Earache

What is earache?

An earache is pain within or surrounding the ear. It is common in children and can have many causes.

When your child has an earache he or she may:

• pull at the ear
• cry or be irritable
• have ear drainage
• have some loss of hearing
• have a fever (if there is infection).

What causes an earache?

Common causes include an infection, an injury, or pressure in the ear.

Middle ear infections are common during or after a cold. When your child has a cold, it may cause the tube between the middle ear and throat to swell. This traps fluid in the middle ear and can allow bacteria to grow there and cause infection and pain. The ear canal itself can also become infected. This usually happens during the summer, in children who have been swimming. The canal may also be injured when objects (such as small toys or cotton swabs) are put in the ear canal.

Pressure inside the ear may be caused by blockage from wax. Toddlers and young children sometimes put small toys or other objects into the ear canal, causing pressure or injury. Changes in air pressure (such as during air travel) can also cause pain.

Children will sometimes say their ear hurts when the pain is actually from another place. This is sometimes caused by teething, chewing gum, or an infection of the scalp, neck, or sinuses.

How is it treated?

Middle ear infections always need to be checked by a healthcare provider. The ear pain is treated with pain medicines like acetaminophen or ibuprofen. Antibiotics are often only used in children under 6 months or when the symptoms won't go away.

Infections of the ear canal are often treated with antibiotic drops, which may also contain medicine for pain.

Objects within the ear canal, including impacted wax, should be removed by your healthcare provider.

How can I take care of my child?

For middle ear or ear canal infections, follow your health provider's instructions for care. To help relieve pain you can:

• Give your child acetaminophen or ibuprofen.
• Put a cold pack or cold wet cloth on the ear for 20 minutes.
• Put a warm moist washcloth or a covered hot water bottle (which should be warm, not hot to the touch) over the ear.

To keep wax from impacting, remember to never put things like cotton swabs into the ear canal. If your child has problems with earwax, you can put 1 to 2 drops of mineral or vegetable oil into the ear canal for a few minutes each day. Wipe away any oil that drips out from the ear. You can reduce this treatment to once per week or less when you see improvement. There are many over-the-counter drops that may be helpful as well.

Your baby's ears may plug up or hurt due to changes in air pressure. This can often be relieved by blowing out while keeping the mouth closed and nose pinched. If traveling by plane, you can help keep your baby's ears clear by nursing or feeding when the plane is climbing and descending. Swallowing helps equalize the air pressure.

When should I call my child's healthcare provider?

Call immediately if:

• Your child is crying inconsolably.
• Your child suddenly has trouble hearing.

Call during office hours if:

• Your child has a fever lasting more than 3 days.