What causes earache in children?

An ear infection can occur in the middle or outer ear, which can cause earache.

A middle ear infection may be caused by bacterial or viral infection. For example, when your child has a cold, the space in the middle ear which normally contains air may be filled with fluid (mucus). Germs such as bacteria or viruses can grow in this mucus and cause infection. Children may experience pain in the ear and fever.

An outer ear infection is less common in children than in adults. It may happen more often to people who swim or people with skin conditions such as eczema around the ear. If you have an outer ear infection, your ear might feel sore or itchy, and there may be a discharge coming out of your ear.

Other causes of children’s earaches may include:

  • Blocked ears from earwax
  • An object such as small toys, seeds, bits of a cotton bud or insects stuck in the ear (common in children)
  • Teething or a dental abscess (if ear pain is accompanied with a toothache)
  • Tonsillitis or a sore throat (if ear pain occurs with pain when swallowing)
  • A perforated eardrum (tear in the eardrum)
  • Altitude changes (such as during or after a plane trip)

If your child keeps getting an earache or if they’ve had an earache for more than 3 days, don't hesitate to contact your doctor.

What are the signs of an ear infection in children?

The signs of an ear infection in little ones may vary, but these are possible symptoms:

  • Pain inside the ear
  • Difficulty hearing
  • Itching
  • Discharge coming out of the ear
  • Feeling as if the ear is blocked or full
  • Feeling sick or vomiting
  • Fever (high temperature)
  • Painful or swollen glands

For babies who can’t talk, signs they may have an ear infection are:

  • Rubbing or pulling at their ear
  • Not reacting to some sounds
  • Being irritable or restless
  • Not wanting to eat
  • Losing their balance

How can I help relieve my child's earache or ear infection?

Most earaches in children are caused by an ear infection, which usually starts to improve in a few days, but sometimes symptoms can last up to a week. You can place a warm or cool flannel against the affected ear to help relieve the pain.

If your child is in pain or has a fever, you can also give them paracetamol or ibuprofen. Nurofen for Children Oral Suspension contains ibuprofen which helps relieve earache and bring down a fever.

Do you need antibiotics for an ear infection?

Most ear infections don’t need antibiotics which make little difference to symptoms, including pain. Our immune system can usually clear germs (bacteria or viruses) that cause ear infections. 

For ear infections inside the ear, your doctor may prescribe antibiotics if:

  • The ear infection doesn't start to get better after three days.
  • Fluid is coming out of your child's ear.
  • Your child is under two and has an infection in both ears.
  • Your child has a condition (such as diabetes) which may increase the risk of infection.

How to help prevent ear infections

Ear infections are quite common and usually clear up on their own, however they can cause discomfort for your child. You cannot always prevent ear infections, but there are some things you can do to try to avoid them:

For inner ear infections:

  • Avoid dummy use after your child is 6 months old.
  • Avoid smoking around your child.
  • Keep your child up to date with their vaccinations.

For outer ear infections:

  • Avoid sticking cotton wool buds or fingers in your child's ears.
  • Making sure your little one uses earplugs when they swim.
  • Avoid water or shampoo in your child's ears.

Never hesitate to see your doctor if your child's earache doesn't improve within 3 days, happens often or if you have any concerns.

When to call a doctor immediately.

Sometimes, ear infections do not get better on their own or may signal something more serious.

See your GP immediately or call 111 if your child has an earache and any of the following:

  • Becomes generally unwell.
  • A very high temperature or feel hot and shivery.
  • Swelling around the ear, or fluid coming out of the ear.
  • Hearing loss or a change in hearing.
  • Something stuck in their ear.
  • Is under 2 years old and has earaches in both ears.
  • A long-term medical condition or weakened immune system.
  • A rash, severe sore throat, vomiting, or dizziness.

Earache is common in young children and although it can be painful, it’s not usually a sign of anything serious. However, if your little one has earache for more than 3 days, or seems to have earache often, contact your doctor.