Ear pain in children may be a sign of an infection in the space behind the eardrum ( middle ear). Ear infections (otitis media) most commonly occur when cold symptoms, such as a runny or stuffy nose and a cough, have been present for a few days.
An ear infection may occur when the eustachian tube swells and closes and fluid accumulates in the middle ear. The combination of fluid and germs (from bacteria or viruses) creates a perfect environment for an infection. Swelling from the infection can cause pain from increased pressure on the eardrum. The pressure can cause the eardrum to rupture (perforate). A single eardrum rupture is not serious and does not cause hearing loss. Repeated ruptures may lead to hearing loss.
Middle ear infections are more common in children than in adults. Young children have short, soft, more horizontal eustachian tubes that are more easily blocked than those of older children and adults.
Ear infection is the most commonly diagnosed bacterial infection in children younger than age 7. Almost all children will have at least one ear infection by the time they are 7 years old. Most ear infections occur in babies between the ages of 6 months to 3 years. After age 7, ear problems may be related to inflammation, infection, or fluid buildup in the middle or external ear. Ear infections are more common in boys than in girls, and they most often occur in children who:
Fluid often remains in the middle ear (serous otitis, or middle ear effusion) after an ear infection. This may cause no symptoms, or it may cause a muffling of sound, decreased hearing, and mild discomfort. The body usually reabsorbs fluid behind the eardrum within 3 months, and hearing returns to normal. Recurrent ear infections and persistent effusion may occur in some children.
Even though ear infections are a common cause of ear pain, not all ear pain means an infection. Other common causes of apparent ear pain in young children include:
When evaluating ear pain in a child, remember that ear infections commonly occur after symptoms of a cold have been present for a few days. When other symptoms, such as fever, are present, ear pain or drainage may be less important than the other symptoms.
Ear problems caused by an injury to the ear can occur at any age. Common injuries include the following:
Check your child's symptoms to decide if and when your child should see a doctor.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.
Oral (by mouth), ear, or rectal temperature
A forehead (temporal) scanner is usually 0.5° F (0.3° C) to 1° F (0.6° C) lower than an oral temperature.
Armpit (axillary) temperature
Note: For children under 5 years old, rectal temperatures are the most accurate.
A baby that is extremely sick:
A baby that is sick (but not extremely sick):
If you're not sure if a child's fever is high, moderate, or mild, think about these issues:
With a high fever:
With a moderate fever:
With a mild fever:
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:
Symptoms of an external ear infection may include:
Vertigo is the feeling that you or your surroundings are moving when there is no actual movement. It may feel like spinning, whirling, or tilting. Vertigo may make you sick to your stomach, and you may have trouble standing, walking, or keeping your balance.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
Pain in children 3 years and older
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Based on your answers, the problem may not improve without medical care.
When ear discomfort or pain is mild or comes and goes and occurs without other symptoms, home treatment may be all that is needed to relieve your child's discomfort. Home treatment measures include the following:
Try a nonprescription medicine to help treat your child's fever or pain:
Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.
Be sure to follow these safety tips when you use a nonprescription medicine:
Call your child's doctor if any of the following occur during home treatment:
There are many steps you can take to help prevent ear problems and injuries.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
If you have made an appointment with your child's doctor, you can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:
To learn more about Healthwise, visit Healthwise.org.
© 1995-2021 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.