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Should Your Child See a Doctor?

Ear Discharge

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Definition

  • Drainage of substances/liquids with varied colors and consistency from the ear canal
  • Drainage through an ear tube is included

Causes 

  • Normal discharge: earwax or water. Earwax is light brown, dark brown, or orange brown in color.
  • Abnormal discharge: cloudy fluid or pus. Main cause is an ear infection with drainage from a ruptured eardrum or through a ventilation tube.

When to Call Your Doctor for Ear Discharge

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Pink or red swelling behind the ear
  • Clear or bloody fluid following head injury
  • Bleeding from the ear canal (EXCEPTION: few drops and follows ear exam)
  • Fever over 104° F (40° C) and not improved 2 hours after fever medicine
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Ear pain or unexplained crying
  • Discharge is yellow or green, cloudy white or foul-smelling (pus)
  • Clear drainage (not from a head injury) persists over 24 hours
 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
 

Parent Care at Home If

  • Probably normal earwax or other harmless discharge and you don't think your child needs to be seen
 

Home Care Advice for Ear Discharge

  1. Earwax:
    • Ear wax protects the lining of the ear canal and has germ-killing properties.
    • If the earwax is removed, the ear canals become itchy.
    • Do not use cotton swabs (Q-tips) in your child's ear.
    • Call Your Doctor If: Begins to look like pus (yellow or green discharge)
     
  2. Clear Discharge (without head trauma):
    • It's probably tears or water that entered the ear canal during a bath, shower, swimming or water fight.
    • Don't overlook eardrops your child or someone else used without telling you.
    • In children with ventilation tubes, some clear or slightly cloudy fluid can occur when a temporary tube blockage opens up and drains.
    • Call Your Doctor If: Clear drainage persists for more than 24 hours or recurs
     
  3. Blood After Ear Exam:
    • If your doctor had to remove ear wax in order to see the eardrum, about 10% of the time this causes a small scratch to the lining of the ear canal. Usually the scratch oozes 1 or 2 drops of blood and then clots.
    • This should heal up completely in a few days.
    • It shouldn't affect the hearing.
    • Don't put anything in the ear canal because it will probably re-start the bleeding.
    • Call Your Doctor If: Bleeding continues or recurs
     
  4. Suspected Ear Infection: Cloudy fluid or pus draining from the ear canal almost always means there's a small tear in the eardrum and a middle ear infection. Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief until the office visit. (See Earache for details)
  5. Call Your Doctor If:
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.


References

  1. Ah-Tye C, Paradise JL, Colborn DK. Otorrhea in young children after tympanostomy-tube placement for persistent middle-ear effusion: prevalence, incidence, and duration. Pediatrics. 2001;107:1251-1258.
  2. Bitar CN, Kluka EA, Steele RW. Mastoiditis in children. Clin Pediatr. 1996;35:391-395.
  3. Guest JF, Greener MJ, Robinson AC, Smith AF. Impacted cerumen: composition, production, epidemiology and management. Q J Med. 2004; 97:477-488.
  4. Isaacson G. Diagnosis of pediatric cholesteatoma. Pediatrics. 2007;120(3):603-608.
  5. Schroeder A, Darrow D. Management of the draining ear in children. Pediatr Ann. 2004; 33(12):843-852.
  6. Schwartz RH and Bahadori RS. What to do for runny ears. Contemp Pediatr. 1999;16(5):121-131.
  7. Urkin J, Gazala E, Bar-David Y. Cleaning earwax: why you shouldn’t play it by ear. Contemp Peds. 2004; 21(2):73-86.
  8. Whatley VN, Dodds CL, Paul RI. Randomized clinical trial of docusate, triethanolamine polypeptide, and irrigation in cerumen removal in children. Arch Pediatr Adolesc Med. 2003; 157:1177-1180.

Disclaimer

This information is not intended to 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: 8/1/2010

Last Revised: 9/14/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.

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