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Parent’s Guide

Parent’s Guide: Earache & Ear Infections

Earaches are the most common reason for pediatric doctor visits. While painful, they are often caused by viruses that heal on their own, or bacteria that may require antibiotics. The main goal at home is managing the pain until you can see a doctor.

1

🚨 When to Get Help

Call 911 Now

  • Child is too weak to stand or not moving.
  • You suspect a life-threatening emergency.

Call Doctor Now or Go to ER

  • Swelling: Pink or red swelling behind the ear (this can be serious).
  • Pain: Severe pain that does not improve 2 hours after taking pain medicine.
  • Stiff Neck: Child cannot move their neck normally.
  • Balance: Child is unsteady when walking.
  • Object: A pointed object (pencil, wire, stick) was put into the ear.
  • Fever: Fever is over 104°F (40°C).

Contact in 24hrs

  • General Earache: Any ear pain should eventually be checked to see if antibiotics are needed.
  • Discharge: Pus or cloudy fluid coming from the ear.
  • Outer Ear: The outer ear is red, swollen, or painful to touch.
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🔎Identifying the Cause

It can be hard to tell exactly what is causing the pain without looking inside, but the symptoms offer clues.

Middle Ear Infection (Otitis Media):

What is it? Fluid and germs trapped behind the eardrum.

Signs: Deep ear pain, fever, fussiness, or trouble sleeping. Often happens on Day 3-5 of a cold.

Age: Most common in ages 6 months to 2 years.

Swimmer’s Ear (Otitis Externa):

What is it? Infection of the skin in the ear canal.

Signs: The ear canal is itchy or painful. The pain gets worse if you pull on the earlobe. Common in summer.

Referred Pain:

Sometimes the ear is fine, but pain radiates from somewhere else, such as teething, a sore throat, or mumps (swollen gland in front of the ear).

Foreign Object:

Young children may push beads, food, or small toys into the ear. If the object is sharp, it causes immediate pain.

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🏠Immediate Home Care

You can safely manage the pain overnight until the doctor’s office opens.

💊 Pain Control (Priority #1):

  • Medicine: Give Acetaminophen (Tylenol) or Ibuprofen (Advil). This usually controls the pain enough for the child to sleep.
  • Warm/Cold Pack: Apply a cold wet washcloth or a warm heating pad to the outer ear for 15-20 minutes. (Do not leave on too long to avoid burns/frostbite).

💧 Managing Discharge:

  • Rupture: If you see pus or cloudy fluid draining from the ear, the eardrum may have developed a small tear from the pressure.
  • Good News: This usually relieves the pain immediately and heals on its own in 2–3 days.
  • Action: Wipe the discharge away. Do NOT plug the ear canal with cotton, as this traps germs inside.

✈️ Airplane Ear:

  • If ear pain occurs during a flight (especially landing), have the child swallow, chew gum, or breastfeed to open the eustachian tubes.
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🏫School & Recovery

  • Contagion: Ear infections are not contagious.
  • Attendance: Your child can return to school or daycare once the fever is gone and they feel well enough to participate.

Medically Reviewed by Dr Michael Villadelgado
Disclaimer: This information is for educational purposes only. You assume full responsibility for how you use it. If you are unsure, always call your doctor.