06/03/2026
👂🔥 3am Ear Pain? It’s Probably an Ear Infection… Here’s What Parents Should Know
If your child has ever woken up crying in the middle of the night, holding their ear, you are not alone.
Ear infections are one of the most common reasons children visit the doctor, especially in babies and toddlers.
The good news? Most of them get better quickly with the right care.
🦠 What actually causes an ear infection?
Most ear infections happen after a cold.
When children have a runny nose, the tiny tube that connects the ear to the back of the nose (the Eustachian tube) can become blocked. Fluid builds up behind the eardrum and sometimes becomes infected.
Because children’s ear tubes are shorter and more horizontal, infections happen much more easily than in adults.
👶 Signs your child might have an ear infection
• Ear pain
• Pulling or rubbing the ear
• Fever
• Crying or irritability
• Trouble sleeping (very common!)
• Reduced appetite
• Fluid draining from the ear
• Temporary hearing difficulty
• Problems with balance
In babies, the signs are often subtle,sometimes just being unsettled or refusing feeds.
💊 Do all ear infections need antibiotics?
No.
Many ear infections are viral and will improve on their own within a few days.
Antibiotics may be needed if:
• The infection is clearly bacterial
• The child is very young
• Symptoms are severe
• Fever persists
• The infection is not improving
Your doctor will decide based on the examination.
😴 Why ear infections hurt more at night
When children lie down, pressure inside the ear increases, which makes the pain worse.
That’s why many parents notice symptoms late at night or in the early hours of the morning.
🌟 Fun facts parents often don’t know
• 80% of children will have at least one ear infection before age 3
• Ear infections often follow a simple cold
• Temporary hearing loss during infection is very common
• Most children outgrow frequent ear infections as their ear anatomy develops
🛠 What helps your child feel better?
✔ Pain relief (paracetamol or ibuprofen when appropriate)
✔ Fluids
✔ Rest
✔ Keeping your child comfortable
Pain control is usually the most important treatment in the first 24–48 hours.
🚨 When to see your doctor
• Severe ear pain
• Fever lasting more than 2–3 days
• Fluid or pus coming from the ear
• Your child seems very unwell
• Repeated ear infections
Ear infections are very common in childhood, and the vast majority of children recover completely without long-term problems.
If you are unsure whether your child has an ear infection, it’s always reasonable to have them checked.
Dr Willem Smit
Paediatrician