New parents seem to hear countless tales of children who have battled chronic ear infections, which can provoke some anxiety the first time they see their own baby tug fussily at her earlobe. With no words to convey whether she is truly in pain, the baby must rely on her parents to look for other signs of illness that might warrant a call to their family doctor. Because an ear infection implies that fluid is present behind the eardrum, the only way to confirm the diagnosis is to have a pediatrician examine the baby's ears.
Pain
Because a baby can't say that his ear hurts, he has to rely on other ways to communicate his discomfort. Although ear tugging and swatting the side of the face have long been named as signs of ear infection, they are not always reliable clues because many healthy infants show similar behaviors. In babies, inconsolable crying, screaming and fussiness are better indicators of pain.
Fever
According to pediatrician Dr. Alan Greene, the combination of pain and fever in infants and toddlers most likely indicates the presence of ear infection. Fever is reported in nearly half of all cases of ear infection in young children and is even more likely in children under 12 months of age.
Disrupted Sleep
When fluid is present in a baby's ear, her inner ear pressure will increase. This pressure, and the pain that comes with it, may worsen when she lies in her crib and can interfere with her sleep. Depending on the baby's age, nighttime waking is not necessarily a sign of ear infection---late in the first year, separation anxiety and excitement over becoming more mobile can also disrupt sleep. When a baby awakens crying but is easily consoled with a hug, an ear infection may not be the primary concern unless other symptoms are present.
Other Symptoms
A baby with an ear infection may seem less interested in taking his bottle or eating solid foods. Vomiting and loose bowel movements can also be signs of an infection. Parents should take note of whether the infant responds normally to their voices and to environmental sounds---fluid accumulation in the ear can affect the baby's hearing. Occasionally, fluid can be seen draining from the affected ear. This fluid is generally clear but may contain pus or blood, indicating a possible ruptured eardrum.
