Middle ear infections are common in infants and toddlers. They are often preceded by a cold and most commonly manifest with ear pain, fussiness, fever, waking from sleep, or decreased appetite. Children can have symptoms ranging from asymptomatic (no symptoms) to all of the symptoms mentioned above. There is no way to know whether or not your child truly has an infection (pus behind the ear drum) without looking in the ear and visualizing the ear drum. An infection is not the only cause of ear pain, therefore it is important for a provider to examine your child's ears if you are concerned. A true infection requires treatment with antibiotics, while clear fluid in the ears, eustachian tube dysfunction, or cerumen (wax) impaction does not.