Ear infections in babies: signs, treatment and when to see a doctor
Ear infections are one of the most common reasons parents bring a young baby to the GP. Because babies cannot tell you their ear hurts, spotting the signs can feel confusing. This article summarises what the NHS says about the types of ear infection, how to recognise them in babies, what you can do at home, and when you need to see a doctor.
Types of ear infection
There are three main areas of the ear that can become infected, and each has slightly different characteristics.
- Middle ear infections (otitis media) are the most common in young children. They are caused by viruses such as the ones that cause colds and flu. When a cold spreads to the middle ear, it can lead to pain, temporary hearing changes, and sometimes a discharge if the eardrum is affected.
- Outer ear infections (otitis externa) affect the ear canal between the eardrum and the outside of the ear. They can be triggered by skin conditions such as eczema, by water getting into the ear, by using earplugs, or by bacterial and fungal infections.
- Inner ear infections are less common and are caused by viral or bacterial infections. They can cause dizziness and balance problems alongside other symptoms.
Signs of an ear infection in a baby
Older children can point to their ear or say it hurts. Babies under 12 months cannot do this, so you need to look for indirect signs. According to NHS guidance, things to watch for include:
- Rubbing or pulling at one or both ears repeatedly, especially when combined with other symptoms
- Not responding to sounds in the way you would normally expect, which can suggest temporary hearing changes
- Increased irritability or crying that seems out of character and is not explained by hunger or tiredness
- Loss of appetite, since feeding and swallowing can increase pressure and discomfort in an infected ear
- Balance problems, such as unsteadiness, which can occur because the ear plays a role in balance
- A high temperature alongside any of the above
- Discharge from the ear, which can be a sign that the infection has caused fluid to build up
It is worth noting that pulling at the ears alone does not always mean an infection. Many babies touch their ears out of curiosity or when they are teething. Look for a combination of signs rather than a single one.
How long do ear infections last?
The NHS states that ear infections often clear up on their own within three days. In some cases, symptoms can last up to a week. This natural resolution is common, which is why many ear infections do not require antibiotics straight away. However, age matters a great deal: any baby under 12 months should be seen by a GP rather than waiting at home to see if things improve.
How to ease your baby's discomfort at home
While you are waiting to see a doctor or monitoring your baby at home, there are some things that can help keep them more comfortable.
- Paracetamol or ibuprofen can relieve pain and bring a temperature down. Always use the formulation and dose designed for your baby's age and weight, and follow the instructions on the packaging carefully.
- If there is visible discharge from the outer ear, you can gently remove it using soft cotton wool. Do not insert cotton buds into the ear canal.
- Keep water and shampoo away from the affected ear during bath time.
- Avoid putting your baby in a swimming pool until the infection has fully cleared.
The NHS is clear that decongestants and antihistamines should not be used for ear infections in babies or children, because there is no evidence that they help and they can cause unwanted side effects.
When to see a doctor
For babies under 12 months, the NHS recommends seeing a GP rather than a pharmacist whenever an ear infection is suspected. Do not wait for symptoms to resolve on their own at this age.
You should seek same-day help or contact NHS 111 if your baby:
- Seems generally unwell or more poorly than the ear pain alone would suggest
- Has a high fever
- Has swelling around or behind the ear
- Has fluid or discharge coming from the ear
- Shows a noticeable change in hearing
- Is vomiting or seems unusually dizzy
- Has a severe sore throat alongside the ear symptoms
- Has a condition that affects their immune system
If earache persists beyond three days in any child, or if ear infections keep coming back, a GP visit is also recommended.
What the GP will do
A GP will examine the inside of your baby's ear using a small handheld light called an otoscope. Based on what they find, and on how unwell your baby seems overall, they will decide on the best course of action. This might include:
- Antibiotic tablets or liquid if a bacterial infection is suspected and the GP feels they are needed
- Antifungal or steroid ear drops for certain types of outer ear infection
- Painkilling ear drops to help with localised discomfort
- Advice to continue monitoring at home if the infection looks mild and is likely to resolve on its own
Occasionally, if a boil has formed in the ear canal, a GP may drain it with a small needle. This is not common but is sometimes necessary to relieve pressure.
Can ear infections in babies be prevented?
No prevention method is guaranteed, but the NHS points to a few steps that may reduce the risk of ear infections in young children:
- Keep childhood vaccinations up to date. The routine vaccine schedule helps protect against some of the viruses and bacteria that can lead to ear infections.
- Avoid smoke exposure. Babies who are regularly around cigarette smoke have a higher risk of ear infections.
- If your baby uses a dummy, the NHS suggests avoiding it after six months, as this may help reduce the frequency of middle ear infections.
Frequently asked questions
How can I tell if my baby has an ear infection?
Because babies cannot say their ear hurts, look for indirect clues: repeatedly rubbing or pulling at one ear, not responding to sounds as expected, increased fussiness, a reduced appetite, and difficulty keeping balance. A high temperature alongside these behaviours is also a common sign.
How long does an ear infection last in a baby?
Ear infections often clear up on their own within three days, though symptoms can sometimes last up to a week. However, babies under 12 months should be seen by a GP rather than waiting at home for symptoms to pass.
When should I take my baby to a doctor for an ear infection?
Any baby under 12 months with a suspected ear infection should be seen by a GP. You should also seek same-day help if your baby seems generally unwell, has a high fever, has swelling around the ear, has discharge coming from the ear, or if symptoms have not improved after three days.
Will my baby need antibiotics for an ear infection?
Not always. Many ear infections resolve without antibiotics. A GP will decide whether antibiotics are appropriate based on your baby's age, symptoms, and how unwell they appear overall.
What can I do at home to help my baby feel more comfortable?
Paracetamol or ibuprofen, given at the correct dose for your baby's age and weight, can help relieve pain and bring down a temperature. Keep water and shampoo away from the affected ear, and avoid using cotton buds inside the ear canal. Do not use decongestants or antihistamines, as there is no evidence they help with ear infections.
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