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Pediatric - Earache


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Does this describe your child's symptoms?

  • 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 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 daycare.

If not, see these topics

When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Not moving or very weak
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)
  • Fever over 104° F (40° C) and not improved 2 hours after fever medicine
  • Pointed object was inserted into the ear canal (e.g., a pencil, stick or wire)
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)

  1. Reassurance:
    • Your child may have an ear infection, but it doesn't sound serious. The only way to be sure is to examine the eardrum.
    • Diagnosis and treatment can safely wait until morning if the earache begins after 5 pm.
    • Ear pain can be controlled with pain medicine and eardrops.
  2. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief or for fever above 102° F (39° C).
  3. 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.)
  4. Avoid Earplugs: 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).
  5. Eardrops: 3 drops of prescription eardrops or olive oil drops 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.
  6. Contagiousness: Ear infections are not contagious.
  7. 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 "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: 1/19/2009

Last Revised: 12/19/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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