Does My Baby Have An Ear Infection?

How to tell if your baby is suffering from an ear infection

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ear infection baby. Sharon Dominick/E+/Getty Images

Yesterday night, as I gingerly settled the baby down in her crib and started my tip-toe escape out of her bedroom (quickly!), I was immediately startled by her shrill cries. Uh-oh, I thought. Here we go. 

Unfortunately, my mom intuition that it would be a long night was spot-on. It was a really long night, one that involved me literally walking laps around my house, trading posts with my husband and eventually, giving up and sleeping straight up with her in the rocking chair as the only sleep she seemed to be able to get was in my arms.

 

After she spiked a fever the next day, continued to be fussy, and eventually refused to breastfeed, I took her to the pediatrician's office to be screened. The diagnosis? 

An ear infection so raging that our doctor literally gasped out loud when he peeked in her ears. Awesome. 

So you can be a little bit ahead of the parenting game and not wait until your baby has a horrible ear infection, here's what you need to know. 

Is it an ear infection? 

One of the hardest parts about deciding if your baby could have an ear infection is that so many of the symptoms of an ear infection can also be a sign of teething. In my case, I thought for sure my daughter was just teething--but I was wrong. To help differentiate, some of the signs and symptoms of an ear infection in babies usually include:

  • Fussiness
  • Loss of appetite, especially with breastfeeding, as the position puts increased pressure on the ear and the sucking motion can cause pain
  • Fever
  • Restless/sleeplessness
  • Vomiting
  • Diarrhea
  • Ear tugging (although this is not as reliable as a sign as many are led to believe)
  • Congestion/drainage

It can also be helpful to consider the circumstances surrounding your baby--has he or she been sick recently? How long have the symptoms been occurring? Are any other children in the home sick?

Does she show any physical signs of teething, like swollen gums? 

Many ear infections can be caused by viruses and clear up on their own, but if your baby has had a cold or the flu recently, for example, he or she may be more likely to develop an ear infection from all that increased drainage in her sinuses. Babies can't exactly blow their noses and spend a lot of time on their backs, placing them even more at risk. 

What you can do

First of all, if you suspect an ear infection in your baby, especially if he or she is under six months of age, don't hesitate to get seen by a pediatrician. As a nurse, I always told my patients it's better to get checked out and be sent home with nothing wrong then wait and regret it--your doctor will never tell you not to come in. 

At the visit, be sure to let the doctor know of all the signs and symptoms you have witnessed, including any medications you have given your baby. Be sure to ask if the doctor is 100% sure antibiotics are necessary--while many parents assume that ear infection = antibiotics, in a lot of cases, they simply aren't necessary and may cause more harm if they are used unnecessarily.

The American Academy of Pediatrics has a helpful guide to talk with your provider about ear infections, as an irritated ear is not always an infected ear in young babies. 

Request a fluid level check of your baby's ear that can provide further clues if an infection is present. The simple test often involves bouncing sound waves through the ear canal--if an infection and fluid are present, the sound wave will register flat, while normal ears will give a "curved" shape. 

Treatment for an ear infection in babies can include:

  • Avoid feeding the baby lying down. If you breastfeed, you may consider using an expressed bottle of breast milk and feeding the baby in a more upright position. 
  • A cool mist humidifier in the baby's room may help ease congestion.
  • Medication--ask your doctor which pain medication is best for your baby. Some pediatricians prefer ibuprofen for infants and dosing can vary with weights. Our personal pediatrician prefers ibuprofen and claims that not only does it work better, but that acetaminophen carries more toxicity risk for babies and children. Also be sure to look at the actual concentration of the medication before giving it. 
  • Antibiotics. If antibiotics are warranted, a 10-day course may be prescribed, especially in babies younger than six months old. 
  • A "wait and see" approach may be appropriate for older children, especially in the absence of pain. 

Sources:

The Diagnosis and Management of Acute Otitis Media.Clinical Practice Guideline. The American Academy of Pediatrics. Accessed online January 7, 2015: http://pediatrics.aappublications.org/content/131/3/e964.full. 

 

 

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