EARACHE (EAR PAIN)
Symptom 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).
Causes
- Usually due to an ear infection.
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, see EAR CONGESTION.
- Due to airplane or mountain travel, see EAR CONGESTION
- Ear discomfort follows lots of swimming, see EAR SWIMMER'S.
WHEN TO CALL YOUR DOCTOR
Call 911 now (your child may need an ambulance:)
- 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 above 105 F (40.6 C).
- 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 (probably ear infection).
HOME CARE ADVICE FOR SUSPECTED EAR INFECTION (until your child can be seen)
- Reassurance: Your child may have an ear infection, but it doesn't sound serious. Diagnosis and treatment can safely wait until morning if the earache begins after 5 pm.
- Pain Medicine: Give acetaminophen (e.g. Tylenol) or ibuprofen for pain relief or for fever above 102°F (39°C).
- 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.)
- 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).
- Eardrops: Prescription eardrops or olive oil drops for pain aren't safe if your child has ear tubes or a hole in the eardrum. Therefore don't use eardrops unless your doctor recommends them.
- Contagiousness: Ear infections are not contagious.
- Call Your Doctor If:
- Your child develops severe pain
- Your child becomes worse
And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.
REFERENCES
- American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Clinical Practice Guideline: Diagnosis and management of acute otitis media. Pediatrics. 2004;113(5):1451-1462.
- Canto RM. Otitis externa and otitis media: A new look at old problems. Emerg Med Clin North Am. 1995;13:445-455.
- Hoberman A, et al. Efficacy of Auralgan for treating ear pain in children with acute otitis media. Arch Pediatr Adolesc Med. 1997;151:675-678.
- Licameli GR. Diagnosis and management of otalgia in the pediatric patient. Pediatr Ann.1999;28(6):364-368.
- Maxson S and Yamauchi T. Acute otitis media. Pediatr Rev. 1996;17:191-195.
- Pirozzo S, Del Mar C. Otitis media. In: Moyer V, Davis RL, Elliott E, et al, eds. Evidence Based Pediatrics and Child Health. London, England: BMJ Publishing Group; 2000. p. 238-247.
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.
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