parent holding crying baby who has a serious ear infectionShare on Pinterest
Westend61/Getty Images

Tiny fingers. Tiny toes. Tiny ears. Everything about your little bundle of joy is, well, little.

Unfortunately, their tiny ears can experience frequent infections. While ear infections are fairly common in young children, they can become serious.

If you’re wondering when you should be concerned about ear infections, the common signs of an ear infection, and even whether pacifier use could be leaving your child more likely to get an ear infection, you’ve come to the right place.

An ear infection is inflammation of the middle ear caused by bacteria or viruses when fluids build up behind the eardrum. Otitis media (OM) is the scientific name for an ear infection.

There are three main types of OM:

  • Acute otitis media (AOM): This is the most common ear infection type. Parts of the middle ear are infected and swollen, and some fluid is trapped behind the eardrum.
  • Otitis media with effusion (OME): This can sometimes occur when an ear infection has run its course, but liquid still remains behind the eardrum.
  • Chronic otitis media with effusion (COME): This happens when fluid remains in the middle ear for a long time or keeps returning even when there is no infection.

While not common, some ear infections can lead to serious health conditions, like:

To help prevent these complications, you can visit your child’s doctor if pain persists or certain symptoms develop.

When to call your pediatrician if your child has an ear infection

Contact your child’s pediatrician or another healthcare professional if your child:

  • is crying nonstop
  • is taking antibiotics and still has a fever after 2 days
  • seems to have ear pain that seems worse or constant
  • still seems to have ear pain after 3 days of antibiotics
  • has the same or worse ear discharge after 3 days on antibiotics
Was this helpful?

If your child isn’t old enough to tell you that their ear hurts, you’ll want to keep an eye out for:

  • crying or fussiness
  • difficulty sleeping
  • fever
  • fluid draining from the ear
  • trouble hearing soft sounds
  • other signs of illness

Ear infections are usually the result of bacteria that develop when fluid builds up behind the eardrum. Viruses can also cause ear infections.

Ear infections often begin when a child has a cold, cough, or other upper respiratory infection. The same viruses responsible for these illnesses can cause an ear infection. A bacterial ear infection can develop during a cold or cough, too.

Your child’s pediatrician can diagnose an ear infection. To make a diagnosis, they will use a light called an otoscope to look for fluid in the middle ear and to monitor pressure. The pediatrician will also use the otoscope to look at the color and position of the eardrum.

The best thing you can do to prevent ear infections in your little one is to reduce the risk of getting ear infections in the first place.

This can include doing things like:

  • vaccinating your baby against the flu and pneumococcal disease
  • washing your hands frequently as well as anything that goes in your baby’s mouth
  • avoiding areas with cigarette smoke
  • limiting your child’s exposure to other children or adults who are sick
  • never laying your baby down with a bottle in their mouth

Children under the age of 5 years have an increased risk of ear infection because of their shorter eustachian tubes.

Additionally, children with Down syndrome are more likely to have ear infections due to their facial structure. Those of First Nations and Inuit descent also have a higher risk of ear infections, though doctors don’t fully know why yet.

Other risk factors for ear infections in young children include:

Occasional ear infections are very common in young children. Research estimates that 5 out of 6 children will have at least one ear infection by the time they turn 3 years old.

If there’s no high fever and much pain, doctors may recommend waiting a few days to see whether things improve before prescribing antibiotics.

When antibiotics are prescribed, they are typically taken for 5 to 10 days. However, pain relief may be felt as early as the first day of taking them. It’s important to take the entire prescribed amount, even if your child starts feeling better.

Your child’s pediatrician may wish to see your child after the antibiotics to make sure that everything has cleared up. Fluid may remain without inflammation for a few weeks.

Some children experience ear infections more frequently than others. If a child experiences frequent ear infections or has trouble hearing because of fluid in the middle ear, their doctor may discuss surgically placing a tube in their ear. The tube can help drain fluids and normalize pressure on both sides of the eardrum.

Does using a pacifier increase the risk of an ear infection?

Research has indicated that the risk of ear infection may be up to three times higher in children who use a pacifier. Additionally, children who use a pacifier continuously may be more at risk of an ear infection than those who only use it occasionally.

However, using a pacifier is a personal choice. In some cases, using a pacifier is recommended.

Talk with your pediatrician if you have questions about pacifier use, especially if your baby has frequent ear infections.

Does side-lying while breastfeeding increase the risk of an ear infection?

At least one study has shown that an infant’s position during breastfeeding is not related to ear infections.

This may be because breast milk is generally less irritating than formula, and breastfed babies are less prone to allergies and respiratory infections.

Can bath or pool water cause ear infections?

Bath water usually won’t get past the eardrum to reach the middle ear. Swimmer’s ear, which can develop from water that stays in the outer ear canal for too long, is not the same as a middle ear infection despite the potential for similar symptoms.

Drying ears thoroughly after swimming or bathing can help reduce the risk of ear infection.

Fussiness and fever can indicate that your little one has developed an ear infection. While this is a common issue for kids, you’ll want to talk with their pediatrician if it persists or doesn’t get better with medication.

The earlier you can start treatment, the more you can help prevent complications from developing.