Teething or an Ear Infection? What Ear Tugging Can Tell You

Ear tugging alone cannot tell you whether your baby is teething or has an ear infection. Teething can come with ear rubbing, but ear infections can also cause it. Look at the whole picture, including temperature, feeding, discharge, and how your baby seems, and seek assessment when you are concerned. A clinician may need to examine the ear; a sleep change or a new tooth cannot settle the diagnosis.

It often starts with an ordinary moment: your baby reaches for an ear while chewing a toy, then has an unsettled night. You notice a red gum and wonder whether that explains everything. It might explain some discomfort, but it is not a reason to overlook another symptom.

This guide helps you organize what you see and choose the next step. It is not a home test for ear infections, and it does not replace an examination when one is needed.

Why the signs can overlap

The NHS teething guide lists sore gums, increased drooling and chewing, fussiness, disrupted sleep, and ear rubbing among possible signs. Some teeth emerge with little discomfort. The presence or absence of a dramatic teething phase does not establish how healthy a baby's ears are.

The National Institute on Deafness and Other Communication Disorders describes middle-ear infections as a separate process involving inflammation and fluid behind the eardrum, often following a respiratory infection. Ear pulling, unsettled sleep, fever, drainage, and changes in hearing or balance can occur.

The practical conclusion is not that every baby who touches an ear is ill. It is that the shared signs do not reliably distinguish the causes. Your baby can be getting a tooth during the same period that they have another illness.

Observe the baby, not just the ear

Before calling for advice, gather what you can without delaying care. You do not need to inspect inside the ear or repeatedly provoke a reaction. A brief account of the day is usually more useful than a confident guess.

Useful details include:

• Your baby's age and when the change began.
• Whether one ear or both seem to bother them.
• Their measured temperature and how you measured it.
• Whether feeding and wet nappies have changed.
• Any cold symptoms, fluid from the ear, swelling, or apparent hearing change.
• What their comfort and alertness are like between unsettled moments.

A note might read: “Pulling the right ear since yesterday, drinking less today, woke crying twice, no temperature reading yet.” That is an understandable starting point. “Definitely teething” closes down possibilities before anyone has assessed them.

If you already gave a medicine, tell the professional its name, concentration, amount, and time. Keep the packaging available. Do not give another dose simply to see whether relief proves the cause; symptom improvement is not a diagnosis.

Do not explain a fever away as teething

The NHS teething page describes a possible slight temperature rise below 38°C. A temperature of 38°C / 100.4°F or higher is a fever, and it should not be dismissed because a tooth is coming through.

The NHS fever guidance advises urgent help for a baby under three months with a temperature of 38°C or higher, or if you think they have a high temperature. For ages three to six months, 39°C or higher also needs urgent advice. A lower reading does not mean you should ignore a baby who looks unwell.

Seek urgent advice for dehydration, concerning feeding changes, or a baby who is not their usual self and worries you. Get emergency help for breathing difficulty, blue or grey coloring, or being hard to wake. Use your local urgent-care or emergency service; in the UK, NHS 111 provides urgent advice and 999 is for emergencies.

Our newborn temperature guide explains measurement and age-specific concerns in more detail. Do not wait to finish reading a guide when your baby needs help now.

When ear symptoms need an assessment

The NHS ear-infection guidance advises seeing a GP when a child under 12 months may have an ear infection. Seek urgent advice for swelling around the ear, fluid coming out, new hearing changes, or being generally unwell. Do not wait several days when those features are present.

If pain persists, symptoms worsen, or you are uncertain how urgently your baby should be seen, contact their healthcare professional. Explain the age and symptoms rather than relying on a general recommendation intended for older children.

During assessment, a clinician can look at the eardrum with an otoscope and decide whether further checks are needed. Treatment depends on the findings. Do not start leftover antibiotics, use someone else's ear drops, or assume antibiotics are always needed.

Before leaving, ask what improvement to expect, when to make contact again, and which changes should prompt earlier help. That follow-up plan is more useful than trying to predict the course from another family's experience.

Offer comfort without putting anything into the ear

While arranging appropriate advice, stay close and respond to your baby's needs. Keep offering their usual milk feeds. If feeding becomes difficult or intake drops, include that in the call rather than focusing only on the ear.

Do not insert cotton buds, fingers, oils, or other home remedies into the ear. The NHS advises against putting objects inside to remove wax. Ask a clinician or pharmacist before using ear drops, especially when there is discharge.

For pain medicine, obtain advice appropriate to your baby's age, weight, health, and the product available where you live. This guide does not provide a universal dose or assume that one country's age rules apply everywhere.

It can help to divide the practical tasks. One adult can comfort the baby while another finds the thermometer, contact number, and medicine packaging. If you are on your own, keep the first phone explanation short and let the service guide the questions.

If the gums are sore, choose simple teething care

For teething discomfort, the FDA recommends gentle gum rubbing with a clean finger or a suitable firm rubber teether. Supervise use, avoid liquid-filled or frozen teethers, and do not use teething necklaces. The FDA warns against benzocaine or lidocaine products and homeopathic teething products because of potentially serious harms.

The NHS also advises against freezing a teething ring or tying it around a baby's neck. Follow the particular product's cleaning and cooling instructions. A chilled product and a hard-frozen object are not interchangeable.

Comfort measures do not cancel the need to assess fever or ear symptoms. You can soothe sore gums while also asking whether something else needs attention.

Keep sleep changes in context

An uncomfortable baby may need extra reassurance. This is not the moment to treat every waking as a routine problem or proof that previous settling support has failed.

Keep infant sleep safe: place your baby on their back on a firm, flat, clear sleep surface. Do not raise the mattress, add a pillow, or leave a teether in the cot to address discomfort. These points follow AAP safe-sleep guidance.

Once health concerns have been addressed, a short record of the routine may help with an ongoing sleep discussion. The Bambii Sleep Academy is general sleep education; it cannot identify an ear infection or tell you that waking is “just teething.”

Common questions

Can teething cause an ear infection?

Teething and a middle-ear infection are different processes. Teething signs do not establish an infection, and a visible tooth does not rule one out. A clinician can assess the ear when symptoms suggest a problem.

My baby pulls an ear but seems well. Should I panic?

Ear pulling by itself is not a diagnosis. Observe the whole baby and ask for advice if it persists or concerns you. Use the urgency guidance above if other symptoms appear.

Can a good night's sleep rule out an infection?

No. Sleep is one observation, not an ear examination. Follow clinical advice and report changes in symptoms, feeding, or wellbeing rather than using one night as a test.

Sources checked October 2, 2026. General education from the Bambii Editorial Team; not individually reviewed by a clinician. Read our editorial standards or send a correction to team@bambii.app. Cover illustration generated with AI.