The common causes Ear ache in children will be either teething, or ear infections. The latter can be outer ear infection (otitis externa,) or otitis media behind the eardrum and mastoiditis is rare these days.


Teething infants can have ear pain, fever, diarrhea and a runny nose. Pain from teeth can be referred to the ear. The baby may very well have an ear infection but if you suspect baby is teething, this could be the cause too. Teething causes gum pain which radiates up the jaw and to the ears. It’s common for babies to grab their ears during teething. However, it’s really hard to tell whether teething pain or ear infection with out an otoscopic examination.

Teething typically begins around 5-6 months of age and continues until 2 or 3 years old, when all 20 baby teeth have finished erupting through the gums. Teething is often an unpleasant experience for infants and their parents, resulting in sleepless nights, increased crying and sore gums.

The stress of teething may make your child more prone to a respiratory infection, so teething and ear infection can both be present.

It’s not easy to tell if it is one or the other, or both. If your infant is badly distressed, off their feeds or has a high fever, ear infection is more likely.

The nerve center that the teeth and the ear drum share are the same. Because of this you may notice that your child will begin to pull on their ears during Teething.

Symptoms during teething

In addition to the more common symptoms of teething, such as drooling, gum swelling, sleeping difficulties, fever, diarrhea, rash, lethargy and irritability, some teething babies may develop a stuffy nose or sinus congestion, similar to the symptoms caused by a cold virus.

Teething calendar

The ages given are averages and babies vary in their development.

Between six and ten months. The first teeth to appear are the two lower front teeth.

Between eight and thirteen months. The top four incisors are next.

Between ten and sixteen months. Two more incisors appear in the lower front and then, the first back teeth (first year molars).

Between sixteen and twenty-three months. The pointed side teeth (canines) are next.

Between twenty-three and thirty-three months. And lastly the remaining back teeth (second year molars). By the time your baby is three, he or she will have all twenty of his or her primary teeth.

How do you know your baby is teething?

He bites his hand, cries at night and appears to be drooling a lot. These are the signs you should look for in your baby. You can expect some irritability and restlessness as well. It’s understandable that he or she’s fussy. His first teeth must push and cut through the gum tissue and that causes some tenderness and soreness.

What can you give to ease the teething pain?

Parents often give their babies a teething ring to “chomp” on. This satisfies their urge to push the teeth through the gum tissue. To relieve teething pain and discomfort, you might try a topical anesthetic.

I recommend DoloGel® to apply as drops or ointment which contains lidocaine and choline salicylate. It’s safe, effective and alcohol-free.

Ibuprofen or Paracetamol and decongestant also can be given orally. All of these can help with sleep.

For Ear ache I usually give Otogesic® ear drops, provided there is no signs of ear infection as such.