Childhood earaches can have many causes.
To treat the earache properly, have a pediatrician examine your child.
At-home remedies can help ease pain while the ear heals.
Earaches are a particularly frustrating malady for children and their parents. The pain can be excruciating, especially for little kids, and it can be tricky for parents to try and pin down the cause and proper treatment. Sherry Baker, MD, a pediatrician at Providence Pediatrics Associates - Northpointe in Spokane, WA, shares her expertise to help make the job of treating earaches a little easier.
What causes an earache?
Earaches are one of the most common reasons for a visit to the pediatrician, Dr. Baker says, but the reasons behind those earaches can vary.
“Most commonly we see earaches because of an ear infection, swimmer’s ear or fluid behind the eardrum,” she says. “Sometimes it can also be caused by pain from other areas, such as a toothache or tonsil infection, or TMJ pain (pain in the jaw joint where the lower jaw connects the skull). And kids put things in their ears; that happens all the time. There are a lot of different things that can trigger an earache. That’s why it’s important to get it evaluated to find the underlying cause.”
Why are kids more likely to get earaches than adults?
Kids younger than school age have an increased risk for ear infections because the Eustachian tube (which connects the middle ear to the upper part of the throat) is shorter, more horizontal, and floppy, making it easier for fluid to build up. As the face elongates and develops, that tube becomes longer, more vertical, and stiffer, and fluid drains more easily, so ear infections become less common.
What are signs of an earache?
For infants, tugging on the ear is not necessarily an indicator of ear pain, Dr. Baker says. “Babies six months to one year of age are finding their ears and pulling at them, as they do when they are discovering all of their body parts,” she says. “If they are more fussy than normal or not sleeping as well as they normally do, those are indicators to me that something is going on, but it’s difficult to tell without looking in the ears, as those are also signs of teething, which is also common at that age.” In addition to fussiness and poor sleep, Dr. Baker suggests parents also look for runny nose and congestion, which lead to ear infection, as well as a fever.
How do doctors diagnose and treat earaches?
The classic middle ear infection is commonly treated with oral antibiotics; but nowadays those may not necessarily be needed, depending on the child’s age, what the doctor finds during the exam, and the type and duration of symptoms.
Dr. Baker says, “If a child is six months or above, it might be caused by a viral illness. If not severe, we can sometimes just do comfort care and observation for a couple of days to see if it clears, and if it doesn’t we’d prescribe antibiotics. Sometimes we see clear fluid behind the eardrum from a cold and it doesn’t look infected yet. It could clear up, or it could become an infection, and it’s hard to tell which way it will go; so, we like to watch it. We don’t want to use oral antibiotics excessively, because it can lead to bacterial resistance to the antibiotic and side effects. When they’re younger, we typically go to the oral antibiotic first.”
For swimmer’s ear, the ear needs to be dry for seven to 10 days during treatment, which consists of antibiotic eardrops because the infection in that case is on the outer ear canal, and drops are more effective. If a child has put something in her ear, the pediatrician can try to remove it during the office visit, but if it’s in too deep it may require a trip to the emergency room or to an ear doctor.
What can parents do to ease the pain?
After the pediatrician has determined the cause of the earache, there are some home remedies that can ease the pain. Dr. Baker recommends ibuprofen or acetaminophen, as well as warm or cold packs on the ear or neck.
If the earache is caused by a cold or flu virus, it can help to give a child plenty of water and place a humidifier in her room to help secretions drain from the Eustachian tube. Other methods used to relieve that kind of pain, like sucking on hard candy or chewing gum, can also help kids during plane flights, especially when altitude changes at takeoff and landing cause pressure buildup. Having babies feed (breast or bottle) during take-off and landing when flying can help.
Can earaches be prevented?
Vaccines are the best way to prevent ear infections, Dr. Baker says. Breastfeeding for the first four to six months and decreasing exposure to smoke can also help.
Parents can try to improve their odds by keeping a humidifier going during flu and cold seasons in fall, winter, and spring and making sure their child is well hydrated; they can also prevent fluid buildup by using nasal saline if a child has a runny nose.
“Getting vaccinated is very important. The pneumococcal and influenza vaccines can help decrease the risk of ear infections. A lot of times an ear infection can start with an upper respiratory viral illness like a cold or flu,” Dr. Baker says.
Do you have questions about earaches and other childhood maladies? The Circle by Providence app gives you provider-approved advice for common issues related to pregnancy and parenting.
Learn more about the Circle by Providence app for expectant and new moms:
Need to see a provider today? Providence Express Care clinics offer same-day appointments for common ear, nose and throat issues. If you’re looking for a pediatrician for your children, find one near you in our physician directory.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.