Otitis media in neonates and infants under 6 months of age has been a confusing topic because of the overlap between acute otitis media and otitis media with effusion (1). The latter is most relevant for hearing issues while the former is an infection that a newborn might not handle as well as a toddler due to an immature immune system. The infection threat is compounded when a baby in intensive care has additional infections or has become debilitated by other comorbidities (2, 3, 4, 5). In these circumstances, tympanocentesis can help in both the diagnosis and the treatment of the problem. Abnormal otoscopy may not be enough to distinguish among acute infection, chronic effusion, and nonresponding infection. Creating the opening in the ear drum will also allow some drainage for decompression and give a sample for culture that will help direct antibiotic therapy (1, 6).