How to tell if your child has a middle ear infection

Published: January 14, 2022

Children are more likely than adults to get ear infections. If your child says their ear hurts, you may wonder: Could it be an ear infection? Middle ear infection (otitis media) is the most common type of ear infection. While some symptoms are easy for parents to spot, others may be more difficult to identify, especially in infants and toddlers. What are the symptoms of a middle ear infection, and what should you do if you suspect your child has one?

What is a middle ear infection?

Otitis media is when the air-filled space behind the eardrum, containing the tiny vibrating bones of the ear, becomes infected by bacteria or a virus. Children often get a middle ear infection with another illness, such as cold, flu or allergies. This can be due to congestion and swelling in the nasal passages, throat and eustachian tubes (tubes that connect the middle ears to the back of the throat).

Common middle ear infection symptoms

Some of the more common signs and symptoms of middle ear infection in children include:

• Experiencing ear pain (otalgia), especially when lying down or just in one ear
• Feeling of fullness in the ear
• Drainage from the ear (otorrhea)
• General feeling of illness
• Fluid behind the eardrum detected through examination

Additional symptoms include:

• Tugging or holding the ears (a sign of pain)
• Fever (100 F or higher)
• Headache
• Irritability, excessive crying, unable to be soothed
• Lack of energy or interest in playing or activities
• Losing balance
• Nausea, vomiting and diarrhea
• Loss of appetite
• Sleeping issues, either going to sleep or staying asleep
• Signs of muffled hearing or hearing loss — child doesn’t respond to sounds

Rare symptoms of ear infection

More rare symptoms of ear infection include:

• Ringing in the ear
• Child experiencing a spinning sensation (vertigo)
• Ruptured eardrum, with sudden flow of drainage from ear

When to see a pediatrician

The symptoms of an ear infection are shared by a number of conditions. It’s important to get a correct diagnosis and treatment as soon as possible. Call your child’s provider if:

• Your child’s symptoms last for a day or more.
• Symptoms are present in a child 6 months and younger.
• Ear pain is severe.
• Your infant or toddler is fussy and can’t sleep well after a cold or other upper respiratory infection.
• You see a discharge of fluid, pus or blood from the ear.

Preventing ear infections

“While parents can’t necessarily prevent children from getting ear infections, there are a few things they can do to reduce their child’s risk of developing one,” said Mark A. Brockman Jr., M.D., pediatrician with Norton Children’s Medical Group – Shepherdsville. “This includes keeping their child up to date on routine vaccinations, breastfeeding as long as possible, and decreasing their child’s exposure to secondhand smoke.”

Additional preventive measures include:

• Avoiding bottles in bed, as this can allow milk to pool around the eustachian tubes and create a rich environment for bacteria to grow.
• Decrease or eliminate the use of pacifiers, as children who use them have an increased incidence of ear infection.
• Consider their care environment, because larger day cares tend to expose kids to more respiratory viruses, which can lead to ear infections.