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My 6-month-old was upset today, and I couldn't figure out why, but she kept rubbing one of her ears. I'm wondering if she might have an ear infection, and what other symptoms to look out for if this is the case.

(She used to pull on her ear while eating, like this question talks about, but she hasn't done that in a while, and usually doesn't do it unless she's eating.)

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3 Answers 3

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This is not medical advice; I am not a doctor and I have no medical training.

http://www.nhs.uk/Planners/birthtofive/Pages/Childhoodillnesses.aspx

They often follow a cold and sometimes cause a temperature. A child may pull or rub at an ear, but babies can’t always tell where pain is coming from and may just cry and seem uncomfortable.

If your child has earache but is otherwise well, give them paracetamol or ibuprofen for 12-24 hours. Don’t put any oil, eardrops or cotton buds into your child’s ear unless your GP advises you to do so. Most ear infections are caused by viruses, which can’t be treated with antibiotics. They will just get better by themselves.

Sometimes people do not recognise that a child has an ear infection.

http://www.nhs.uk/conditions/Otitis-media/Pages/Introduction.aspx

Chronic otitis media is a middle ear infection that lasts for a long time or keeps coming back. As the symptoms are often less severe than those of an acute infection, the infection may go unnoticed and untreated for a long time. This may cause more damage than an acute infection.

Here's a technical list for diagnosing symptoms: http://www.cks.nhs.uk/otitis_media_acute/evidence/supporting_evidence/diagnosing_acute_otitis_media

Limited evidence from a systematic review suggests that the most accurate individual symptoms and signs for diagnosing acute otitis media (AOM) are ear pain, ear rubbing, a cloudy or distinctly red or bulging tympanic membrane, or a distinctly immobile tympanic membrane (on pneumatic otoscopy). Fever, upper respiratory tract symptoms, crying, restless sleep, and irritability are individually less useful, but no studies have assessed the accuracy of several symptoms and signs combined. These findings are limited by bias in the studies included in the review.

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Crankiness and lethargy are the first clues that something is up. Nasal congestion is another. A low grade fever is the best clue to an infection of one form or another. Whether it is in the ear or not really doesn't matter .. the doctor can figure it out. The point when a fever becomes an emergency varies by age .. talk to your pediatrician. When in doubt call your doctor or another provider.

If you think it may be a repetitive thing you may want to buy an "otoscope" so you can look and see yourself if it is the ear or the throat.

My daughter had a problem with ear infections when she was an infant and toddler. I have nasal and sinus allergies and she inherited it. Usually they were provoked by nasal congestion that ended up in her ear canals. We learned to pay close attention to nasal congestion and treat it quickly with OTC meds, which cut (but did not eliminate) the ear infections. She pretty much outgrew them by kindergarten.

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Buying an otoscope it rather useless unless you're trained to know what to look for. Without medical background, I have no idea what looks normal and what doesn't. –  Torben Gundtofte-Bruun Sep 12 '11 at 6:56
    
You don't have to go to medical school to look in an ear. The pictures that come with a consumer oriented otoscope are good enough to determine if something is not right, which is all you need. It helped us quite a bit to decide between ear infection (go see doctor) and cold (ride it out). –  tomjedrz Sep 12 '11 at 14:32
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Many things can be "not right" but not visible with an otoscope. If a child has frequent ear infections with an associated presenting pattern, an otoscope may be very helpful. But it should NOT be used as a primary indicator to parents that there is no need to see a physician or to determine that there is no problem that needs to be addressed. –  Marie Hendrix Sep 13 '11 at 1:39

Tugging at an ear is sometimes a symptom of ear pain; however, this behavior can also be related to teething or a blocked eustachian tube. A blocked eustachian tube may cause sensations similar to those felt when flying or traveling in mountains.

The eustachian tube connects the middle ear to the mouth and can be blocked by inflammation, allergies, colds, infections or even milk. This tube opens several times per week when functioning adequately and normalizes the pressure in the middle ear. If it does not open regularly for any reason the eardrum becomes "sucked" backwards and can effect hearing.

Visual inspection with an otoscope even by a specialist will often not reveal a retracted eardrum. Tympanometry is a specialized test that is painless and designed to assess the mobility of the eardrum.

Ear infections are often present with NO observable indicators and is therefore sometimes called the "silent" illness. Any persist symptoms or concerns should be addressed to assure your child's health and hearing.

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