Parents often observe their infants pulling at their ears and wonder if this indicates an ear infection or simply discomfort from teething. Some symptoms can overlap, making differentiation challenging. Understanding the characteristics of teething discomfort versus an ear infection helps parents provide comfort and determine when medical advice is needed. This article clarifies the relationship between teething and ear pain, guiding how to identify the underlying cause of a child’s distress.
Understanding Teething Discomfort
Teething is a natural developmental stage, starting around six months of age, where a baby’s first teeth push through the gums. This process causes localized inflammation and discomfort in the mouth and jaw area. Common signs include increased drooling, general fussiness, and babies chewing on objects to soothe their gums. Parents might also notice swollen or tender gums where a tooth is about to erupt.
The discomfort from erupting teeth, especially molars, can radiate along the jawline. This referred pain can make babies rub their ears or cheeks to alleviate the sensation, even though the pain originates in the gums. Some babies may experience a slight increase in body temperature, which is typically a low-grade fever below 101°F (38.3°C).
Common Causes of Ear Aches
Earaches in infants and young children frequently result from ear infections, known medically as otitis media. These infections occur when bacteria or viruses cause fluid to build up behind the eardrum in the middle ear. This fluid accumulation creates pressure and inflammation, leading to pain. Ear infections often follow a cold, sore throat, or upper respiratory infection, as bacteria or viruses can spread from the throat to the middle ear through the Eustachian tubes.
Signs of an earache not related to teething include persistent ear pulling or tugging, increased irritability, and difficulty sleeping, especially when lying down, which intensifies pressure in the middle ear. A higher fever, sometimes exceeding 102°F (38.9°C), indicates an ear infection. Other causes of ear pain include swimmer’s ear (otitis externa), an infection of the outer ear canal associated with moisture buildup, or a foreign object in the ear.
Differentiating Teething from Ear Infections
Distinguishing between teething discomfort and an ear infection is challenging due to overlapping symptoms like fussiness and ear pulling. However, specific signs help differentiate the two. Teething pain is intermittent, relieved by chewing on objects or gentle gum massage. The discomfort is localized to the gums, which may appear swollen or red, and excessive drooling is an accompanying symptom.
An ear infection, conversely, presents with more persistent and intense pain. While ear pulling can occur with both, consistent and forceful tugging, particularly when accompanied by other symptoms, points more strongly to an infection. A differentiator is fever: teething may involve a mild temperature elevation below 101°F (38.3°C), whereas ear infections present with a higher fever, reaching 102°F (38.9°C) or more.
Children with ear infections may also exhibit difficulty sleeping due to increased pressure when lying flat, reduced appetite, or a noticeable change in hearing or balance. A recent cold or upper respiratory infection precedes an ear infection, increasing its likelihood. Unlike teething, ear infections can lead to fluid discharge from the ear, which may appear yellowish or white.
When to Seek Medical Attention
Parents should consult a healthcare professional if they observe specific red-flag symptoms suggesting a condition beyond typical teething discomfort. Medical attention is warranted if a child has a fever of 102°F (38.9°C) or higher, or if a lower fever persists for more than 2-3 days. Persistent crying, inconsolable pain, or a noticeable increase in irritability, especially if the child seems sicker, also warrant professional advice.
Any fluid draining from the ear, whether clear, yellowish, or pus-like, requires immediate medical evaluation, as this can indicate a ruptured eardrum due to infection. A child who is unusually drowsy, unresponsive, has difficulty hearing, or shows signs of balance problems should also be seen by a doctor. For infants under six months of age, any fever or suspected ear pain generally warrants a prompt medical consultation due to their developing immune systems and potential for more serious complications. Only a medical professional can definitively diagnose an ear infection and recommend appropriate treatment.