Earache  
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This Care Guide Covers:
  • 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

If not, see these topics
When to Call Your Doctor
Call 911 Now (your child may need an ambulance) If
  • Not moving or too weak to stand
  • You think your child is having a life-threatening emergency
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Earache is severe 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)
  • Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
  • Fever over 104° F (40° C)
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • Earache, but none of the symptoms above (Reason: Could be an ear infection)
  • Pus or cloudy discharge from ear canal
Causes & Health Information

Cause

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CARE ADVICE FOR EARACHE (Use this until you talk with your doctor)
  1. What You Should Know:
    • 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 be helped with pain medicine and eardrops.
    • Here is some care advice that should help until you talk with your doctor.
  2. Pain Medicine:
    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
  3. Cold Pack:
    • 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: A hot or cold pack kept on too long could cause a burn or frostbite.
  4. Eardrops:
    • If pain medicine does not help the pain, try eardrops. You can use plain olive oil or mineral oil (baby oil).
    • Use 3 drops every 4 hours.
    • There are also prescription eardrops for pain that you can use. (Same dose). Ask your child's doctor about these during office hours.
    • Caution: Don't use eardrops if has ear tubes or a hole in the eardrum.
  5. Ear Drainage:
    • 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)
  6. Fever:
    • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. See Dose Table. Note: Lower fevers are important for fighting infections.
    • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
    • For babies, dress lightly. Don't wrap in too many blankets. Reason: Can make the fever higher.
  7. Return to School:
    • Ear infections cannot be spread to others.
  8. Call Your Doctor If:
    • Pain becomes severe
    • 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 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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.