Ear infections in the toddler years

An ear infection happens when a cold or sore throat causes swelling in the middle ear, which traps fluid behind the eardrum. Germs from the nose and throat spread easily into this area and the fluid provides a perfect environment for them to grow and multiply. The medical name for an ear infection is acute otitis media, sometimes shortened to AOM, and children are more prone to them than adults.


Symptoms of an ear infection usually start within 2 to 7 days after the start of a cold or other upper respiratory tract infection and include intense ear pain. Signs to look for include:

  • Tugging and pulling at ears and crying
  • Fever (temperature higher than 100.4ºF or 38ºC)
  • Fussiness and trouble sleeping
  • Poor appetite, vomiting, or diarrhea
  • Fluid drainage from the ear that is thick and yellow or bloody (this may indicate the eardrum has burst. The hole will repair itself within a few weeks).


If you suspect that your child has an ear infection, call their healthcare provider. They will ask you about your child’s recent health, and may ask you to come in so they can conduct an exam using an otoscope, an instrument which helps them see inside the ears. The exam is not painful, but children may not want their ears examined. You can help with the process run more smoothly by holding your child and hugging their arms and body while their provider completes the exam.


The treatment a healthcare provider prescribes will depend on your toddler’s age, medical history, and symptoms. Antibiotics may be prescribed for children under the age of 2, especially if there is an infection in both ears. If you are given antibiotics for your child it is important to take them exactly as prescribed. Their provider may also recommend child-appropriate doses of acetaminophen or ibuprofen for pain. It’s important to follow the directions from your provider, or on the box. Products containing aspirin should never be given to children or infants.

Follow-up and long term effects

Your child’s symptoms should start to improve within 24 to 48 hours (with or without antibiotics). Fever and discomfort may continue even after starting antibiotics, but they should start to feel a bit better each day. If your toddler doesn’t improve after 48 hours or gets worse, call their healthcare provider for guidance.

Ear infections in very young children can cause hearing problems and issues with learning to speak. Children who are younger than 2 years will need a follow-up ear exam two to three months after being treated for an ear infection to ensure that fluid build up in the ear (which can be painless and go unnoticed) has resolved.


Ear infections are practically a rite of passage for tiny ears, but there are some ways to reduce the risks for your child:

  • Make sure they get all recommended vaccines, including the annual flu vaccine.
  • Wash your hands and their hands often to prevent the spread of colds which can lead to ear infections.
  • Secondhand smoke, even just on a parent or caregiver’s clothing, can raise risks of AOM.
  • Conversely, breastfeeding has been shown to lower ear infection frequency.
  • Studies have shown that using a pacifier past 6 months old increases risks for ear infections.

Ear infections aren’t any fun for anyone involved, but luckily, they only last a few days. Hopefully with this guide you’ll be prepared to make your child as comfortable as possible while protecting them from any lasting complications and limiting the chances of future encounters!


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