EARS, PULLING AT OR ITCHY

DEFINITION

A child repeatedly pulls, tugs, pokes or itches the outer ear or ear canal
No crying or report of earache

Causes

Main cause (infants): normal touching and pulling with discovery of ears. This behavior is usually not seen before 4 months of age
Main cause (older children): mild swimmer's ear from: (1) water accumulation during swimming or showers, (2) soap or shampoo retention, or (3) canal irritation from cotton-tipped swabs. Some children are reacting to a piece of earwax in the ear canal.
Most younger children (under age 2 or 3) who pull or poke at the ear are unable to confirm or deny the presence of an earache. Dr. Ray Baker examined 100 children with ear-pulling as the chief complaint. The main conclusion was that simple ear-pulling without other symptoms of an illness or infection was never associated with ear infections.

See More Appropriate Topic (instead of this one) If

Child is mainly crying and not pulling at ears, see CRYING CHILD OLDER THAN 3 MONTHS OLD.

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WHEN TO CALL YOUR DOCTOR FOR EARS, PULLING AT OR ITCHY

Call Your Doctor Now (night or day) If

Your child looks or acts very sick.
Fever above 104°F (40°C) and not improved 2 hours after fever medicine.
Age less than 12 weeks with fever greater than 100.4 F (38.0 C) rectally. (Caution: Do NOT give your baby any fever medicine before being seen.)

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

You think your child needs to be seen.
Seems to be in pain or crying without an obvious reason.
Starts awakening from sleep.
Fever or symptoms of a cold are present.
Drainage from the ear canal.
Constant digging inside 1 ear canal.

Call Your Doctor During Weekday Office Hours If

You have other questions or concerns
Pulling at the ear continues over 3 days
Itching continues over 1 week

Parent Care at Home If

Normal ear touching or pulling
Itchy ear canal

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HOME CARE ADVICE

Reassurance:

Most of these children have discovered their ears and are playing with them.
Some have an itchy ear canal.
Ear pulling that is a new symptom and begins when a child has a cold usually is caused by fluid in the middle ear. Less often it's caused by an ear infection.
Ear pulling without other symptoms is not a sign of an ear infection.

Habit: If touching the ear is a new habit, ignore it (prevent doing it for attention).
White Vinegar Eardrops: For itchy ear canal, use ½ strength white vinegar by diluting it with equal parts water. Place 2 drops in each ear canal daily for three days (reason: restore the normal acid pH). (Exception: ear drainage, ear tubes or hole in eardrum.)
Avoid Soap: Keep soap and shampoo out of the ear canal.
Avoid Cotton Swabs: Cotton swabs remove the earwax that normally protects the lining of the ear canal, and this leads to itching and irritation.
Expected Course: With this treatment, most itching is gone in 2 or 3 days.
Call Your Doctor If:

Pulling at the ear continues for more than 3 days
Itching continues for more than 1 week
Your child becomes worse

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

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REFERENCES

Baker RB. Is ear pulling associated with ear infection? Pediatrics. 1992;90:1006-1007.
Guest JF, Greener MJ, Robinson AC, Smith AF. Impacted cerumen: composition, production, epidemiology and management. Q J Med. 2004; 97:477-488.

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.

See Other Topics:

Crying Child Older Than 3 Months Old (Irritability, Fussiness)

View Anatomic Index of Topics