaminophen (Tylenol) may help relieve pain and fever. Use the medication as recommended by your doctor and the instructions on the pain reliever’s bottle. For best results, try giving your child a dose before bed.

Warm oil

If there is no fluid draining from your child’s ear and a ruptured eardrum isn’t suspected, place a few drops of room temperature or slightly warmed olive oil or sesame oil in the affected ear.

Stay hydrated

Offer your child fluids often. Swallowing can help open the eustachian tube so the trapped fluid can drain.

Elevate your baby’s head

Slightly elevate the crib at the head to improve your baby’s sinus drainage. Do not place pillows under your baby’s head. Instead, place a pillow or two under the mattress.

Homeopathic eardrops

Homeopathic eardrops containing extracts of ingredients such as garlic, mullein, lavender, calendula, and St. John’s wort in olive oil may help relieve inflammation and pain.

Preventing ear infections

Although many ear infections can’t be prevented, there are steps you can take to lessen your baby’s risk.


Breastfeed your baby for six to 12 months if possible. Antibodies in your milk can protect your baby from ear infections and a host of other medical conditions.

Avoid secondhand smoke

Protect your baby from exposure to secondhand smoke, which can make ear infections more severe and more frequent.

Proper bottle position

If you bottle feed your baby, hold the infant in a semi-upright position so formula doesn’t flow back into the eustachian tubes. Avoid bottle propping for the same reason.

Healthy environment

When possible, avoid exposing your baby to situations where cold and flu bugs abound. If you or someone in your household is sick, wash your hands often to keep the germs away from your baby.


Make sure your child’s immunizations are up-to-date, including flu shots (for 6 months and older) and pneumococcal vaccines.

When to call the doctor

The Centers for Disease Control and Prevention (CDC) recommends seeing a doctor if your baby has any of the following symptoms:

  • fever higher than 100.4°F (38°C) if your baby is under 3 months, and over 102.2°F (39°C) if your baby is older
  • discharge of blood or pus from the ears

Also, if your baby has been diagnosed with an ear infection and symptoms don’t improve after three to four days, you should return to the doctor.