Earaches & Ear Infections in children

ear infections

Earaches and Ear Infections in Children

Earache is surprisingly common in children and one of the main reasons why parents call a doctor out of hours. In many cases the ‘ache’ can be due to an ear infection in the middle part of the ear known as otitis media.

What causes earache?

Otitis media is a result of an infection in the Eustachian Tube. This thin tube connects the nose to the ear. When children get a cold or another part of the body becomes infected, the Eustachian Tube can become blocked. This causes fluid to build up and become infected, which in turn results in ear ache.

Children aged 6 – 18 months are the most likely sufferers of an ear infection, with 75% of all otitis media cases appearing in those under 10 years old.1

Children are more prone to otitis media than adults because their immune systems find it harder to fight off infections. As a result, they tend to have more respiratory infections, such as the common cold.2 Naturally, the Eustachian tube is smaller in children too and more likely to become blocked.2

Signs to look for

The main symptoms of otitis media

  • earache
  • a high temperature (fever) of 38°C (100.4°F) or higher
  • being sick
  • lack of energy
  • slight deafness

In younger children, who can’t explain what is wrong, otitis media is often difficult to detect. What’s more, it’s easy to explain the symptoms away as general irritability or tiredness. Here are a few signs to look out for.

  • Pulling or tugging of the ear
  • Irritability
  • Restlessness at night
  • Poor feeding
  • Loss of balance
  • Fever
  • Crying
  • Tiredness or poor sleep
  • Slight deafness.

How you can help

In most cases, otitis media clears up without any treatment within three to four days. But, if you’re worried or think your child needs medication to tackle the infection, consult your doctor or pharmacist. Although antibiotics are an effective treatment, don’t be surprised if your doctor doesn’t prescribe them. Some experts now recommend waiting a few days to see if the infection gets better on its own.1,3

However, you can focus on easing your child’s pain and fever. Experts recommend using analgesics, such as paracetamol or ibuprofen, which have been formulated for use in children, as they can ease the pain of otitis media1 and relieve any fever. Aspirin should be avoided in children under 16 years , because of the risk of developing Reye’s Syndrome, a serious brain and liver condition.4

Otitis media is common. In fact, one third of children will have six or more episodes of otitis media by the time they are seven years old. The following factors have been suggested to play a role2,3.

  • Your child has their first bout of otitis media early in infancy
  • Using a pacifier
  • Attending daycare
  • Being around someone who smokes
  • Being fed while lying down
  • Being breastfed for less than three months.


  1. Scottish Intercollegiate Guidelines Network. Diagnosis and management of childhood otitis media in primary care. A national clinical guideline. SIGN 66. February 2003. Available at: http://www.sign.ac.uk/pdf/sign66.pdf.
  2. UK NHS Choices. Otitis media. Available at: http://www.nhs.uk/conditions/otitis-media/Pages/Introduction.aspx?print=634161067689386100.  Accessed July 2010.
  3. American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guideline. Subcommittee on management of otitis media. Diagnosis and management of acute otitis media. Pediatrics, 2004; 113: 1451-1465. Available at: http://aappolicy.aappublications.org/cgi/reprint/pediatrics;113/5/1451
  4. UK NHS Choices. Reye’s Syndrome. Available at: http://www.nhs.uk/conditions/reyes-syndrome/Pages/Introduction.aspx. Accessed July 2010.