Yes, an ear infection, specifically Acute Otitis Media (AOM), can cause a toddler to vomit, though this is often considered a non-specific symptom compared to ear pain and fever. An ear infection occurs when fluid builds up behind the eardrum in the middle ear. This space connects to the back of the nose and throat via the Eustachian tube. This fluid accumulation, typically due to a viral or bacterial infection, causes inflammation and pressure, leading to systemic symptoms in young children.
Why Ear Infections Cause Nausea and Vomiting
Digestive distress during an ear infection stems from several physiological responses. A significant factor is the generalized illness accompanying the infection, particularly a high fever. A systemic infection often triggers malaise and stimulates the brain’s vomiting center, which responds to inflammatory signals. Intense pain from the infection can also directly trigger nausea reflexes.
The most specific mechanism relates to the inner ear, which houses the vestibular system responsible for balance. Although AOM is a middle ear infection, the pressure and inflammation can sometimes affect neighboring inner ear structures. This disruption sends confusing signals to the brain about spatial orientation, which is interpreted as dizziness or vertigo. This sensation of unsteadiness is closely linked to the nausea and vomiting reflex.
Recognizing Other Signs of Ear Infection
Since toddlers cannot verbalize ear pain, parents must look for behavioral and physical cues. The most common sign is the toddler tugging, pulling, or rubbing at the affected ear, attempting to alleviate deep pressure.
An increase in irritability and crying, especially when the child is lying down, frequently signals an ear infection, as lying flat increases pressure and pain. Other signs include:
- Fever, which may be low-grade or high.
- Unsteadiness or loss of balance when walking.
- Yellow or white fluid draining from the ear (otorrhea), indicating a tear in the eardrum.
- A decrease in appetite or refusal to feed, as pressure changes from sucking and swallowing can be painful.
- Hearing difficulty or a reduced response to quiet sounds.
Managing Vomiting and Preventing Dehydration
The primary focus during any illness involving vomiting is managing fluid loss and preventing dehydration. The safest and most effective method is Oral Rehydration Therapy (ORT), which involves offering small, frequent sips of fluid. This allows the stomach time to absorb liquid without triggering the vomiting reflex.
For toddlers over one year old, give about one to two tablespoons (15 to 30 mL) of fluid every 20 minutes. Commercial oral rehydration solutions containing electrolytes are recommended over plain water or sugary drinks. Once vomiting has stopped for several hours, parents can slowly reintroduce bland, starchy foods like crackers or plain toast.
Appropriately dosed over-the-counter pain relievers, such as acetaminophen or ibuprofen, can also help manage associated symptoms. Reducing ear pain and fever lessens overall systemic distress, which may decrease nausea and vomiting episodes. Always follow dosing instructions precisely based on the child’s weight or age.
When to Seek Immediate Medical Attention
While many ear infections resolve with supportive care, certain signs require immediate medical evaluation to prevent complications. Dehydration is a serious risk for toddlers who are vomiting frequently. Seek prompt attention if you notice signs of severe dehydration, such as:
- No urination for six to eight hours.
- A dry mouth and tongue.
- A lack of tears when crying.
- A sunken soft spot on an infant’s head.
A high fever that remains above 102°F (38.9°C) despite medication, or any fever in an infant under six months old, should be reported to a healthcare provider. Persistent vomiting lasting longer than 24 hours, or the presence of blood or green-yellow bile in the vomit, are also red flags. Additionally, seek care if the toddler exhibits severe pain unrelieved by medication, swelling behind the ear, or appears lethargic and unresponsive.