When to seek medical advice

What is an earache?

Causes of earache

Symptoms of acute otitis media

Home treatment

When to seek medical advice

See the doctor immediately or call 911 if:

• Your child has an earache and a stiff neck. Video: How to test for a stiff neck
  
  
• Your child has an earache and difficulty balancing or dizziness.
  
  
• Pus or blood is running out of your child's ear. This may indicate that his ear drum has ruptured.
  
  
• You suspect that your child has something stuck in his ear.
  
  
• Your child has an earache and the skin behind his ear is swollen and red.
  

Make an appointment with your doctor if:

• Your child is under 1 year old, and you believe he may have an ear infection.
  
  
• Your child is over than 1 year old and has an earache and a fever.
  
  
• Your child has an acute earache that causes him to cry, and the pain is not responding to pain relievers like acetaminophen or ibuprofen.
  
  
• Your child still has an earache or fever after 2 days of treatment with antibiotics.

What is an earache?

When a child has a cold or a fever, he may experience pain in one or both ears. While younger child may not yet be able to verbally tell you that he is in pain and where the pain is located, he will often give you nonverbal signs:

• He may have sudden screaming fits
  
• He may appear to be in pain
  
• He may be irritable
  
• He may hold or pull on the affected ear

Causes of earache

The most common cause of earache is a middle ear infection (known medically as acute otitis media), and is often the result of an infection in the upper respiratory tract, like a cold.

The infection causes the mucous membranes in the Eustachian tube (the tube that connects the middle ear to the back of the throat) to swell, and so the pressure behind the ear drum increases. The resulting low pressure in the ear then leads to a build-up of fluids and possible middle ear infection.

Video: What happens during a middle ear infection?

Video: What happens during a typical examination of a child's ears ?

Symptoms of acute otitis media

Prior to a middle ear infection, a cold or other upper respiratory infection causes the mucous membranes in the Eustachian tube (the tube that connects the middle ear to the back of the throat) to swell which then decreases the air pressure behind the ear drum. The resulting low pressure in the ear can then lead to a build-up of fluids and middle ear infection.

Once the middle ear is infected, pus builds up behind the ear drum, and as a result, the increased pressure on the ear drum causes pain. At the same time, the ear drum itself becomes thick and swollen.

Click these links to compare a normal ear drum to an inflamed ear drum.

At some point, the ear drum may rupture, letting the pus run into the ear canal and out the ear.

Home treatment

If your child is 2 years old or older, is not seriously ill, and has no fever, you can simply monitor his condition for 1-2 days. Many cases of middle ear infection will get better on their own after a few days.

You can give your child the following treatment to ease his earache:

1. Have your child lie down with his head slightly elevated. This will help ease the earache.
   
   
2. Give your child some decongestant nose drops if he has a stuffy nose. This will make it easier for him to breathe and to eat. Don't use these decongestant drops for more than 2 to 3 days.
   
   
3. Give you child pain relievers like acetaminophen or ibuprofen to help lessen the ear pain. Follow the dosage instruction on the package.
   
   
4. Place a warm compress carefully over your child's ear for approximately 20 minute. This may ease the earache considerably.
   
   
5. Schedule a check-up with your child's doctor 2-3 weeks after the ear infection so the doctor can make sure that your child's ear drums are normal.
   
   
6. Don't expose your child to cigarette smoke, because cigarette smoke has been shown to increase the frequency and severity of ear infections.