Medical Conditions

Baby Ear Infections (Otitis Media)

Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist

Content reviewed against published AAP, AAP, CDC guidelines

Editorial policy

Last reviewed:

If your baby has been diagnosed with or you suspect baby ear infections (otitis media), here is what the evidence says.

The short answer

Ear infections are one of the most common childhood illnesses, and most children will have at least one by age 3. They are caused by fluid buildup behind the eardrum, often following a cold. While uncomfortable, most ear infections are not dangerous and many resolve on their own, though some need antibiotics.

Key takeaways

  • Ear infections are one of the most common childhood illnesses, and most children will have at least one by age 3. They are caused by fluid buildup behind the eardrum, often following a cold. While uncomfortable, most ear infections are not dangerous and many resolve on their own, though some need antibiotics.
  • Usually normal when: Your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething
  • Call your doctor if: Your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear
  • Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
— Fever and Your Child, American Academy of Pediatrics (AAP)

Thousands of parents search for this exact thing. You are not alone.

What Parents Should Know

According to AAP, CDC guidelines, ear infections are one of the most common childhood illnesses, and most children will have at least one by age 3. They are caused by fluid buildup behind the eardrum, often following a cold. While uncomfortable, most ear infections are not dangerous and many resolve on their own, though some need antibiotics. At 0-6 months, ear infections in babies under 6 months are less common but are treated more aggressively when they occur. Because very young infants cannot fight infections as effectively, doctors typically prescribe antibiotics promptly for this age group. Signs can be subtle: increased fussiness, difficulty feeding, or disrupted sleep. It is generally considered normal when your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething. However, you should contact your pediatrician promptly if your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething
Your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear
A single ear infection that responds to treatment and resolves fully
Your baby under 3 months has any signs of an ear infection (fever, fussiness, feeding difficulty), as young infants need prompt evaluation
Mild fussiness during a cold without signs of ear pain such as crying when lying flat or refusing to feed on one side
Redness or swelling behind the ear, which could indicate mastoiditis, a rare but serious complication requiring emergency care
Some fluid behind the eardrum (middle ear effusion) persisting for a few weeks after an infection, which is normal and usually clears
Your baby seems to have recurring ear infections (3 or more in 6 months)

When to Seek Immediate Care

  • Your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear
  • Your baby under 3 months has any signs of an ear infection (fever, fussiness, feeding difficulty), as young infants need prompt evaluation
  • Redness or swelling behind the ear, which could indicate mastoiditis, a rare but serious complication requiring emergency care

By Age

What to expect by age

0-6 months

Ear infections in babies under 6 months are less common but are treated more aggressively when they occur. Because very young infants cannot fight infections as effectively, doctors typically prescribe antibiotics promptly for this age group. Signs can be subtle: increased fussiness, difficulty feeding, or disrupted sleep.

6-12 months

This is when ear infections become more common, often following upper respiratory infections. Babies at this age may tug at their ears, become irritable, have trouble sleeping lying flat, or develop a fever. The AAP recommends antibiotics for confirmed ear infections in this age group, though mild cases in babies over 6 months may be observed for 48-72 hours.

12-24 months

Toddlers remain very susceptible to ear infections as their Eustachian tubes are still short and horizontal. They may point to or hold their ears, become clingy, or have balance issues. For children over 2 with mild symptoms, watchful waiting (pain management without immediate antibiotics) is a reasonable first approach per AAP guidelines.

2-3 years

Ear infections typically become less frequent as children grow and their Eustachian tubes mature. If your child has had 3 or more infections in 6 months or 4 or more in a year, your pediatrician may discuss ear tubes (tympanostomy tubes), which are a very common and effective procedure to reduce recurrence.

What to Tell Your Pediatrician

  • Describe when you first noticed baby ear infections (otitis media) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby seems to have recurring ear infections (3 or more in 6 months).
  • Mention if your baby consistently pulls at one ear and seems uncomfortable, especially after colds.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething
  • A single ear infection that responds to treatment and resolves fully
  • Mild fussiness during a cold without signs of ear pain such as crying when lying flat or refusing to feed on one side
  • Some fluid behind the eardrum (middle ear effusion) persisting for a few weeks after an infection, which is normal and usually clears
Mention at your next visit when...
  • Your baby seems to have recurring ear infections (3 or more in 6 months)
  • Your baby consistently pulls at one ear and seems uncomfortable, especially after colds
  • You notice your child does not seem to hear well or is not responding to sounds normally after a recent ear infection
Act now when...
  • Your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear
  • Your baby under 3 months has any signs of an ear infection (fever, fussiness, feeding difficulty), as young infants need prompt evaluation
  • Redness or swelling behind the ear, which could indicate mastoiditis, a rare but serious complication requiring emergency care

What You Can Do at Home

  • Keep track of when you notice baby ear infections (otitis media) — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething — this is generally within the range of normal.
  • At 0-6 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
  • While monitoring at home, seek immediate care if your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear.

Ear Infection vs. Teething - How to Tell the Difference

Ear pulling is one of the most commonly confused symptoms in babies - it can indicate either teething or an ear infection, and telling the difference can be tricky. Teething causes referred pain to the ear area (especially when molars are coming in), leading babies to pull or rub their ears. An ear infection typically follows a cold and is associated with fever, disrupted sleep, and increased fussiness. The key differences: teething ear pulling is usually without fever and is accompanied by drooling and gum swelling, while ear infections typically cause fever, follow a cold, and may cause more intense pain when lying down.

Baby Pulling or Tugging at Ears

Baby ear pulling is one of the most common concerns parents bring up, but it is rarely a sign of an ear infection on its own. Babies discover their ears around 4-6 months and often pull, rub, or tug at them out of curiosity, self-soothing, teething discomfort, or tiredness. Ear pulling is concerning for infection mainly when accompanied by fever, fussiness, disrupted sleep, or cold symptoms. Without other symptoms, ear pulling is almost always harmless exploration.

Excessive Ear Wax in Baby

Ear wax (cerumen) is normal and protective - it traps dust and germs and keeps the ear canal moisturized. Babies naturally produce ear wax, and the amount varies from child to child. You should never put cotton swabs, fingers, or anything else into your baby's ear canal. Ear wax normally works its way out on its own. Simply wipe away any visible wax on the outer ear with a damp cloth during bath time.

Signs of Hearing Loss in Babies

Most babies are screened for hearing loss at birth, but some hearing problems develop later or are missed. Early signs include not startling to loud sounds, not turning toward voices by 6 months, or not babbling by 9 months. Catching hearing loss early is critical for language development.

Milestone

Milestone Checklists by Age

Track your baby's developmental milestones from birth to 5 years with age-specific checklists.

Triage

Fever Decision Tree

Step-by-step guidance for evaluating your baby's fever by age and temperature.

Triage

Excessive Crying Triage

Determine whether crying patterns need medical attention.

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is baby ear infections (otitis media) normal?
Ear infections are one of the most common childhood illnesses, and most children will have at least one by age 3. They are caused by fluid buildup behind the eardrum, often following a cold. While uncomfortable, most ear infections are not dangerous and many resolve on their own, though some need antibiotics.
When should I call the doctor about baby ear infections (otitis media)?
Your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear Your baby under 3 months has any signs of an ear infection (fever, fussiness, feeding difficulty), as young infants need prompt evaluation Redness or swelling behind the ear, which could indicate mastoiditis, a rare but serious complication requiring emergency care
When is baby ear infections (otitis media) normal?
Your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething A single ear infection that responds to treatment and resolves fully Mild fussiness during a cold without signs of ear pain such as crying when lying flat or refusing to feed on one side
What causes baby ear infections (otitis media)?
Ear infections are one of the most common childhood illnesses, and most children will have at least one by age 3. They are caused by fluid buildup behind the eardrum, often following a cold. While uncomfortable, most ear infections are not dangerous and many resolve on their own, though some need antibiotics. Common explanations include: Your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething. A single ear infection that responds to treatment and resolves fully.
What should I mention to my pediatrician about baby ear infections (otitis media)?
You should mention baby ear infections (otitis media) at your next visit if: Your baby seems to have recurring ear infections (3 or more in 6 months). Your baby consistently pulls at one ear and seems uncomfortable, especially after colds. You notice your child does not seem to hear well or is not responding to sounds normally after a recent ear infection.
Is baby ear infections (otitis media) normal at 0-6 months?
Ear infections in babies under 6 months are less common but are treated more aggressively when they occur. Because very young infants cannot fight infections as effectively, doctors typically prescribe antibiotics promptly for this age group. Signs can be subtle: increased fussiness, difficulty feeding, or disrupted sleep.
Is baby ear infections (otitis media) normal at 6-12 months?
This is when ear infections become more common, often following upper respiratory infections. Babies at this age may tug at their ears, become irritable, have trouble sleeping lying flat, or develop a fever. The AAP recommends antibiotics for confirmed ear infections in this age group, though mild cases in babies over 6 months may be observed for 48-72 hours.
Should I go to the ER for baby ear infections (otitis media)?
Seek emergency care if your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear, or if your baby under 3 months has any signs of an ear infection (fever, fussiness, feeding difficulty), as young infants need prompt evaluation. When in doubt, call your pediatrician's after-hours line for guidance.
Does baby ear infections (otitis media) go away on its own?
In many cases, baby ear infections (otitis media) resolves on its own, especially when your baby tugs or plays with their ears without any other symptoms, as babies often explore their ears out of curiosity or during teething. By 2-3 years, ear infections typically become less frequent as children grow and their Eustachian tubes mature. If your child has had 3 or more infections in 6 months or 4 or more in a year, your pediatrician may discuss ear tubes (tympanostomy tubes), which are a very common and effective procedure to reduce recurrence.
AAPAAPCDC

References

  1. [1]American Academy of Pediatrics. The Diagnosis and Management of Acute Otitis Media. Pediatrics, 2013. AAP
  2. [2]HealthyChildren.org. Ear Infection Information. AAP
  3. [3]Centers for Disease Control and Prevention. Ear Infection. CDC

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Baby Ear Infections (Otitis Media).

Things to mention

  • Describe when you first noticed baby ear infections (otitis media) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby seems to have recurring ear infections (3 or more in 6 months).
  • Mention if your baby consistently pulls at one ear and seems uncomfortable, especially after colds.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Your baby seems to have recurring ear infections (3 or more in 6 months)
  • Your baby consistently pulls at one ear and seems uncomfortable, especially after colds
  • You notice your child does not seem to hear well or is not responding to sounds normally after a recent ear infection

Urgent signs to report immediately

  • Your baby has ear pain along with a high fever (above 102.2F/39C), severe irritability, or fluid or blood draining from the ear
  • Your baby under 3 months has any signs of an ear infection (fever, fussiness, feeding difficulty), as young infants need prompt evaluation
  • Redness or swelling behind the ear, which could indicate mastoiditis, a rare but serious complication requiring emergency care

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Related Resources

Fever TriageCrying TriageEar Infection TriageTeething GuideMilestone ChecklistsWell-Baby Visit PrepMedicine Dosage CalculatorBaby Sign Language GuideEmergency ContactsBaby Tracker

Bottom line

Most cases of baby ear infections (otitis media) are normal. Talk to your pediatrician if your baby has ear pain along with a high fever (above 102.2f/39c), severe irritability, or fluid or blood draining from the ear.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Related Medical Concerns

Ear Infection vs. Teething - How to Tell the Difference

Ear pulling is one of the most commonly confused symptoms in babies - it can indicate either teething or an ear infection, and telling the difference can be tricky. Teething causes referred pain to the ear area (especially when molars are coming in), leading babies to pull or rub their ears. An ear infection typically follows a cold and is associated with fever, disrupted sleep, and increased fussiness. The key differences: teething ear pulling is usually without fever and is accompanied by drooling and gum swelling, while ear infections typically cause fever, follow a cold, and may cause more intense pain when lying down.

Baby Pulling or Tugging at Ears

Baby ear pulling is one of the most common concerns parents bring up, but it is rarely a sign of an ear infection on its own. Babies discover their ears around 4-6 months and often pull, rub, or tug at them out of curiosity, self-soothing, teething discomfort, or tiredness. Ear pulling is concerning for infection mainly when accompanied by fever, fussiness, disrupted sleep, or cold symptoms. Without other symptoms, ear pulling is almost always harmless exploration.

Excessive Ear Wax in Baby

Ear wax (cerumen) is normal and protective - it traps dust and germs and keeps the ear canal moisturized. Babies naturally produce ear wax, and the amount varies from child to child. You should never put cotton swabs, fingers, or anything else into your baby's ear canal. Ear wax normally works its way out on its own. Simply wipe away any visible wax on the outer ear with a damp cloth during bath time.

Signs of Hearing Loss in Babies

Most babies are screened for hearing loss at birth, but some hearing problems develop later or are missed. Early signs include not startling to loud sounds, not turning toward voices by 6 months, or not babbling by 9 months. Catching hearing loss early is critical for language development.

Toddler Speech Regression After Ear Infection

Ear infections can temporarily affect hearing by causing fluid buildup behind the eardrum, which muffles sound like hearing through water. If your toddler's speech regressed during or after an ear infection, it is likely because they cannot hear clearly enough to practice and produce speech sounds. For most children, speech returns to normal once the infection clears and hearing is restored. However, chronic ear infections with persistent fluid (lasting 3+ months) can cause meaningful delays in speech and language development, especially during the critical period of language learning.

Baby Not Responding to Sounds

Babies should respond to sounds from birth - startling at loud noises, calming to familiar voices, and turning toward sounds by 4-6 months. If your baby consistently doesn't react to sounds, a hearing evaluation should be your first step. Hearing loss affects about 1-3 in 1,000 newborns and is highly treatable when caught early - early identification leads to much better language outcomes.