Should Your Child See a Doctor?
- Pain or discomfort in or around the ear
- Child reports an earache
- Younger child acts like he did with previous ear infection (e.g., crying or fussy)
- Usually due to an ear infection
- Ear infections can be caused by viruses or bacteria. Usually, your child's doctor can tell the difference by looking at the eardrum.
- Ear infections peak at age 6 months to 2 years
- The onset of ear infections peaks on day 3 of a cold
Return to School
- An earache or ear infection is not contagious. No need to miss any school or child care.
When to Call Your Doctor for Earache
Call 911 If…
- Your child is not moving or too weak to stand
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 (can't touch chin to chest)
- Pointed object was inserted into the ear canal (e.g., a pencil, stick or wire)
- Weak immune system (sickle cell disease, HIV, chemotherapy, organ transplant, chronic steroids, etc.)
- 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
- Earache, but none of the symptoms described above (Reason: possible ear infection)
- Pus or cloudy discharge from ear canal
Home Care Advice for Suspected Ear Infection (until your child can be seen)
- Your child may have an ear infection. The only way to be sure is to examine the eardrum.
- Diagnosis and treatment can safely wait until morning if the earache begins after your child's doctor's office is closed.
- Ear pain can be controlled with pain medicine and eardrops.
- Pain Medicine:
Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief or for fever above 102° F (39° C).
- Local Cold:
Apply a cold pack or a cold wet wash cloth to the outer ear for 20 minutes to reduce pain while the pain medicine takes effect. (Note: Some children prefer local heat for 20 minutes.)
- Ear Drainage:
If pus or cloudy fluid is draining from the ear canal, the eardrum has ruptured from an ear infection. Wipe the pus away as it appears. Avoid plugging with cotton (Reason: Retained pus causes irritation or infection of the ear canal).
3 drops of olive oil (or prescription eardrops) will usually relieve pain not helped by pain medicine. If your child has ear tubes or a hole in the eardrum, don't use them.
Ear infections are not contagious.
- Call Your Doctor If:
- Your child develops severe pain
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
- American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Clinical Practice Guideline: Diagnosis and management of acute otitis media. Pediatrics. 2004;113(5):1451-1462.
- Bolt P, et al. Topical lidocaine eardrops reduce pain in AOM. Arch Dis Child. 2008;93:40-44.
- Canto RM. Otitis externa and otitis media: A new look at old problems. Emerg Med Clin North Am. 1995;13:445-455.
- Hoberman A, et al. Efficacy of Auralgan for treating ear pain in children with acute otitis media. Arch Pediatr Adolesc Med. 1997;151:675-678.
- Licameli GR. Diagnosis and management of otalgia in the pediatric patient. Pediatr Ann. 1999;28(6):364-368.
- Maxson S and Yamauchi T. Acute otitis media. Pediatr Rev. 1996;17:191-195.
- McWilliams DB, Jacobson RM, Van Houten HK. A program of anticipatory guidance for the prevention of emergency department visits for ear pain. Arch Pediatr Adolesc Med. 2008;162(2):151-156.
- Pirozzo S, Del Mar C. Otitis media. In: Moyer V, Davis RL, Elliott E, et al, eds. Evidence Based Pediatrics and Child Health. London, England: BMJ Publishing Group; 2000. p. 238-247
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: 8/1/2010
Last Revised: 10/1/2010 1:52:18 PM
Copyright 1994-2011 Barton D. Schmitt, M.D.