Last reviewed: November 8, 2026 · Based on guidance from the American Academy of Pediatrics, the CDC, Seattle Children's Hospital and the NHS.
Quick answer: An ear infection in a baby usually shows up as fussiness, crying (often worse when lying down or feeding), trouble sleeping and sometimes a fever, often a few days into a cold. Many ear infections clear up on their own within 2 to 3 days, and your doctor may suggest watching and waiting before starting antibiotics. Babies under 2 years old, and babies with severe pain or a high fever, are more likely to need antibiotics. Call your pediatrician if you think a baby under 12 months has an ear infection, and call right away if a baby under 3 months has a fever of 100.4°F (38°C) or higher.
Ear infections are one of the most common reasons babies see the doctor, especially in cold and flu season. The American Academy of Pediatrics (AAP) says nearly 5 out of every 6 children have at least one ear infection before their third birthday. The good news: most are mild, most get better quickly, and hearing usually goes back to normal once the infection clears.
Here’s how to spot an ear infection in your baby, what treatment usually looks like, how to ease the pain safely at home and the signs that mean you should call the doctor.
What Is an Ear Infection?
Most baby ear infections are middle ear infections (doctors call them acute otitis media). The middle ear is the small space behind the eardrum. It’s connected to the back of the throat by a thin tube called the eustachian tube.
When your baby has a cold or allergies, that tube can swell and get blocked. Fluid gets trapped behind the eardrum, and bacteria or viruses grow in it. That’s why ear infections so often follow a cold. Seattle Children’s notes they often start around day 3 of a cold.
Why babies get so many ear infections
- Shorter, flatter tubes. A baby’s eustachian tubes are shorter, narrower and more horizontal than an adult’s, so fluid doesn’t drain as easily.
- A young immune system. Babies are still building their defenses against common germs.
- Lots of colds. Every cold is a new chance for fluid to build up. Child care, older siblings and winter all mean more colds.
Ear infections are most common between 6 months and 2 years old, and they stay common until about age 8.
Signs of an Ear Infection in Babies
Babies can’t tell you their ear hurts, so you have to watch for clues. Common signs include:
- Fussiness and crying, often more than usual for a cold
- Pain that’s worse when lying down, so night waking increases
- Crying or pulling away during feeds, because sucking and swallowing can hurt
- Eating less than usual
- Fever. About half of children with an ear infection have one. It can range up to 104°F.
- Not reacting to sounds the way they normally do
- Fluid draining from the ear. Yellow, white or blood-tinged fluid that looks different from normal earwax can mean the eardrum has a small tear.
- Rubbing or pulling at the ear, especially along with the signs above
Does ear pulling mean an ear infection?
Not on its own. The AAP points out that babies and toddlers often tug their ears just to soothe themselves. Ear pulling is more meaningful when it comes with fever, a cold, extra crying or poor sleep. The only way to know for sure is a doctor’s exam: your pediatrician has to look at the eardrum with a lighted scope, and an ear infection can’t be diagnosed over the phone.
How Ear Infections Are Treated
Treatment depends on your baby’s age, how sick they are and what the doctor sees in the ear. A red, bulging eardrum is the classic sign of a middle ear infection.
Watchful waiting
The AAP says about 80% of childhood ear infections clear up without medicine. For a mild infection, your doctor may suggest waiting 2 to 3 days (48 to 72 hours) to see if your child gets better before giving antibiotics. Some doctors write a “just in case” prescription and ask you to fill it only if your child isn’t improving after 2 to 3 days. This helps avoid antibiotic side effects, which about 1 in 5 children get, such as diarrhea, stomach pain or a rash.
When antibiotics are more likely
Your doctor is more likely to prescribe antibiotics right away if:
- Your baby is under 2 years old
- The infection looks severe, or there’s serious pain or a high fever
- Symptoms have lasted more than 2 to 3 days or are getting worse
- Your baby has a weakened immune system or another health condition
If your baby is on antibiotics, give the full course, even when they seem better after a couple of days. According to Seattle Children’s, the fever should be gone within 48 hours, and ear pain should be better by day 2 and gone by day 3.
What about ear tubes?
Ear tubes are tiny tubes placed in the eardrum during a short surgery to let fluid drain. They may be an option for children with severe, repeated ear infections, or with hearing or speech problems after many infections. Your pediatrician can refer you to an ear, nose and throat (ENT) specialist if this comes up.
How Long Does an Ear Infection Last?
| What | Typical timeline |
|---|---|
| Mild infection without antibiotics | Often better within 2 to 3 days, symptoms can last up to a week |
| Fever on antibiotics | Gone within 48 hours |
| Ear pain on antibiotics | Better by day 2, gone by day 3 |
| Small eardrum tear with drainage | Usually heals in 2 to 3 days |
| Fluid behind the eardrum | Can take weeks; clears within 1 to 2 months in 90% of children |
| Muffled hearing | Usually mild and goes away as the fluid clears |
Leftover fluid is normal after an ear infection and doesn’t mean the infection is still there. If your baby still doesn’t seem to hear well after the infection has cleared, tell your pediatrician.
How to Ease Your Baby’s Ear Pain at Home
- Pain medicine. Under 6 months, use acetaminophen (Tylenol) only. From 6 months, acetaminophen or ibuprofen (Motrin, Advil) are both options. Check the right dose for your baby’s weight with your pediatrician. For babies under 3 months, call the doctor before giving any medicine.
- A cold or warm washcloth. Hold a cold, wet washcloth on the outer ear for up to 20 minutes. Some children prefer gentle warmth instead. Never leave it on longer, to avoid burns or frostbite.
- Extra feeds and fluids. Offer breast milk or formula often. If your baby fusses lying flat, try feeding more upright.
- Treat the cold. Saline drops and gentle suction can help a stuffy nose. See our guide on why your newborn sounds congested for safe nose-clearing tips.
- Wipe away drainage. Gently clean fluid from the outside of the ear. Don’t plug the ear with cotton.
What not to do
- Never give aspirin to a baby or child, because of the risk of Reye’s syndrome.
- Don’t put anything into the ear, including cotton swabs, oils or fingers.
- Don’t use ear drops unless your doctor prescribed them for this infection.
- Skip cough and cold medicines. The CDC says to avoid them under age 4 unless a doctor tells you otherwise. The NHS also notes decongestants and antihistamines don’t help ear infections.
Even with good care at home, your baby still needs a sleep space that follows safe sleep rules. Place your baby on their back on a flat, firm surface with nothing else in the crib, even if they seem more comfortable propped up.
When to Call the Doctor
Call your pediatrician if:
- Your baby is under 12 months and you think they have an ear infection
- Your baby has a fever of 102.2°F (39°C) or higher
- You see fluid, pus or blood coming from the ear
- Symptoms last more than 2 to 3 days or are getting worse
- Your baby seems to have trouble hearing
- On antibiotics, the fever is still there (or comes back) after 48 hours, or the ear pain isn’t better after 3 days
- Your baby keeps getting ear infections
Get medical care right away if:
- Your baby is under 3 months with a fever of 100.4°F (38°C) or higher. Read more in our guide to what counts as a fever in a baby.
- The fever is above 104°F (40°C)
- There’s pink or red swelling behind the ear
- Your baby has a stiff neck, new vomiting or one side of the face looks weak or droopy
- Severe pain or crying isn’t better 2 hours after a dose of ibuprofen
- Your baby looks or acts very sick
Call 911 if your baby is very weak, not moving or you think it’s a life-threatening emergency.
Can You Prevent Ear Infections?
You can’t prevent every ear infection, but these steps lower the risk:
- Keep up with vaccines, including the pneumococcal and yearly flu vaccines. Our guide to flu in babies covers this season’s flu shot.
- Breastfeed if you can. The CDC recommends breastfeeding only for the first 6 months and continuing for at least 12 months.
- Keep your baby away from smoke, including secondhand smoke and smoke on clothes.
- Don’t bottle feed lying flat, and never prop a bottle for naps or overnight.
- Wash hands often and keep your baby away from sick people when you can, to cut down on colds.
- Think about pacifier habits. The NHS suggests trying not to use a pacifier after 6 months. Pacifiers at sleep time also lower SIDS risk in the first year, so talk with your pediatrician if your baby gets frequent ear infections.
Ear Infections and Flying
A baby with an ear infection can usually fly. Seattle Children’s says flying is safe once your child is on antibiotics. To help with pressure changes, feed your baby or offer a pacifier during takeoff and landing so they swallow often. If your baby is 6 months or older, your pediatrician may suggest a dose of ibuprofen about 1 hour before takeoff. For more travel tips, see our guide on when you can fly with a baby.
Is It an Ear Infection or Just a Cold?
A cold alone usually causes a runny or stuffy nose, sneezing and a cough, but your baby still eats, sleeps and plays fairly normally. An ear infection is more likely if, a few days into the cold, your baby suddenly gets fussier, sleeps worse, cries during feeds or starts a new fever. If you’re not sure, call your pediatrician. And if a cough is your main worry, our guide to baby coughs explains what each cough means.
Frequently Asked Questions About Ear Infections in Babies
How can I tell if my baby has an ear infection?
Look for extra fussiness, crying when lying down or feeding, poor sleep, eating less and sometimes a fever, often a few days into a cold. Fluid draining from the ear is another sign. Only a doctor can confirm it by looking at the eardrum, so call your pediatrician if you suspect one in a baby under 12 months.
Do ear infections in babies go away on their own?
Often, yes. The AAP says about 80% of childhood ear infections clear up without medicine, so for mild cases your doctor may suggest waiting 2 to 3 days before antibiotics. Babies under 2, and babies with severe pain or a high fever, are more likely to get antibiotics right away.
How long does an ear infection last in a baby?
Many get better within 2 to 3 days, though symptoms can last up to a week. On antibiotics, the fever should be gone within 48 hours and the pain gone by day 3. Fluid behind the eardrum can linger for weeks, and it clears within 1 to 2 months in 90% of children.
Is ear pulling a sign of an ear infection?
Not by itself. Babies often tug their ears just to soothe themselves. Ear pulling is more likely to mean an infection when it comes with a fever, a cold, extra crying or trouble sleeping.
Are ear infections contagious?
No, the ear infection itself isn’t contagious. But the colds, flu and RSV that often lead to ear infections do spread. Your baby can usually go back to child care once any fever is gone and they feel well enough for normal activities.
Can a baby with an ear infection fly?
Usually, yes. Seattle Children’s says flying is safe once your child is on antibiotics. Feeding or offering a pacifier during takeoff and landing helps your baby swallow and ease ear pressure. If your baby is 6 months or older, ask your pediatrician about giving ibuprofen about 1 hour before takeoff.
The Bottom Line
Ear infections are very common in babies, especially between 6 months and 2 years and a few days into a cold. Watch for fussiness, crying when lying down or feeding, poor sleep and fever. Many clear up within 2 to 3 days, and your doctor will decide whether to wait or start antibiotics based on your baby’s age and symptoms. Ease the pain with the right medicine for your baby’s age and a cool or warm washcloth, never put anything in the ear, and call your pediatrician if your baby is under 12 months, has a fever of 102.2°F or higher, has ear drainage or isn’t better in 2 to 3 days. A baby under 3 months with a fever of 100.4°F or higher needs a doctor right away.
This article is for general information and isn’t a substitute for medical advice. Always contact your pediatrician with questions about your baby’s health.
5 Sources
Newborn Stages uses trusted sources, including government health agencies, children’s hospitals and pediatric organizations, to support the facts in our articles. Read our editorial policy to learn how we research, fact-check and keep our content accurate.
- American Academy of Pediatrics, HealthyChildren.org. Ear Infections in Children: Information for Parents.
- American Academy of Pediatrics, HealthyChildren.org. Ear Infection Symptoms.
- Centers for Disease Control and Prevention. Ear Infection Basics.
- Seattle Children’s Hospital. Ear Infection Questions.
- NHS. Ear infections.
