Definition
- A child repeatedly pulls, tugs, pokes or itches the outer ear or ear canal
- No crying or report of earache
Causes
- Main cause (infants): normal touching and pulling with discovery of ears. This behavior is usually not seen before 4 months of age
- Main cause (older children): mild swimmer's ear from: (1) water accumulation during swimming or showers, (2) soap or shampoo retention, or (3) canal irritation from cotton-tipped swabs. Some children are reacting to a piece of earwax in the ear canal.
- Not an ear infection: Most younger children (under age 2 or 3) who pull or poke at the ear are unable to confirm or deny the presence of an earache. Dr. Ray Baker examined 100 children with ear-pulling as the chief complaint. The main conclusion was that simple ear-pulling without other symptoms of an illness or infection was never associated with ear infections.
When to Call Your Doctor for Ear - Pulling At or Itchy
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- Fever over 104° F (40° C) and not improved 2 hours after fever medicine
- Age under 12 weeks with fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen.)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen
- Seems to be in pain or crying without an obvious reason
- Starts awakening from sleep
- Fever or symptoms of a cold are present
- Drainage from the ear canal
- Constant digging inside 1 ear canal
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Pulling at the ear continues over 3 days
- Itching continues over 1 week
Parent Care at Home If
- Normal ear touching or pulling
- Itchy ear canal
Home Care Advice for Ear Pulling Habit or Itchy Ear Canal
- Reassurance:
- Most of these children have discovered their ears and are playing with them.
- Some have an itchy ear canal.
- Ear pulling that is a new symptom and begins when a child has a cold usually is caused by fluid in the middle ear. Less often it's caused by an ear infection.
- Ear pulling without other symptoms is not a sign of an ear infection.
- Habit: If touching the ear is a new habit, ignore it (prevent doing it for attention).
- White Vinegar Eardrops: For itchy ear canal, use ½ strength white vinegar by diluting it with equal parts water. Place 2 drops in each ear canal daily for three days (Reason: restore the normal acid pH). (EXCEPTION: ear drainage, ear tubes or hole in eardrum)
- Avoid Soap: Keep soap and shampoo out of the ear canal.
- Avoid Cotton Swabs: Cotton swabs remove the earwax that normally protects the lining of the ear canal, and this leads to itching and irritation.
- Expected Course: With this treatment, most itching is gone in 2 or 3 days.
- Call Your Doctor If:
- Pulling at the ear continues for over 3 days
- Itching of ear continues for over 1 week
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
References
- Baker RB. Is ear pulling associated with ear infection? Pediatrics. 1992;90:1006-1007.
- Guest JF, Greener MJ, Robinson AC, Smith AF. Impacted cerumen: composition, production, epidemiology and management. Q J Med. 2004; 97:477-488.
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.