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You expected lots of amazing changes with pregnancy, but some of them might still surprise you. Case in point: Being pregnant might give you a higher chance of getting an ear infection, of all things.

Ear infections during pregnancy may happen for several reasons. They’re usually relatively harmless and easily treated.

But see a doctor if you have any kind of infection during pregnancy. If left untreated, ear infections can be harmful for your health and to your growing baby — and in rare cases may lead to complications.

Infections in general are more common when you’re pregnant. And ear, nose, and throat changes during pregnancy might increase your risk of ear infections in particular. An ear infection can be caused by a bacterial or viral infection.

Pregnancy changes that may make this more likely include:

  • Higher basal metabolic rate (BMR). During pregnancy, your body requires increased oxygen levels and blood volume. This means that your heart also works harder to move all this fluid around. You might get an earache — though not necessarily an infection — if there’s fluid buildup inside the ear.
  • Hormonal changes. During pregnancy, estrogen and progesterone levels go up. These hormones can affect your immune system, making you more susceptible to illness from bacteria and viruses. However, the exact link between hormones and infections isn’t entirely clear.
  • More fluid. Increased blood flow means more fluid staying in your body. This can lead to other side effects. For example, you may have noticed that during pregnancy you often have a stuffy nose. More fluid in your nose and sinuses during pregnancy might increase the risk of an ear infection.

Changes during pregnancy can also cause other temporary ear issues like vertigo or dizziness. Your hearing and balance might be affected during pregnancy if you have an existing condition like Meniere’s disease.

And if it’s allergy, cold, or flu season, everyone has a higher chance of getting ear and other infections.

An infection or damage in the inner ear can sometimes lead to:

  • vertigo
  • hearing loss
  • tinnitus (ringing in the ears)

Symptoms of ear infection include:

  • burning, sharp, or dull pain — especially if you press on the outer ear
  • swelling, redness, or inflammation of the ear canal
  • itching in and around the ear
  • hearing loss
  • tinnitus, or ringing in the ear
  • headache
  • yellow or green drainage from the ear

Home remedies may help soothe symptoms when used with prescription medication — or if a doctor decides that you don’t need medical treatment. Home remedies for earaches include:

  • ear drops made from a mixture of one part rubbing alcohol and one part vinegar (don’t use this remedy if you have other ear issues, such as damage to the ear canal)
  • a warm compress, like a gently heated water bottle or towel
  • herbal ear drops (clear this with an OB during pregnancy)

See a doctor regularly for prenatal care. Let your doctor know immediately if you think you may have an ear infection.

Not all earaches are infections — however, it’s always safer to get checked. An infection can spread and damage your hearing.

Tell your doctor if you have any other ear symptoms, like tinnitus (ringing in your ears). Other serious health conditions like high blood pressure or iron deficiency anemia can also cause some ear symptoms like tinnitus.

In some cases, your doctor may refer you to an otolaryngologist or ENT specialist, which is a doctor who specializes in disorders associated with the ear, nose, or throat.

Check with your doctor before taking over-the-counter pain medication. Acetaminophen is considered safe during pregnancy, but you should avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve).

In most cases, antibiotics are used to treat serious bacterial ear infections. However, during pregnancy, many antibiotics may not be safe to take. Your doctor can select the best option.

Your doctor will look inside your ear canal for inflammation. They may remove fluid to be tested.

If you have a serious bacterial ear infection, your doctor may prescribe antibiotic ear drops that will need to be used for up to 2 weeks. Other treatments that may be safe during pregnancy include ear washes and ointments.

Any kind of infection can be harmful to you and therefore your baby.

If left untreated, a serious ear infection can spread to the brain or other areas of the body. If you have a serious infection, your doctor may recommend taking an antibiotic that’s safer during pregnancy.

You can’t always avoid an ear infection or any other kind of infection. However, you may be able to reduce your risk of an ear infection during pregnancy with these tips:

  • Don’t scratch your inner ear, especially with cotton swabs.
  • Use a soft flannel cloth to clean the outside of your ears and the inner rim.
  • Wear a swimmers cap or keep your head above water if you’re swimming.
  • If you get water in your ears, try removing it with a soft, clean cloth.

The many changes in your body during pregnancy may increase your risk for some kinds of infections, including those of the ear.

In most cases, ear infections during pregnancy are mild. However, it’s important to see a doctor if you have any kind of ear symptoms.

In serious cases, an ear infection can cause lasting damage and affect your hearing if left untreated.

Not all pain medications and antibiotics are safe during pregnancy, though. Your doctor can prescribe the safest treatment for you.