Tugging at their ear isn’t the only thing to watch out for.
For parents, few things are more upsetting than a toddler with an ear infection. Not only are they extra cranky, but it can be hard to figure out exactly what is bothering them, especially before they start really speaking. Unfortunately, toddlers are sick all the time (my 2.5-year-old, for example, has been congested for the last four months), and since their endless energy can make it easy to miss things, figuring out how to tell if your toddler has an ear infection can be a little tricky.
According to the National Institute of Health, ear infections in toddlers are par for the course: they estimate that five out of six children will experience an ear infection before their third birthday. Ear infections are easy to treat and will sometimes even go away on their own, but that still doesn’t mean you want to ignore them. They can be really painful and uncomfortable, and getting some type of treatment for your child can be beneficial for everyone. Look out for the signs that your toddler has an ear infection so you know exactly when to call their pediatrician for a sick visit.
There are different types of ear infections out there, but some are more common in toddlers than others. “The most common type of ear infection in toddlers is a middle ear infection, or acute otitis media (AOM),” explains Dr. Jonathan Maynard, a pediatrician with Providence Mission Hospital. “AOM often develops after a period of congestion, especially as children are recovering from a common cold.”
The most obvious sign of an ear infection is pain in and around the ear. Maynard notes that a toddler who is tugging, rubbing, or holding their ear may be experiencing some of that discomfort. “Depending on the age of the child, the ear tugging can be very obvious, like pulling on the ear or sticking a finger in their ear,” adds Dr. Gary Kirkilas, a Phoenix Children’s pediatrician. “Or it can be subtle with just touching the ear.”
Both Maynard and Kirkilas note that there are other symptoms to watch out for as well, including:
The above symptoms are fairly common, but sometimes there are other signs that aren’t quite as obvious. Sure, you expect an ear infection to cause pain around the ear and maybe a rise in temperature, but digestive issues? It’s possible. “Some toddlers may develop an upset stomach, vomiting, or diarrhea with an ear infection,” Maynard says. “This is because the inner part of the ear is likely inflamed. This inflammation can affect your toddler’s balance, which can affect their stomach and digestive system.”
Your toddler might also complain of a sore throat, which Maynard explains can happen often. “Ear infections can sometimes mimic a sore throat, as the act of swallowing can irritate an inflamed middle ear.” And if you notice a bump below the affected ear, don’t be alarmed. Maynard says this is more than likely just the lymph nodes swelling in response to the infection.
You may also notice that even after an ear infection has been resolved and your child seems to be doing a lot better, they’re still experiencing some discomfort in the ear area. That likely doesn’t mean they caught another infection. “After an ear infection has resolved, the space behind the ear drum is often filled with pus and fluid,” explains Kirkilas. “It can take several weeks for this fluid to drain, which results in a prolonged period of diminished ability to hear.”
If you catch an ear infection in time and get it treated promptly, it can be easily treated and your toddler will be OK within a few days. Sometimes, though, the infection can become more serious. “An ear infection is usually considered severe if your child develops a fever higher than 102.2° F, their pain has persisted over 48 hours, or there is any sign of bloody discharge from their ears,” Maynard says. Kirkilas notes that seeing blood or pus drain from the ear can be a sign that the ear drum has ruptured. If you suspect your toddler has a severe infection, both doctors recommend calling your pediatrician or going into an urgent care immediately.
Watch out for these symptoms even if your child is on an antibiotic. “Antibiotics, such as amoxicillin, are very effective against middle ear infections, but in rare cases your child may have a resistant infection that requires switching antibiotics,” Maynard says. He recommends calling your doctor if their symptoms do not improve within 48 hours of treatment.
You should also look out for persistent hearing loss. “If your child suffers from recurrent ear infections for several months, their pediatrician may refer them to a specialist who can place tubes in the eardrum to help prevent fluid from collecting,” Maynard says.
If your child’s symptoms check all the boxes of an ear infection, don’t panic! Remember, this is a common and easily treated infection, and while illness in little ones can be scary, especially for first time moms, you can get this under control. First things first: make an appointment with their pediatrician before you start treating anything on your own. “While your child’s s symptoms may suggest an infection, a direct examination of the ear drum is needed to diagnose AOM,” Maynard says.
In the meantime, both Maynard and Kirkilas say you can offer acetaminophen or ibuprofen to reduce any fever and help with pain (be sure to contact your doctor to find out the exact dosage for your tot). Maynard also recommends having them drink a lot of fluids and elevating their head, which may relieve ear pressure. Your pediatrician may also prescribe antibiotics to fight off the ear infection.
Dr. Jonathan Maynard, a pediatrician with Providence Mission Hospital
Dr. Gary Kirkilas, Phoenix Children’s pediatrician