Abdominal Pain - Female
Abdominal Pain - Male
Acne
Animal or Human Bite
Antibiotics: When Do They Help
Arm Injury
Arm Pain
Asthma Attack
Athlete's Foot
Back Pain
Bed Bug Bite
Bee or Yellow Jacket Sting
Blisters
Bottle-Feeding Formula Questions
Breast-Feeding Questions
Bruise
Burn
Chest Pain
Chickenpox
Circumcision Problems
Colds
Constipation
Cough
Coughs: Meds or Home Remedies
Cracked or Dry Skin
Cradle Cap
Croup
Crying Baby - Before 3 Months Old
Crying Child - 3 Months and Older
Cut, Scrape, or Bruise
Diaper Rash
Diarrhea
Diarrhea Diseases From Travel
Dizziness
Drinking Fluids - Decreased
Dry Skin
Ear - Congestion
Ear - Discharge
Ear - Injury
Ear - Pulling At or Rubbing
Ear - Swimmer's
Ear Infection Questions
Earache
Earwax Buildup
Ebola Exposure
Eczema
Emergency Symptoms Not to Miss
Eye - Allergy
Eye - Foreign Body or Object
Eye - Injury
Eye - Pus or Discharge
Eye - Red Without Pus
Eye - Swelling
Fever
Fever - How to Take the Temperature
Fever - Myths Versus Facts
Fifth Disease
Finger Injury
Fire Ant Sting
Flu
Fluid Intake Decreased
Food Allergy
Foreskin Care Questions
Frostbite
Genital Injury - Female
Genital Injury - Male
Hair Loss
Hand-Foot-And-Mouth Disease HFMD
Hay Fever
Head Injury
Headache
Heat Exposure and Reactions
Heat Rash
Hives
Human or Animal Bite
Immunization Reactions
Impetigo - Infected Sores
Infection Exposure Questions
Influenza - Seasonal
Influenza Exposure
Insect Bite
Jaundiced Newborn
Jellyfish Sting
Leg Injury
Leg Pain
Lice - Head
Lymph Nodes - Swollen
Medication - Refusal to Take
Mental Health Problems
Molluscum
Mosquito Bite
Mosquito-Borne Diseases from Travel
Motion Sickness
Mouth Injury
Mouth Ulcers
Neck Pain or Stiffness
Newborn Appearance Questions
Newborn Illness - How to Recognize
Newborn Rashes and Birthmarks
Newborn Reflexes and Behavior
Nose Allergy Hay Fever
Nose Injury
Nosebleed
Penis-Scrotum Symptoms
Pinworms
Poison Ivy - Oak - Sumac
Puncture Wound
Rash or Redness - Localized
Rash or Redness - Widespread
Reflux Spitting Up
Ringworm
Roseola
Scabies
Scrape
Sinus Pain or Congestion
Skin Foreign Body or Object
Skin Injury
Skin Lump
Sliver or Splinter
Sore Throat
Spider Bite
Spitting Up - Reflux
Stomach Pain - Female
Stomach Pain - Male
Stools - Blood In
Stools - Unusual Color
Strep Throat Exposure
Strep Throat Infection
Sty
Sunburn
Suture Questions
Swallowed Foreign Body or Object
Swallowed Harmless Substance
Swimmer's Itch - Lakes and Oceans
Tear Duct - Blocked
Teething
Thrush
Tick Bite
Toe Injury
Toenail - Ingrown
Tooth Injury
Toothache
Umbilical Cord Symptoms
Urinary Tract Infection - Female
Urination Pain - Female
Urination Pain - Male
Vaginal Symptoms
Vomiting With Diarrhea
Vomiting Without Diarrhea
Warts
Wheezing Other Than Asthma
Wound Infection

Resources

Is Your Child Sick?TM


Earache

Is this your child's symptom?

  • Pain or ache in or around the ear
  • The older child complains about ear pain
  • Younger child acts like he did with last ear infection or cries a lot
  • Not caused by an ear injury

Causes of Earaches

  • Ear Infection. An infection of the middle ear (space behind the eardrum) is the most common cause. Ear infections can be caused by viruses or bacteria. Usually, a doctor can tell the difference by looking at the eardrum.
  • Swimmer's Ear. An infection or irritation of the skin that lines the ear canal. Main symptom is itchy ear canal. If the canal becomes infected, it also becomes painful. Mainly occurs in swimmers and in the summer time.
  • Ear Canal Injury. A cotton swab or fingernail can cause a scrape in the canal.
  • Ear Canal Abscess. An infection of a hair follicle in the ear canal can be very painful. It looks like a small red bump. Sometimes, it turns into a pimple. It needs to be drained.
  • Earwax. A big piece of hard earwax can cause mild ear pain. If the wax has been pushed in by cotton swabs, the ear canal can become blocked. This pain will be worse.
  • Ear Canal Foreign Body (Object). Young children may put small objects in their ear canal. It will cause pain if object is sharp or pushed in very far.
  • Airplane Ear. If the ear tube is blocked, sudden increases in air pressure can cause the eardrum to stretch. The main symptom is severe ear pain. It usually starts when coming down for a landing. It can also occur during mountain driving.
  • Pierced Ear Infections. These are common. If not treated early, they can become very painful.
  • Referred Pain. Ear pain can also be referred from diseases not in the ear. Tonsil infections are a common example. Tooth decay in a back molar can seem like ear pain. Mumps can be reported as ear pain. Reason: the mumps parotid gland is in front of the ear. Jaw pain (TMJ syndrome) can masquerade as ear pain.

Ear Infections: Most Common Cause

  • Definition. An infection of the middle ear (the space behind the eardrum). Viral ear infections are more common that bacterial ones.
  • Symptoms. The main symptom is an earache. Younger children will cry, act fussy or have trouble sleeping because of pain. About 50% of children with an ear infection will have a fever.
  • Diagnosis. A doctor can diagnose a bacterial ear infection by looking at the eardrum. It will be bulging and have pus behind it. For viral ear infections, the eardrum will be red but not bulging.
  • Age Range. Ear infections peak at age 6 months to 2 years. They are a common problem until age 8. The onset of ear infections is often on day 3 of a cold.
  • Frequency. 90% of children have at least 1 ear infection. Frequent ear infections occur in 20% of children. Ear infections are the most common bacterial infection of young children.
  • Complication of Bacterial Ear Infections. In 5% to 10% of children, the eardrum will develop a small tear. This is from the pressure in the middle ear. The ear then drains cloudy fluid or pus. This small hole most often heals over in 2 or 3 days.
  • Treatment. Bacterial ear infections need an oral antibiotic. Viral ear infections get better on their own. They need pain medicine and supportive care.

When to Call for Earache

Call 911 Now

  • Not moving or too weak to stand
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Severe earache and not improved 2 hours after taking ibuprofen
  • Pink or red swelling behind the ear
  • Stiff neck and can't touch chin to chest
  • Pointed object was put into the ear canal. (Such as a pencil, stick or wire)
  • Not alert when awake ("out of it")
  • Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

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

Call 911 Now

  • Not moving or too weak to stand
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Severe earache and not improved 2 hours after taking ibuprofen
  • Pink or red swelling behind the ear
  • Stiff neck and can't touch chin to chest
  • Pointed object was put into the ear canal. (Such as a pencil, stick or wire)
  • Not alert when awake ("out of it")
  • Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

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

Care Advice for Earache

  1. What You Should Know About Earaches:
    • Your child may have an ear infection. The only way to be sure is to look at the eardrum.
    • It is safe to wait until your doctor's office is open to call. It is not harmful to wait if the pain starts at night.
    • Ear pain can usually be controlled with pain medicine.
    • Many earaches are caused by a virus and don't need an antibiotic.
    • Here is some care advice that should help until you talk with your doctor.
  2. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  3. Cold Pack for Pain:
    • Put a cold wet washcloth on the outer ear for 20 minutes. This should help the pain until the pain medicine starts to work.
    • Note: Some children prefer heat for 20 minutes.
    • Caution: Heat or cold kept on too long could cause a burn or frostbite.
  4. Ear Infection Discharge:
    • If pus is draining from the ear, the eardrum probably has a small tear. Usually, this is from an ear infection. Discharge can also occur if your child has ear tubes.
    • The pus may be blood-tinged.
    • Most often, this heals well after the ear infection is treated.
    • Wipe the discharge away as you see it.
    • Do not plug the ear canal with cotton. (Reason: Retained pus can cause an infection of the lining of the ear canal)
  5. Fever Medicine:
    • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Note: Fevers less than 102° F (39° C) are important for fighting infections.
    • For all fevers: Keep your child well hydrated. Give lots of cold fluids.
  6. Return to School:
    • Ear infections cannot be spread to others.
    • Can return to school or child care when the fever is gone.
  7. Call Your Doctor If:
    • Pain becomes severe
    • You think your child needs to be seen
    • Your child becomes worse

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

Disclaimer: This information is not intended to 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.


Copyright 1994-2017 Schmitt Pediatric Guidelines LLC. All rights reserved.

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