Earache in Children: Causes, Symptoms & Relief

Earache and ear pain is common in children and can be uncomfortable—for both kids and their carers. The good news is that most earaches and ear infections aren’t serious and often get better on their own.
In many cases, simple pain relief, rest, and a bit of TLC at home are all that’s needed. Knowing how to manage the pain, what to steer clear of, and when to get medical advice can make a big difference.
And if you’re ever unsure or things don’t seem to be improving, it’s always a good idea to check in with your doctor.

What to do:

Pain relief medicines like paracetamol or ibuprofen (such as Nurofen for Children) can be effective for children. Ibuprofen relieves aches, pain, fever and has anti-inflammatory properties which is particularly useful if your child’s earache is caused by an infection. Ibuprofen may not be suitable for all children, check with a pharmacist or your GP if you’re unsure. Always read and follow the instructions on the packet.
Use a warm or cool compress (flannel) over the ear to ease pain.
Gently wipe the outer ear with cotton wool to remove any discharge.
Keep the ear dry and avoid letting your child swim or wet the ears during infection, particularly at bathtime.
For mild symptoms, watchful waiting for 2–3 days is recommended before seeking medical advice from a healthcare professional.

What to avoid:

Do not insert cotton buds, fingers, or any objects into their ear.
Don’t smoke in the household and try to remove your child from places where there may be smoke or heavy pollution, if possible.
Avoid swimming or getting the ear wet if there’s pain, discharge, or suspected infection.
Don’t use over-the-counter ear drops unless advised by a healthcare professional—especially if the eardrum may be perforated.
Don’t delay treatment in babies and children under 2 years and if pain is severe, persistent or in both ears.
Keep your baby home from daycare to avoid infecting others and allow them to fully recover. They can return once the fever and pain has subsided.
Don’t let your child sleep with a bottle (drinking while lying down can trap fluid in the ear).

Causes of Earache

Earache can be a result of a range of possible causes. Here are some of the common causes, in children:

Children are more susceptible to middle ear infections, (Otitis Media) caused by viruses and bacteria. The middle ear is the area just behind the eardrum. In young children the middle ear structures are immature and function less efficiently than in adults, making them more prone to getting infected.
Children can also get outer ear infections (Otitis Externa) affecting the ear canal (the tube between the outer ear and the eardrum), which is caused by something irritating the ear canal, such as eczema, water or wearing earplugs, or a fungal or bacterial infection.
Earwax buildup can cause pain in the ear and might affect your child’s hearing temporarily. Fortunately a doctor can usually pick this up during a simple ear examination.
Colds, sinus infections, or throat infections can lead to referred pain in the ear. Children might experience pain when swallowing and they may also have a fever.
Teething in babies or tooth problems in children may also cause ear pain.
Perforated eardrum can happen when an infection causes fluid to build up in the eardrum, making is bulge and rupture (perforate). A perforation can also happen when an object gets stuck in the ear. This usually happens more often to children.

How to know if your baby has earache

Knowing if a baby or young child has earache, might be tricky to spot. A baby or young child might have earache if they:

rub or pull their ear
do not react to some sounds
have a temperature of 38°C or above
are irritable or restless
are off their food
keep losing their balance
earache and ear pain can affect 1 or both ears.

You may also notice some of the symptoms seen in adults, for ear infections, including:

A fever (high temperature)
Discharge (fluid) coming from the ear
Scaly skin in and around the ear

Treatment When More Help is Needed

Most ear infections clear up on their own , but bacterial infections may require antibiotics.
Children under 2 years of age with ear infection in both ears, may need antibiotics or if the symptoms don’t improve or worsen within 3 days.
Earwax blockages may need removal by a healthcare professional.
Topical antibiotics may be prescribed for outer ear infections (swimmer’s ear).
Occasionally, ENT referral or surgical drainage may be needed for recurrent or serious cases.

When to See a Doctor

Make a GP appointment if your child has earache that lasts more than 3 days, or keeps coming back.

See a GP immediately or get urgent help if your child:

has severe pain, high fever, or fluid/discharge from the ear,
has hearing loss, balance issues, or swelling around the ear or face,
is crying persistently or noticeably changed behaviour or unwell,
has something stuck in their ear,
is under 2 years and has earache in both ears.

This article is for general information only and not intended as a substitute for medical advice. All information presented on these web pages is not meant to diagnose or prescribe. In all health-related matters, always consult your healthcare professional. Always read the product label. Use only as directed. Incorrect use could be harmful. If symptoms persist consult your healthcare professional.

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