How to Identify an Ear Infection in Your Child

Ear check up
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It is usually pretty easy to recognize when your older child has an ear infection since they can just tell you 'hey, my ear hurts.'

For younger preschool age children, toddlers, and infants, knowing when they have an ear infection can be much more difficult for parents.

Are they tugging on their ears because they have an ear infection or are they just teething?

Are they fussy or waking up because their ears hurt?

Ear Infection Symptoms

Common symptoms of ear infections in children can include:

  • Ear pain (otalgia)
  • Tugging on the ears or holding the ears
  • Fever
  • Fussiness, irritability, excessive crying, etc.

Keep in mind that many children with an ear infection also have a cold, with a cough and runny nose, just before or during their ear infection.

When It's Not an Ear Infection

Without a recent cold, it is less likely that your child's 'ear infection symptoms' are actually caused by an ear infection, though.

Especially in a younger child, the above non-specific symptoms can also be caused by a sore throat and many viral infections. And except for fever, many younger children can have those same symptoms when they are teething or simply overtired.

Children with an ear infection may also have ear drainage (otorrhea) if the ear drum ruptures. Some parents might confuse ear wax with ear drainage from an infection, though.

And ear pain can sometimes be caused by swimmer's ear, an outer ear infection, instead of a more classic middle ear infection.

Confirming Ear Infection Symptoms

If you think that your child has an ear infection, see your pediatrician to confirm the diagnosis. In addition to ear infection symptoms, your child should have signs of inflammation of his ear drum on physical examination, such as a red, bulging ear drum.

If your child does indeed have an ear infection, depending on his age and symptoms, you and your pediatrician can decide if he needs antibiotics right away or if he can simply be observed to see if the ear infection will go away on its own, as dictated by the latest ear infection treatment guidelines.


American Academy of Pediatrics. Clinical Practice Guidelines. Diagnosis and Management of Acute Otitis Media. PEDIATRICS Vol. 113 No. 5 May 2004, pp. 1451-1465.

Behrman: Nelson Textbook of Pediatrics, 18th ed.