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My oldest had ear infections left and right when she was little. She NEVER tugged at her ears or even ran a fever with any of them. She ended up needing tubes... I am NOT a fan of antibiotics, but I would still bring your little one to confirm that it is in fact a an ear infection. You don't have to give him the meds if you don't want to.
Hylands makes an ear ache drop that is all natural that will relieve any pain that he may be having. They also make an ear ache tablet, but I am not sure what ages is recommended for those.
The main thing I would be concerned with is if he is prone to getting them. With my oldest (she is 5 now) she battled them for 18 months before the doctors agreed to put tubes in. It effected her hearing, which ended up effecting her speech.
Good luck and I hope he feels better soon
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