Earache

Pediatric HouseCalls Online

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 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 daycare.

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.

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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).
• Fever over 104° F (40° C) and not improved 2 hours after fever medicine
• Pointed object was inserted into the ear canal (e.g., a pencil, stick or wire).

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

• All other earaches, but none of the symptoms described above (Reason: probably an ear infection)

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HOME CARE ADVICE FOR SUSPECTED EAR INFECTION (until your child can be seen)

1. Reassurance:

   • Your child may have an ear infection, but it doesn't sound serious. The only way to be sure is to examine the eardrum.
   • Diagnosis and treatment can safely wait until morning if the earache begins after 5 pm.
   • 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. Avoid Earplugs: 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 prescription eardrops or olive oil drops 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.

Last Reviewed: 1/19/2009

Last Revised: 12/19/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.