Ear Infection Care for Children and Adults

Ear pain can turn a night upside down, especially for little ones. By video, we can talk through symptoms, help with comfort and pain relief, and help you decide whether and where an in-person ear exam is needed.

Become a Patient

A mother holds her sleepy toddler, who rests their head on her shoulder.

Understanding Ear Infections

Ear infections are one of the most common reasons young children need care, and adults get them too. A middle ear infection, called acute otitis media, happens when fluid behind the eardrum becomes infected, often a few days after a cold. Sometimes fluid stays behind the eardrum without infection, which is called otitis media with effusion and can muffle hearing for a while. Swimmer's ear, or otitis externa, is different. It is an infection of the outer ear canal, often after water gets trapped in the ear, and it tends to hurt when the outer ear is touched or pulled.

Young children get middle ear infections more often because the tubes that drain their ears are shorter and more level, so fluid collects more easily after a cold. Risk is higher with group childcare, exposure to tobacco smoke, bottle-feeding while lying down, frequent pacifier use in older babies and a family history of ear infections. Breastfeeding, staying up to date on vaccines and a smoke-free home all lower the risk. Swimmer's ear is more likely after swimming or bathing, and with scratching, cotton swabs, earbuds or hearing aids that irritate the skin of the ear canal.

Here is an honest note about telehealth. Diagnosing a middle ear infection requires looking at the eardrum with a lighted instrument called an otoscope, and that takes an in-person exam. By video, we can review symptoms, help with pain relief, talk through whether swimmer's ear seems likely, and help you decide whether and where you or your child should be seen in person. For children, a parent or guardian joins the video visit. When a hands-on exam is needed, we will help you arrange it. Not every ear infection needs antibiotics, and current guidelines support watchful waiting for some children with mild symptoms.

Signs & Symptoms of Ear Infections

Ear pain. Pain can be sharp or dull and is often worse when lying down.
Tugging or rubbing the ear. Babies and toddlers who cannot say what hurts may pull at an ear, though teething can cause this too.
Fussiness and poor sleep. Extra crying, irritability and waking at night are common in young children.
Fever. A fever often comes with a middle ear infection, especially in children.
Fluid draining from the ear. Yellow, cloudy or bloody drainage can mean the eardrum has a small tear, which usually heals on its own.
Muffled hearing or fullness. The ear may feel plugged, or a child may not respond to sounds as usual.
Pain when the outer ear is touched. Itching, redness and pain when the earlobe is pulled point toward swimmer's ear.
Trouble with balance. Some children and adults feel dizzy or unsteady with an ear infection.

What to Expect

A video visit to review symptoms, fever readings from a home thermometer, recent colds, swimming and past ear infections
Help with pain relief, including safe, weight-based dosing of over-the-counter medicines for children
An honest answer about whether an in-person ear exam is needed, and help arranging one nearby
Guidance on swimmer's ear and on watchful waiting versus antibiotics, following current guidelines
Follow-up for repeat infections or lasting hearing concerns, with referral to an ear, nose and throat specialist when needed

How We Care for Ear Infections

Assessment

We start with a video visit to talk through when symptoms began, fever readings, recent colds, swimming, past ear infections and any ear tubes. Because a middle ear infection can only be confirmed by looking at the eardrum, we will tell you plainly when an in-person exam is the right next step and help you decide where to go.

Treatment Plan

Pain relief comes first, using acetaminophen or ibuprofen dosed for age and weight. Ibuprofen is not used in babies younger than 6 months. When an infection is confirmed, guidelines support either watchful waiting with close follow-up or an antibiotic, depending on age, severity and whether one or both ears are involved. Swimmer's ear is usually treated with ear drops.

Ongoing Care

We check in on how symptoms are improving and help arrange an in-person recheck if they are not. For repeated infections, fluid that lingers, or concerns about hearing or speech, we help coordinate a hearing check or a referral to an ear, nose and throat specialist.

Benefits

Experience With Babies and Children

Brooke Tuttle, FNP-C, is a board-certified family nurse practitioner who has practiced family medicine since 2017, after 11 years as a registered nurse in labor and delivery, postpartum and well-baby nursery care.

Honest Guidance

We tell you plainly what can be handled by video and when an in-person ear exam is the safer choice.

Care for the Whole Family

Children, teens and adults in your family can all receive care from the same provider, with a parent or guardian joining video visits for children.

Your Care Journey

Video Visit (Day 1)

We review symptoms, help with pain relief and decide together whether an in-person ear exam is needed. If it is, we help you arrange one nearby.

Days 2 to 3

Many ear infections start to improve within 2 to 3 days. If you are using watchful waiting and symptoms are not better or are getting worse, the plan usually shifts to an antibiotic.

Weeks 2 to 12

Fluid behind the eardrum can linger for weeks after an infection clears, which may muffle hearing for a while. It usually resolves on its own, and we keep an eye on it.

Long-Term Care

If ear infections keep coming back, fluid stays for 3 months or longer, or hearing or speech seem affected, we help arrange a hearing check or a referral to an ear, nose and throat specialist.

Warning Signs That Need Prompt Care

Fever in a young baby. Any fever of 100.4°F (38°C) or higher in a baby younger than 3 months needs urgent care.

Stiff neck or severe headache. These, especially with fever, need emergency care.

Swelling behind the ear. Redness, swelling or tenderness behind the ear, or an ear that sticks out more than usual, needs urgent care.

A very sick appearance. A child who is unusually sleepy, hard to wake, confused or not drinking needs urgent care.

High fever with severe pain. A fever of 102.2°F (39°C) or higher with severe ear pain should be seen in person promptly.

Facial weakness. Drooping on one side of the face needs urgent care.

Sudden hearing loss or severe dizziness. These should be evaluated promptly in person.

Pain that is not improving. Ear pain that is worse after 2 to 3 days, or drainage that continues, needs an in-person check.

If a child has a stiff neck, is very hard to wake, or has trouble breathing, or a baby under 3 months has a fever, call 911 or go to the nearest emergency room.

When to Reach Out

If you or your child has ear pain, reach out through our contact page. We can help you sort out the next step, including when to be seen in person.

Evidence-Based Treatment

Guidelines from the American Academy of Pediatrics call for a middle ear infection to be diagnosed by seeing a bulging eardrum or new drainage from the ear, which is why an in-person exam matters. Pain relief with acetaminophen or ibuprofen is recommended for everyone. For children 6 months and older with mild symptoms, watchful waiting with follow-up in 2 to 3 days is an accepted option, because many infections clear on their own. Antibiotics are generally recommended for babies younger than 6 months with a confirmed infection, for severe symptoms, and for children 6 to 23 months with infection in both ears. When an antibiotic is chosen, amoxicillin is a common first choice unless there is an allergy or recent use. Swimmer's ear is treated with antibiotic ear drops, and oral antibiotics are rarely needed. Ear tubes may be considered for frequent repeat infections or fluid that lasts with hearing loss. Vaccines, breastfeeding and a smoke-free home help prevent infections.

Common Questions About Ear Infections

Can an ear infection be diagnosed by video visit?

Not a middle ear infection. Confirming one requires looking at the eardrum with an otoscope, which needs an in-person exam. By video, we can review symptoms, help with pain relief, talk through whether swimmer's ear seems likely, and help you decide whether and where to be seen in person. Visits are for patients located in Utah, and a parent or guardian joins for children.

Do all ear infections need antibiotics?

No. Many middle ear infections clear on their own within a few days, and guidelines support watchful waiting for some children 6 months and older with mild symptoms. Antibiotics are recommended for young babies, severe symptoms and certain other situations. Pain relief helps in every case.

What is the difference between swimmer's ear and a middle ear infection?

Swimmer's ear is an infection of the outer ear canal, often after water stays in the ear. It usually hurts when the outer ear is touched or pulled, and it is treated with ear drops. A middle ear infection is behind the eardrum, often follows a cold, and is common in young children. Telling them apart for certain usually takes a look in the ear.

How can I ease my child's ear pain at home?

Acetaminophen or ibuprofen, dosed for your child's age and weight, is the main treatment for ear pain. Ibuprofen is not used for babies younger than 6 months. A warm compress held over the ear may also help. Ask before using any ear drops, especially if there is drainage or your child has ear tubes.

What if my child keeps getting ear infections?

Repeated infections are common in young children and often become less frequent with age. If infections keep returning, fluid lasts 3 months or longer, or hearing or speech seem affected, we can help arrange a hearing check or a referral to an ear, nose and throat specialist, who may discuss ear tubes.

Does insurance cover ear infection care?

Sagebrooke Family Medicine is an insurance-based practice, and we are in the process of joining insurance plans. What you pay depends on your plan, including any copay, deductible or coinsurance. Contact the practice to check whether your plan is accepted, and check with your insurer about coverage for medications and any in-person care you may need.

Get Help Sorting Out Ear Pain

Reach out through our contact page to ask about a telehealth visit for ear pain, for children and adults located in Utah. We will help you decide on the right next step.