How can I tell if my baby has an ear infection?

Babies can't tell you their ear hurts, so look for a cluster of signs: rubbing or pulling at the ear, crying more when lying down or waking at night, a temperature of 38°C or above, feeding poorly, being irritable, or not reacting to sounds. Ear pulling on its own is common and doesn't always mean infection. The NHS advises seeing a doctor for any suspected ear infection in a baby under 12 months.

Do ear infections in children need antibiotics?

Often not. The NHS and NICE say most ear infections get better on their own within about 3 days, sometimes up to a week, and antibiotics make little difference for many children. A doctor decides whether antibiotics are needed after examining the ear, taking into account your child's age, how unwell they are, whether both ears are affected and whether there is discharge.

What helps earache in a child at home?

Give paracetamol (from 2 months) or ibuprofen (from 3 months and over 5kg) at the dose on the pack for your child's age, and never aspirin under 16. A warm flannel held against the ear can be soothing. Keep water out of the ear and don't put anything inside it. Raising the head slightly at night may make your child more comfortable.

Is it safe to put oil or drops in my child's ear?

Don't put oil, garlic, home remedies, cotton buds or any drops into a painful ear unless a doctor or pharmacist has checked it. If the eardrum has a hole in it, which can happen with a middle-ear infection, some drops can cause harm. Cotton buds can push wax or an object deeper and injure the ear canal.

When is earache an emergency?

Go to the ER if there is redness, tenderness or swelling behind the ear that pushes the ear outwards, which can be mastoiditis, or if your child has a stiff neck, severe headache, is very drowsy or floppy, has new weakness of one side of the face, or is under 3 months old with a fever. Call 911 if your child is hard to wake or has a seizure.

What is the difference between swimmer's ear and a middle-ear infection?

Swimmer's ear (otitis externa) is an infection of the ear canal, often after water gets trapped in it. It causes itching and pain that gets worse when the outer ear is touched or pulled. A middle-ear infection (otitis media) is behind the eardrum, usually follows a cold and often comes with fever. They are treated differently, so a doctor should look in the ear.

Earache in a Child: Ear Infection Signs and When to See a Doctor

With children back at school and cold season starting in Amman, earache is everywhere: a child crying in the middle of the night and pulling at their ear, or a fever that arrives a few days after a runny nose. Middle-ear infections are one of the most common childhood illnesses, usually follow a cold and usually get better on their own. This guide explains how to spot one in a child who can't talk yet, what eases the pain safely, what not to put in the ear, and the signs that mean a doctor today or the ER now.

What are the signs of an ear infection in a baby or toddler?

An older child will tell you their ear hurts. In a baby, the NHS says you may notice:

Rubbing or pulling at the ear.
Crying more when lying down, and waking repeatedly at night.
A temperature of 38°C or above.
Not wanting to feed or eat, and being irritable or restless.
Not reacting to some sounds, or losing their balance.
Fluid or pus coming out of the ear.

The American Academy of Pediatrics points out that ear pulling on its own isn't proof of infection, as many babies do it to self-soothe or when teething. What matters is the cluster of signs together, especially after a cold.

Is it swimmer's ear or a middle-ear infection?

Not every earache is a middle-ear infection. These are the main differences, based on the NHS:

	Middle-ear infection (otitis media)	Swimmer's ear (otitis externa)
Who gets it	Mostly babies and young children, often after a cold	Children and adults, often after swimming or getting water in the ear
Where it is	Behind the eardrum	In the ear canal, between the outside of the ear and the eardrum
Typical signs	Deep earache, fever, muffled hearing, a child who is irritable and off their food	Itching, pain that is worse when the ear is touched or pulled, swelling of the canal
Discharge	Sudden fluid or pus can mean the eardrum has burst; pain often eases after	Discharge from the canal is common
Usual course	Often better in about 3 days without antibiotics; sometimes up to a week	Usually needs ear drops chosen by a doctor or pharmacist

Earache can also come from the throat: tonsillitis often causes pain that spreads to the ear when swallowing. If your child's throat hurts too, see our guide to sore throat, tonsillitis and when to see a doctor.

Can you treat earache at home?

Yes, in most cases. The NHS says most ear infections clear up within 3 days, though symptoms can last up to a week, and NICE guidance explains that many children don't need antibiotics. What helps:

Pain and fever relief: paracetamol from 2 months, or ibuprofen from 3 months if your child weighs over 5kg, at the dose on the pack for their age. Never give aspirin to anyone under 16.
A warm flannel (or a cool one, if your child prefers) held against the outside of the ear.
Wipe any discharge from the outside of the ear with clean cotton wool, without going into the canal.
Keep water and shampoo out of the ear, and skip swimming until it's better.
Plenty of fluids and rest. The NHS notes decongestants and antihistamines don't help ear infections.

What not to put in the ear

Don't put warm oil, olive oil, garlic, home remedies or any drops into a painful ear before a doctor or pharmacist has looked at it, and don't use cotton buds or a finger. If fluid is coming out, the eardrum may have a hole, and some drops can do harm. Cotton buds push wax further in and can injure the canal.

What about antibiotics?

A doctor decides, after looking in the ear, whether your child needs antibiotics. According to NICE, they may be considered for infection in both ears in a child under 2, when there is discharge from the ear, or when the child is very unwell. Sometimes the doctor will suggest waiting two or three days with pain relief and reviewing.

When should you take a child with earache to a doctor or the ER?

Call 911 for

A child who is floppy, unresponsive or hard to wake.
A seizure (fit).
Difficulty breathing.

Go to the ER now

Redness, tenderness or swelling behind the ear that makes it stick out — possible mastoiditis, rare but serious.
A stiff neck, severe headache, dislike of bright light, or a rash that doesn't fade when pressed.
A child who seems very unwell, unusually drowsy or confused.
A baby under 3 months with a temperature of 38°C or above.
New weakness or drooping on one side of the face, or severe dizziness.
Something stuck in the ear, especially a button battery — don't try to remove it yourself.

Urgent care or a doctor the same day

Earache that hasn't improved after 2–3 days.
Fluid or pus coming out of the ear.
A change in hearing or new hearing loss.
A baby under 12 months you think has an ear infection, or a child under 2 with pain in both ears.
A very high temperature, vomiting, or a child who seems generally unwell.
Repeated ear infections, or a child with a long-term condition or weakened immune system.

Home care is usually fine

A child over 1 with earache and a cold who is eating, drinking and playing between doses of pain relief.
A mild fever that responds to paracetamol or ibuprofen, with pain easing day by day.

For fever thresholds by age, read our guide to child fever and when to worry. If it all started with a cough and cold and your child is getting worse, our guide to flu, RSV and COVID explains when to see a doctor.

What happens when you come in?

The doctor asks about the symptoms and how long they've lasted, checks the temperature, then looks inside the ear with an otoscope to see the eardrum and canal, and checks the throat, neck and the area behind the ear. Most children don't need any tests. The doctor then explains whether it's a middle- or outer-ear infection, how to manage the pain, and whether your child needs antibiotics or drops. If there are signs of mastoiditis or another complication, the team will arrange the next step. Urgent care sees children as walk-ins 24/7, and the emergency department is there for the red flags.

Child crying with earache tonight?

If your child is floppy or hard to wake, call 911. Otherwise, Emergency Plus in Dabouq, Amman is open 24/7: walk-in urgent care and an emergency department with emergency physicians on site, and an Arabic and English speaking team.

Call us 24/7: +962 79 247 1313

Sources

Medical disclaimer: This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. If you think you are experiencing a medical emergency, call 911 or go to the nearest emergency department immediately. Emergency Plus in Dabouq, Amman is open 24/7 — +962 79 247 1313.