Earaches can occur in the middle or outer ear. Middle ear earaches are most commonly caused by a bacterial or viral infection. For example, when your child has a cold, bacteria can grow in the passages that connect the middle ear to nose. If these passages block up, the middle ear becomes infected and inflamed. The build-up inside the ear places pressure on the eardrum, causing it to bulge and become painful for your child.

Other causes of earaches such as: 

  • fluid building up inside the ear 
  • blocked ears from earwax or other objects 
  • injury to the ear canal from cotton buds or other objects 
  • teething or a dental abscess (if accompanied by a toothache) 
  • tonsillitis or a sore throat (if ear pain occurs with swallowing) 
  • a perforated eardrum (hole in the eardrum) 
  • altitude changes (such as during or after a plane trip) 

If you’re not sure what’s causing their earache or if you’re worried about your child's hearing, speak to your GP. 

What are some signs of an earache?

Earache and ear infections can be miserable for a child of any age and be worrying for you, as a parent or carer. The signs to look for include:  

  • sharp, dull, or burning pain in one or both ears 
  • hearing problems 
  • scaly skin or discharge in or around the ear 
  • feeling pressure or fullness in the ear 
  • lack of energy 
  • feeling sick 
  • itching and irritation around the ear 
  • fever 
  • irritability or crying 
  • sleeping problems 

For babies who can’t talk, be on the lookout if your baby is: 

  • pulling at their ear 
  • ignoring loud sounds 
  • being irritable 
  • not wanting to eat 
  • losing their balance 

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

Most earaches usually clear up within a few days. Symptoms of ear infections can sometimes last for up to a week, however.

Tips you can try at home include getting your child to rest in an upright position instead of lying down, to help relieve some of the pressure and place a warm flannel against the affected ear to help relieve the pain.

If your child is in pain you can also give them some pain relief medicine to soothe their earache. Nurofen for Children 3 months to 12 years - Strawberry contains ibuprofen which has anti-inflammatory properties.

In older children, nasal sprays can help to reduce the swelling in the nasal passages which leads to the middle ears. Using a nasal spray will not help the ear infection clear away any faster but if your child also has a stuffy nose, it can help to unblock it for a few hours. However; do not give this to your child except under the advice of your GP or pharmacist, and never for more than days in a row. Avoid using any over-the-counter ear drops without first seeing your GP, as they can cause problems if your child's eardrum has a perforation (holey).

Do you need antibiotics for an ear infection?

Most ear infections are caused by viruses which can't be treated with antibiotics. Many people believe that antibiotics will help to reduce ear pain, but this isn't the case. Aside from using painkillers and monitoring your child's wellness and body temperature, often the best course of action is to wait for the ear infection to clear on its own. 

Your GP may decide to prescribe antibiotics, however, 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 cystic fibrosis) which may increase the risk of complications  

Is it normal to have regular earaches and ear infections?

Regular ear infections in children can lead to a condition called glue ear. Glue ear occurs when sticky fluid builds up in your child's ear. This can lead to unclear speech or behavioral problems. Children with glue ear or regular ear infections may be treated with something called an ear tube - a narrow tube made of plastic or metal which allows air to flow to and from the middle ear. If your child is regularly suffering from ear infections, takes a long time to recover, or there is discharge coming out of the ear, see your GP. 

How to prevent ear infections

Ear infections aren't fun so it's great to know that there are steps you can take to try and prevent them. Some ways you can prevent ear infections include: 

  • make sure your child is up to date with vaccinations 
  • avoid smoking around your child 
  • avoid using a dummy after your child is six months old 
  • don't stick cotton wool buds or your fingers in your child's ears 
  • insert earplugs into your child's ears when they swim 
  • avoid getting water or shampoo into your child's ears 
  • when bathing your child, pull a shower cap over the ears 
  • treat conditions that affect your child's ears, such as eczema or an allergy to hearing aids 

As always, remember to see your doctor if your child's earache doesn't improve or if you have any concerns. 

When to call a doctor

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

See your GP if your child has any of the following: 

  • a very high temperature 
  • an earache that doesn't improve after 3 days 
  • swelling or fluid coming out of the ear 
  • hearing loss 
  • a severe sore throat, vomiting, or dizziness 
  • regular ear infections 
  • a long-term medical condition or weakened immune system 

If an ear infection is causing severe pain that cannot be relieved by medication, a doctor may decide to make a small cut inside the ear to drain away the excess fluid.