Ear grabbing is a common behavior in infants and toddlers that often concerns parents, yet it is usually not a sign of a serious issue. While tugging at an ear can occasionally point to discomfort or a medical problem, the action is frequently benign and part of normal development. Understanding the different reasons behind the behavior, from self-discovery to illness, helps parents respond appropriately.
Normal Developmental Reasons
For many infants, ear grabbing is simply a result of discovering a new body part. Between four and twelve months, babies intensely explore their bodies, and their ears are readily accessible for examination. This action is a motor skill milestone, and the tactile sensation of the ear is a novel experience they enjoy exploring.
The action can also be a form of self-soothing, similar to thumb-sucking. Babies often use the repetitive motion of pulling or rubbing their ears to calm down when they are tired or overstimulated. If the ear tugging happens primarily before a nap or bedtime, it is likely a sign of fatigue rather than pain. A baby may also be scratching an itch due to mild skin irritation or the presence of earwax.
Non-Infectious Sources of Discomfort
One common non-infectious cause of ear grabbing is teething, which is often mistaken for an ear infection. The nerves supplying the jaw and gums are closely connected to the nerves in the ear. This connection causes pain from erupting teeth to “radiate” or be felt in the ear, particularly when the back molars are pushing through the gums.
Other sources of localized irritation can also prompt a baby to touch or pull their ear. Skin conditions like dry skin, eczema, or cradle cap can extend to the skin behind or inside the ear, causing itchiness and flaking. Environmental factors, such as water or soap residue trapped in the ear canal after a bath, can cause temporary irritation. Pressure changes, such as those experienced during a flight or rapid elevation change, can also cause mild discomfort resulting in ear pulling.
Identifying Signs of an Ear Infection
While ear grabbing alone is rarely the sole indicator of a middle ear infection (otitis media), it frequently occurs alongside other symptoms when an infection is present. An ear infection is caused by fluid buildup behind the eardrum, which becomes infected and inflamed, often following an upper respiratory illness. The pain from this pressure and inflammation causes a baby to tug at the ear more consistently and forcefully.
A more reliable indicator of an ear infection is the presence of systemic symptoms, not just isolated ear pulling. These accompanying signs include a fever, typically over 100.4°F, and increased crying or irritability that is difficult to soothe. The pain tends to worsen when the baby is lying down, which can lead to difficulty sleeping or frequent night waking.
Other distinct warning signs include a loss of appetite or a refusal to feed, due to painful pressure changes that occur with sucking and swallowing. Fluid draining from the ear canal (yellow, brown, or white) is a definitive sign of infection. Since the inner ear is involved in balance, an infection may also cause a loss of balance or clumsiness in older infants and toddlers.
When to Contact a Pediatrician
Simple ear pulling without other signs of illness can usually be managed by monitoring the baby at home. However, contact a healthcare provider if the ear grabbing is persistent and accompanied by other symptoms. If your baby has a fever of 100.4°F or higher, or if the fussiness and ear-tugging behavior lasts for more than 24 hours, contact the pediatrician.
Red flag symptoms that require prompt medical attention include any fluid drainage from the ear, which may indicate a perforated eardrum. Extreme fussiness, inconsolable crying, or lethargy are also reasons to seek care immediately. For babies under six months old, any fever or sustained symptoms should be evaluated by a medical professional due to their developing immune systems.