Ear Infections: How To Tell

An ear infection will usually cause an earache, due to bulging and stretching of the eardrum. However, since the peak age for ear infections is 6 months to 2 years old, many of these children are too young to complain of an earache. So how does a parent know when it's time to have their child's ears looked at? Here are the best indicators:

  • First: The complaint of an earache in an older child is a reliable sign for an ear infection. Even if the earache resolves after 12 hours, still have your child seen. After undergoing maximal stretch, the bulging eardrum no longer hurts. If your child is doing a lot of swimming, it could be swimmer's ear. Increased pain with movement of the outer ear suggests this diagnosis.
  • Second: In children under age 2, the most reliable symptoms are crying without an obvious reason, the sudden onset of crankiness, or the recent onset of awakening from sound sleep. All of these symptoms suggest an earache, especially in a child with a cold.
  • Third: Fever is not so helpful, since half of children with ear infections don't have a fever. But in a child with a cold, the delayed onset of fever after the initial fever is gone for over 24 hours, suggests a secondary bacterial infection (again usually in the middle ear).
  • Fourth: The sudden onset of a yellow or cloudy discharge from the ear canal is usually due to an ear infection that has "popped". That means the eardrum ruptured causing a small hole for the pus to drain from. But don't panic - this ear drainage does not mean that the ear infection is any more serious, and this small tear usually heals in a few days.

 

If your child has any of these symptoms of an ear infection, call your healthcare provider.

By the way, here are some unreliable and misleading symptoms that you probably won't need to call your healthcare provider about:

  • Pulling at the ears is usually just a chance habit. Less than 5 percent of these children have an ear infection.
  • Rubbing the ear is usually due to an itchy ear canal.
  • Muffled hearing and popping noises in the ear are usually due to a blocked Eustachian tube – often associated with a sudden increase in the pollen count.
  • And finally, a clear discharge is usually just the delayed appearance of water that came from a bathtub or sprinkler.

 

If you think your child may need to be seen, call your healthcare provider for advice.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D. FAAP

Last Review: 6/1/2008

Last Revised: 6/1/2000

Copyright 1994-2008 Barton Schmitt, M.D. Parent Advice Messages.

 

Is Your Child Sick?

Pediatric HouseCalls Symptom Checker is a parent guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at Children's Hospital Colorado. Dr. Schmitt has developed other health tools for parents, including the 3rd edition of Your Child’s Health (available in bookstores) and KidsDoc, a new iPhone and Android app for parents (available online).

A Parent's Guide to Healthy, Happy Kids! Subscribe to have our quarterly newsletter mailed to your home.

Children's Hospital Colorado Family Health Library

Ask Kate the librarian for the health information you need!