Earache

Symptoms

DEFINITION

  • Pain or discomfort in or around the ear
  • Child reports an earache
  • Younger child acts like he did with previous ear infection (e.g., crying or fussy)

Cause

  • Usually due to an ear infection
  • Ear infections can be caused by viruses or bacteria. Usually, your child’s doctor can tell the difference by looking at the eardrum. 
  • Ear infections peak at age 6 months to 2 years
  • The onset of ear infections peaks on day 3 of a cold

Return to School

  • An earache or ear infection is not contagious. No need to miss any school or child care.

See More Appropriate Topic (instead of this one) If

  • Ear congestion but no pain or is due to airplane or mountain travel, see EAR CONGESTION.
  • Due to airplane or mountain travel, see EAR CONGESTION.
  • Ear discomfort follows lots of swimming, see EAR SWIMMER'S

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

  • Not moving or very weak

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Earache is severe and not improved 2 hours after taking ibuprofen
  • Pink or red swelling behind the ear
  • Stiff neck (can't touch chin to chest)
  • Pointed object was inserted into the ear canal (e.g., a pencil, stick or wire)
  • Weak immune system (sickle cell disease, HIV, chemotherapy, organ transplant, chronic steroids, etc)
  • Fever over 104° F (40° C) and not improved 2 hours after fever medicine
  • You think your child needs to be seen

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • Earache, but none of the symptoms described above (Reason: possible ear infection)
  • Pus or cloudy discharge from ear canal

Care at Home

HOME CARE ADVICE FOR SUSPECTED EAR INFECTION (until you talk with your doctor)

  1. Reassurance:
    • Your child may have an ear infection. The only way to be sure is to examine the eardrum.
    • Diagnosis and treatment can safely wait until morning if the earache begins after your child's doctor's office is closed. 
    • Ear pain can be controlled with pain medicine and eardrops.
  2. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief or for fever above 102° F (39° C).
  3. Local Cold: Apply a cold pack or a cold wet wash cloth to the outer ear for 20 minutes to reduce pain while the pain medicine takes effect. (Note: Some children prefer local heat for 20 minutes.)
  4. Ear Drainage:
    • If pus or cloudy fluid is draining from the ear canal, the eardrum has ruptured from an ear infection.
    • Wipe the pus away as it appears.
    • Avoid plugging with cotton (Reason: Retained pus causes irritation or infection of the ear canal).
  5. Eardrops: 3 drops of plain olive oil (or prescription eardrops) will usually relieve pain not helped by pain medicine. If your child has ear tubes or a hole in the eardrum, don't use them.
  6. Contagiousness: Ear infections are not contagious.
  7. Call Your Doctor If:
    • Your child develops severe pain
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.

Last Review Date: 6/1/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Version Year: 2012

Copyright 1994-2012 Barton D. Schmitt, M.D.

Is Your Child Sick?

Pediatric HouseCalls Symptom Checker is a parent guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at Children's Hospital Colorado. Dr. Schmitt has developed other health tools for parents, including the 3rd edition of Your Child’s Health (available in bookstores) and KidsDoc, a new iPhone and Android app for parents (available online).

Are You Sick?

David A Thompson, MD is the author of Adult HouseCalls Symptom Checker. He is a board-certified emergency medicine physician at Northwestern Memorial Hospital in Chicago. He has a national reputation in telephone triage, decision support tools, medical information technology and quality improvement. Adult HouseCalls Symptom Checker is a decision support tool for adults that has been reviewed and approved by adult physicians.

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