Earaches in Infants 0-24 Months

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About Earaches

If you think that having your baby wear a hat will prevent earaches, think again. While it’s a common belief, there is no basis for it. Also, cold temperatures and wind in your baby’s ears will not cause middle ear infections. Of course, there are plenty of good reasons for putting a hat on your little one, even though they take great pleasure in taking it off!


Most babies and children will experience the pain of at least one earache before they turn six years old. While any baby or child can get an earache or suffer from ear pain, some are more vulnerable to earaches than others, including babies and children who:

  • Are around people who smoke since they are more likely to suffer from allergies and colds, which can lead to blocked Eustachian tubes and ear infections
  • Swim a lot — particularly in chlorinated pools
  • Have had a previous ear infection
  • Have a family history of ear infections
  • Attend day care (greater exposure to germs)
  • Were born prematurely or with a low birth weight
  • Have frequent colds or other infections
  • Take a bottle to bed
  • Use a pacifier
  • Are male (boys get them more)
  • Have nasal speech (indicating large adenoids)
  • Have allergies with nasal congestion
  • Have diabetes or skin allergies

Common causes of earaches in babies

Generally, earaches are caused by a build-up of fluid behind your baby’s tympanic membrane or eardrum, which is located in the middle ear. This happens when the Eustachian tube (a drainage tube that runs from the middle ear to the back of the throat) becomes blocked. When this tube is blocked, build-up of fluid in the middle ear causes pain. Colds, allergies and adenoid swelling can cause Eustachian tube blockage.

Earaches can be either short term (acute) or long term (chronic). Both types have common causes.

Ottis externa (or “swimmer’s ear”) affects your baby’s ear canal (which extends from the eardrum to the outer ear). As the name suggests, this type of earache is caused by excess moisture, usually by polluted or chlorinated water. But it’s also caused by irritation brought on by cotton-tipped swabs and earplugs, or if your baby lacks enough preventative earwax. Tugging or pulling on your baby’s earlobe will increase the pain of ottis externa.

Ottis media (a middle-ear infection) can cause inflammation and/or infection of the inner ear and is usually brought on by a cold or allergies.

Wax blockage is another cause of earaches. The hair follicles and glands that line your baby’s inner ear produce a waxy oil called cerumen. Cerumen helps protect the ear by trapping particles like dust and microorganisms. While this earwax either falls out or is removed when the ears are washed, too much wax can block your baby’s ear canal and harden within it. Be very careful when trying to clean out earwax in your baby’s ear because you may actually push it deeper and cause blockage.

Perforated or ruptured eardrums can also cause earaches and ear pain. Infection, foreign objects in the ear and barotraumas (damage due to pressure changes, like in an airplane or when diving) can cause the rupture, which is accompanied by sharp pain. When the eardrum is damaged, bacteria can travel into the inner ear and cause infection.

Common symptoms of earaches in babies

Your baby may not be old enough to tell you verbally that they have an earache, but they may be telling you in other ways, including:

  • Unexplained crying
  • Banging their heads
  • Rubbing, pulling or tugging on their ears (although this may be a sign of teething as well)
  • Fever
  • Nausea or vomiting
  • Diarrhea
  • More irritable or fussy than usual
  • Lack of appetite
  • Disturbed sleep
  • Hearing loss/deafness — caused by a blocked Eustachian tube and fluid collected in your baby’s middle ear
  • A clear discharge, pus or blood coming from the affected ear — DO NOT attempt to clean out a leaking ear canal because you may cause more irritation or accidentally damage your baby’s eardrum - leave that to your doctor
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