Comparison · Pregnancy Smart
Ear infection vs. teething: how to tell the difference
How do the options compare?
The lens is a clinician's: guideline endorsement, pregnancy evidence, dosing, onset, and tolerability. Cost and formulation notes appear where relevant.
| Sign | Teething | Ear infection | What it means |
|---|---|---|---|
| Ear pulling or tugging | Commonly reported during teething, but not a reliable sign on its own | Also commonly reported with an ear infection; by itself, ear pulling does not reliably point to either cause | Ear pulling alone should not be used to decide between the two; look at the fuller pattern of symptoms instead |
| Fever | At most an occasional low-grade temperature on the day a tooth emerges; MedlinePlus states teething does not cause true fever | About two-thirds of children with an ear infection run a fever, usually low-grade but sometimes higher | A real, measured fever should not be attributed to teething and needs its own evaluation, especially in a baby under 3 months |
| Sleep and mood | Mild irritability and some sleep disruption around the day a tooth breaks through | Irritability, disturbed or restless sleep, and poor feeding are common, often more pronounced or longer-lasting than typical teething fussiness | Symptoms lasting several days beyond a single tooth's eruption window lean away from teething alone |
| Drooling and mouth signs | Increased drooling, gum swelling or tenderness, and a strong urge to chew on firm objects | Not a typical feature; ear infection symptoms center on the ear itself, not the mouth | Visible gum swelling over an emerging tooth points toward teething specifically |
| Ear-specific signs | Not expected; teething does not typically cause fluid drainage or a visibly affected ear | Fluid or pus draining from the ear, or a red, bulging eardrum on exam, points specifically to an ear infection | Any ear drainage needs a pediatric evaluation regardless of whether teeth are also coming in |
- Teething does not cause fever or diarrhea, and a caregiver who is worried about either symptom should contact the child's health care provider rather than attributing it to a new tooth. 1
- FDA guidance lists mild irritability, a low-grade temperature, drooling, gum discomfort, and a strong urge to chew as the occasional, mild symptoms of teething, none of which include true fever or ear drainage. 2
- About three out of four children have at least one ear infection by their third birthday, with tugging at the ear, crying more than usual, fluid draining from the ear, trouble sleeping, and balance or hearing changes as the practical, non-verbal warning signs. 3
- Beyond ear tugging, common ear infection signs include irritability, disturbed or restless sleep, poor feeding, and loss of appetite, with roughly two-thirds of affected children also running a typically low-grade fever, a more sustained pattern than the mild warmth sometimes seen with teething. 4
- A preceding upper respiratory infection is the most common risk factor for an ear infection, and incidence peaks between 6 and 12 months of age, an age range that overlaps heavily with active tooth eruption, part of why the two get confused so often. 4
- Because ear pulling alone cannot distinguish the two, a true fever, especially 100.4°F (38°C) or higher in a baby under three months, is the detail that should prompt evaluation rather than being dismissed as either teething or waited out. 5
Which option makes sense?
The comparison above is intentionally evidence-first, not brand-first. Please consult your healthcare provider to translate it into a plan that fits your pregnancy specifics.
Disclosure: Pregnancy Smart is a supplement maker. The options compared above sit outside our own product line; this page describes their pregnancy evidence on its own merits.
Frequently asked questions
My baby keeps pulling their ear. Is it teething or an ear infection?
Ear pulling alone can't tell you, since it's a commonly reported sign of both and isn't reliable on its own for either. Look at the fuller pattern instead: drooling and gum swelling lean toward teething, while a real fever, fluid draining from the ear, or sleep and feeding trouble that doesn't ease lean toward an ear infection.
Does teething cause a fever the way an ear infection does?
Not in the same way. MedlinePlus states plainly that teething does not cause fever, while roughly two-thirds of children with an ear infection do run a fever, usually low-grade but sometimes higher. A measured fever should prompt its own evaluation rather than being written off as teething.
What symptoms point more toward teething?
Increased drooling, visible gum swelling or tenderness over the spot where a tooth is emerging, a strong urge to chew on firm objects, and at most a mild, brief low-grade warmth are the pattern more consistent with teething than an ear infection.
What symptoms point more toward an ear infection?
Fluid or pus draining from the ear, a fever that is more than just mild warmth, irritability and sleep disruption that last several days rather than around one tooth's eruption, and poor feeding are more typical of an ear infection than of teething.
Why do parents mix these two up so often?
Partly because ear pulling shows up with both, and partly because ear infections peak in incidence between 6 and 12 months of age, which overlaps heavily with when many babies are actively cutting teeth, so the two are simply happening in the same window for a lot of families.
Can my baby have both teething and an ear infection at the same time?
Yes, and that overlap is part of why relying on one sign like ear pulling doesn't settle the question. If your baby has any sign that points toward an ear infection, such as fever, ear drainage, or persistent irritability, it's worth having it checked regardless of whether teeth are also coming in.
Should I just wait a day or two to see which one it is?
That depends on what you're seeing. Mild fussiness and drooling with no fever can reasonably be watched for a short time, but any fever, especially in a baby under three months, fluid draining from the ear, or symptoms that are getting worse rather than better warrant a call rather than a wait-and-see approach.
Is there a test that tells teething and an ear infection apart for certain?
A pediatric clinician can look inside the ear with an otoscope to check for the fluid buildup and redness typical of an ear infection, a more definitive check than any symptom pattern a parent can observe at home. There is no equivalent single test for teething; it is identified by the visible tooth and the absence of other explanations like infection.
Related in the library
Symptoms
Does teething cause fever in babies?
Symptoms
Ear infection symptoms in babies
Is it safe?
Newborn Fever: When to Seek Immediate Medical Care
Is it safe?
Newborn hearing screening: results and next steps
Symptoms
Cow milk protein allergy in babies: signs and feeding
Symptoms
Breastfed baby refusing a bottle: what to check
Comparisons
Safe vs. unsafe ways to ease teething pain
References
MedlinePlus · https://medlineplus.gov/ency/article/002045.htm
Safely Soothing Teething Pain in Infants and Children
FDA · https://www.fda.gov/consumers/consumer-updates/safely-soothing-teething-pain-infants-and-children
MedlinePlus · https://medlineplus.gov/earinfections.html
NCBI Bookshelf · https://www.ncbi.nlm.nih.gov/books/NBK470332/
When your baby or infant has a fever
MedlinePlus · https://medlineplus.gov/ency/patientinstructions/000319.htm
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.