Ear pain in children

Overview

Ear pain, also called earache, is discomfort or pain in one or both ears. It is very common in children and often caused by an infection or fluid buildup behind the eardrum.

Yes, ear pain is very common, especially in children under age 5. About 4 out of 5 children will have at least one ear infection by age 3.

Ear pain mostly affects young children because their eustachian tubes (the small passages between the ear and throat) are shorter and more horizontal, making it easier for fluid to get trapped.

Symptoms

Common symptoms

• Earache or pain in the ear
• Fussiness or irritability
• Tugging or pulling at the ear
• Trouble sleeping
• Fever (especially 100.4°F or higher)
• Fluid draining from the ear
• Trouble hearing or not responding to sounds

Symptoms in children

• Increased crying or fussiness
• Rubbing or pulling the ear often
• Not responding to soft sounds
• Loss of appetite
• Vomiting or diarrhea (sometimes)

Symptoms in older adults

• Less common in older adults
• May include earache, hearing loss, dizziness, or pain when moving the ear

Causes

Main causes

• Middle ear infection (otitis media) – caused by bacteria or viruses
• Fluid behind the eardrum (glue ear)
• Ear canal infection (swimmer's ear)
• Colds or allergies that block the eustachian tubes
• Teething (in babies) – pain felt in the ear
• Foreign object stuck in the ear

Risk factors

• Age (especially 6-24 months)
• Childcare attendance
• Bottle feeding instead of breastfeeding
• Exposure to secondhand smoke
• Season – more common in winter
• Family history of ear infections

When to see a doctor

See a doctor urgently if:

• Ear pain with high fever (over 102°F / 39°C)
• Child is under 6 months with ear pain
• Fluid or blood draining from ear
• Child seems unusually sleepy or confused

Book a routine appointment if:

• Mild ear pain that lasts more than a day or two
• Mild fever without emergency signs
• Child has had several ear infections

Diagnosis

A doctor will look into your child's ear with a special tool called an otoscope (a small light with a magnifying lens). They check for redness, swelling, or fluid behind the eardrum.

Tests that may be done

• Otoscopy – looking into the ear
• Tympanometry – a puff of air to test eardrum movement
• Hearing test if infections are frequent

What to expect at your appointment

The doctor may also check your child's throat and listen to their breathing. The exam is quick and usually does not hurt.

Treatment

Most ear infections go away on their own within a few days. Treatment focuses on easing pain and helping the body fight the infection.

Self-care at home

• Give your child plenty of rest
• Apply a warm (not hot) cloth to the outside of the ear for comfort
• Keep your child upright to help fluid drain
• Offer plenty of fluids
• Use over-the-counter pain relief suitable for children (always check with doctor or pharmacist for the right dose)

Medical treatments

If symptoms are severe or do not improve, a doctor may recommend antibiotics. These are usually given as liquid medicine for a week or so. Sometimes ear drops are used for infections of the ear canal. In children with frequent infections, a doctor might suggest a small tube placed in the eardrum (grommet) to help fluid drain.

When is surgery considered?

Surgery (placing small tubes called grommets) may be considered if your child has many ear infections over several months or has hearing or speech problems.

Living with this condition

Most children recover quickly from an ear infection. While they have pain, comfort them and follow the doctor's advice.

Lifestyle tips

• Avoid exposing your child to cigarette smoke
• Keep your child away from sick people when possible
• Practice good hand washing

Diet and exercise

A healthy diet and plenty of fluids can support the immune system. No special restrictions.

Mental health and emotional wellbeing

Ear pain can be stressful for both child and parent. Frequent infections may cause temporary hearing loss that can affect speech development. If you are worried, talk to your doctor.

Prevention

You can reduce the risk by breastfeeding (if possible), avoiding smoke exposure, keeping vaccinations up to date, and practicing good hygiene.

Vaccines

The pneumococcal vaccine (PCV) and the flu vaccine can help prevent some ear infections. Talk to your doctor about your child's vaccination schedule.

Screening programmes

No routine screening. If your child has frequent infections, the doctor may recommend hearing tests.

Complications

If left untreated

• Hearing loss (usually temporary)
• Spread of infection to nearby areas (mastoiditis – infection behind the ear)
• Rarely, meningitis if the infection spreads to the covering of the brain

Long-term outlook

Most children with ear pain get better without any long-term problems. Even if an infection causes temporary hearing trouble, it usually goes away when the infection clears. With good care and follow-up, serious complications are very rare.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.