Many newborn ear infections don't show classic signs like fever or early pulling. Instead, it may show signs like irritability, poor feeding, or fragmented sleep. Parents have to trust their intuition or take their kid to a paediatrician. They can't articulate their pain, which makes ear infections hard to identify. Some new parents also misinterpret troubled behaviours as other discomfort.
Newborn Ear Infection
A newborn's ear has three main parts: the outer ear, the middle ear, and the inner ear. The Eustachian tube connects the middle ear to the throat, which is responsible for fluid retention and equalising pressure. This tube is short and narrow in newborns. Fluid, mucus, and pathogens from the nasal passage travel into the middle ear, but the immaturity of this tube impairs mucus clearance during feeding or a cold. After birth, some newborns often retain some fluid in the middle ear. These inherently don't cause infection. However, it can trap bacteria and increase otitis media risk, especially with feeds and colds. The bacteria multiply and cause inflammation, pus formation, and eardrum pressure.
Early Ear Infection Signs in Newborns
- Behavioural Changes: When newborns face discomfort in their ears, they show it through their behaviour. Babies become irritable for a reason. Calm babies suddenly become fussy and don't soothe. This irritation and fussiness don't settle even after feeding and a diaper change.
- High-pitched Crying: Without any reason or trigger, the baby cries persistently. An ear infection cries often look more high-pitched, sharp, and strained than the usual hunger cry. Crying escalates when the baby is laid flat or touched around the head and neck.
- Restlessness: Especially during sleeping, babies show restlessness and wake up frequently. They arch their backs, showing discomfort.
- Difficulty Feeding: When the middle ear is inflamed, sucking pressure may cause pain. Newborns don't latch properly, keep pulling away, or refuse to feed.
- Sleep Changes: Newborns face disrupted sleep even if they are tired. When a baby changes position, it can increase pressure in the middle ear, which increases discomfort. As a result, the baby wakes crying frequently.
- Body Cues: Newborns don't tug ears or localise pain. But some may rub their ear against the mattress or caregiver's shoulder or turn their head repeatedly, in an attempt to relieve pressure. Tightened facial muscles, pursed lips, or furrowing brows may indicate discomfort, which turns into crying when the baby is held, lifted, or repositioned.
- Increased Sensitivity: Dressing, burping, or repositioning may trigger crying because these actions may touch the area around the ear, jaw, and neck. If the baby shows consistent discomfort when you touch around these areas, check the ears for infection.
Physical Signs
- Ear Inspection: At home, parents can gently pull the ear upward and back to examine the ear canal opening for redness, swelling, or discharge.
- Discharge: If clear, yellow, or blood-tinged fluid from the ear canal comes, it may indicate an ear infection.
- Bad Odour: A foul or bad smell from the ear is another sign of infection. The smell typically comes from bacterial buildup. Don't mistake the smell for dried milk or skin oil.
- Redness: If the skin around the ear canal looks red or swollen, it can be a sign of irritation or inflammation. Mild redness can occur from friction or sensitivity, but extreme or progressive redness accompanied by swelling should be reported to the doctor immediately.
Find the Difference Between Ear Infections and Other Common Conditions
Newborns show almost the same reactions to every pain and strain. This makes the new parents confused and misinterpret signs. Here are a few common conditions and how they differ from ear infections.- Teething: Teething results in gum swelling, drooling, and a desire to chew objects. An ear infection comes with sleep disruption, potential fluid drainage, and pain when lying flat.
- Gas or Colic: If the baby cries for more than 3 hours a day, for 3 plus days per week, withdrawing legs close to the abdomen, it indicates colic. Gas symptoms often resolve after burping, passing gas or stool, or being gently rocked. The ear infection may persist despite motion and feeding.
- Reflux: Reflux-related discomfort happens after feeding. Arching, vomiting after feeding and weight changes are some common reflux symptoms. Whereas an ear infection comes with pain and discomfort during sucking and swallowing, and refuses to latch and feed.
- Overstimulation: Turning away from bright light and noise, and calms once the light goes dim and sound is reduced. An ear infection comes with unsoothable crankiness that doesn't relax even with swaddling or calming.
- Congestion: Cold or fever shows temperature rise and cough, which may last about 7-10 days. Viral old chases runny or blocked nose, sneezing, and mild fever. Congestion eases with saline drops.
Ways to Soothe Your Newborn’s Ear Infection at Home
- Change Position: Elevate the head of the crib by using rolled towels. It promotes Eustachian tube drainage and reduces supine pressure. Hold the baby upright during and after feeding, as it may reduce ear pressure.
- Warm Compress: Apply a warm cloth or sock with warm rice over the infected ear. Repeat this a few times to soothe irritation. Make sure the rice socks or water is not hot.
- Cool Compress: To reduce swelling and inflammation, apply cool pressure on the area.
- Pain Relief: After careful examination, paediatricians will suggest pain relief medicines.
- Feeding: Don't force-feed the baby. Offer small, frequent feeds of breast milk or formula. Burp during and after feeding to curb reflux.
- Soothing Environment: Don't overstimulate the newborn with bright lights or noise. Keep the place dim and avoid loud music. Gentle rocking, swaddling, and white noise offer security and distraction from pain.
It's hard to identify ear infections in newborns. They can't localise pain or tug their ear. Many newborns show minimal physical signs. You can identify an ear infection by closely noticing its changes. If feeding gets painful or distressing response or consistent high-pitched crying, it may indicate an ear infection. If you notice subtle signs or have an intuition, immediately consult with a paediatrician.
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.
FAQs on Ear Infections Signs In Newborns: How To Spot And Soothe Ear Infections Early
- How common is fluid in newborn ears?
Fluid is commonly present in the middle ear due to amniotic fluid, birth secretion, and congestion. Though it clears on its own, it can persist for months and may lead to infection. This happens because the connecting tube from the middle ear to the throat is short, narrow, and mostly horizontal, which makes fluid drainage hard. - How common is hearing loss in newborns?
Hearing loss in newborns can be temporary and permanent. Prematurity, low birth weight, and infections due to fluid in the middle ear can be the main reasons behind temporary hearing loss. Permanent hearing loss is less common and may be due to genetic factors, which can be present at birth or develop later in life.