Ear Infection & Earaches: Symptoms, Home Remedies & Prevention Tips

earaches

WHAT is an EAR infection and what causes earache in kids?

An earache is pain inside or around the outside of the ear. Earaches result from problems in different parts of the ear, sometimes caused by an ear infection.

Read about:

I)  Common Causes of Earaches in Children

II) How to Manage Earaches in Kids

Common Causes of Earaches in Children:

1. Blocked Eustachian Tube 

blocked eustachian tube

The Eustachian Tube connects our inner ear to the back of our nose/throat region. It normally drains mucus and fluid from behind the eardrum into the back of the throat. When nasal congestion builds up due to colds or allergies it causes the Eustachian Tube to become blocked. This leads to a sensation of clogged or full ears.

What to Watch Out For with a Blocked Eustachian Tube?

Temporary Hearing Loss

 Your child might have temporary hearing loss when the Eustachian Tube is blocked due to mucus congestion. When this happens, then fluid behind the eardrum can’t drain into the back of the throat. That inhibits the eardrum and the little ear bones that help us hear from moving easily. In turn, we can’t differentiate the sounds & tones of what we’re hearing. 

The good news is that this will resolve once the fluid clears from behind the ear. The tough news is that this may take a few weeks to months.

2. Middle Ear Infection 

middle ear infection

Middle Ear Infections are the most common cause of earaches in kids. They tend to happen more in winter months when nasal congestion (from colds & viruses) causes blockage of the Eustachian Tube as discussed above. When the fluid behind the ears can’t drain properly, viruses & bacteria settle into this fluid and create an infection. 

¾ of all children will have at least 1 ear infection by 3 years of age. As kids get older and their necks get longer, the Eustachian Tube becomes more vertical instead of horizontal in position and drains mucus & fluid more easily. This reduces the frequency of Middle Ear Infections as we get older. 

What to Watch Out For with a Middle Ear Infection? 

Fever

If viruses or bacteria settle into the fluid behind the eardrum, they can cause an ear infection. Once an infection starts the body will mount a fever. This tends to happen more with bacterial infections than viral infections.

Fussiness

Babies & toddlers may be clingy, fussy & cry due to discomfort. They may pull away when breast or bottle feeding due to pressure changes in the ear when they’re sucking. Babies may also tug/scratch at their ears. Pain tends to be worse when lying down so babies might want to be held upright to reduce the sensation of pressure & pain.

Change in Digestive Patterns 

Kids may have a poor appetite when they have an ear infection. They may also have vomiting or diarrhea.

How to prevent Middle Ear Infection? 

Breastfeed Your Baby 

Breastfeeding has been shown to reduce risk of ear infection in infants. The American Academy of Pediatrics recommends exclusively breastfeeding until 6 months of age and continuing to breastfeed till 1 year of age while adding solid foods.

Don’t Prop the Bottle

If bottle feeding, hold your baby at an incline while feeding. Laying the baby down and propping up the bottle can allow for milk to roll into the Eustachian Tubes and lead to congestion & fluid build up. This can then increase the risk for middle ear infections. 

Avoid second-hand smoke exposure

Studies show that second hand smoke can increase the risk of ear infection by 2-3 fold.

Keep Up to Date on Vaccinations

Pneumococcal or Prevnar Vaccine is given to infants to prevent meningitis, ear infections & blood infections. Over the last 20 years it has greatly reduced ear infections from the most common & severe strains of bacteria that cause ear infections.

Flu Vaccine has been shown to reduce the risk of ear infections by keeping babies healthier & potentially less congested by infections like the flu. Though daycare might be a necessity, we see more ear infections in children who are repeatedly exposed to viruses that cause colds.

3. Swimmer’s Ear 

swimmer ear

This is an infection of the ear canal also known as otitis externa. It results from water getting into the ear canal and causing irritation & swelling of the ear canal’s skin lining. Sometimes bacteria settle into this area of swelling and lead to an infection. 

We expect Swimmer’s Ear more in summer months when kids are outdoors swimming, but it can also happen when water gets in the ear canal with bathing.

What to Watch Out For with Swimmer’s Ear?

Itching & Pain of the Ear Canal

This results from irritation of the ear canal. When the irritation gets worse, itching leads to pain.

Pain with pressure

Pulling on the ear or pressing on the skin at the entry of the ear canal makes pain in the ear canal worse.

Swelling of Ear Canal

The opening of the ear canal may look red, swollen or completely shut to you. Your child may complain of fullness in the ear or difficulty hearing.

Drainage

You might see whitish/yellowish fluid coming out of the ear 

How to Prevent Swimmer’s Ear? 

Ear Plugs

The best way to keep their ear canals from getting wet is to have your child wear ear plugs when swimming. Some water might still get into the ear, but it won’t be as much. 

Hair Dryer

After swimming, you can dry the ear canal with a hair dryer on a low setting at a distance of at least 12 inches away from the ear.

Swimmer’s Ear Drops

After using the hair dryer or in place of using the hair dryer, you can use over the counter swimmer ear drops with vinegar or alcohol to dry the ear canal out.

4. Ear Canal Injury

ear canal injury

Since kids will be kids, injury can happen when children scratch in their ears, use Q-tips in the ear canal or when they put pencils, sticks & toys in their ears.

How to Prevent Ear Canal Injury?

Be vigilant & stop your child if they put Q-tips or other objects in their ears. 

5. Blocked Ear Canal 

Small toys, beans, paper and the like can get lodged in the ear canal. Earwax is naturally protective to keep objects from flying into or settling in our ears, but if it gets pushed too deep inside by earbuds or attempted removal, it can cause a lot of pain. If wax or a foreign body gets lodged too far into the canal, pain will intensify.

How Can You Prevent Having a Blocked Ear Canal?

Again, don’t let your child put anything in their ears. Get your doctor’s recommendation on if & how you should remove your child’s ear wax.

6. Swelling of the Ear

An insect bite on the ear can lead to significant pain because the cartilage tissue of the ear doesn’t have a lot of elasticity to stretch when inflamed.

An infected ear piercing of the ear lobe can create swelling or pus build up within the lobe. 

If the outer part of the ear is infected it will be accompanied by redness, swelling and pain with touch or motion of ear. The ear may look like it is sticking out and be tender to touch.

7. Referred Pain

Referred Pain is pain from elsewhere that radiates to the ear. Commonly, referred ear pain can happen with teething, cavities, jaw pain, Temporomandibular Joint (TMJ) Inflammation, Sinus infections, Salivary Gland or Throat/Tonsil Infections.

What to Watch Out For with Referred Pain?

Sore Throat or Headaches

If your doctor doesn’t identify an ear infection with earache, headache or throat pain, (s)he will look more broadly to identify the source of pain that may include sinus, throat or tonsil infections.

Popping or Clicking Sound in Ears

Pain with jaw motion or chewing related to jaw inflammation or TMJ issues can lead to popping or clicking sound in ears along with pain.

Fussiness in Babies

In babies, teething can cause fussiness to be worse with lying down, low grade fevers & pain with sucking/chewing. This sometimes causes teething to be confused with a middle ear infection. 

How to Prevent Referred Ear Pain?

Minimize Nasal Congestion

Keep seasonal allergies controlled to reduce nasal congestion that might subsequently lead to an earache.

Evaluate Underlying Cause

If ear pain comes & goes, it may be due to underlying causes like reflux or TMJ pain. It’s best to speak with your doctor on how to resolve the root cause.

See Your Dentist

Take your child to the dentist regularly to make sure no cavities are forming.

II) Home Remedies for Earaches:

Moist Heat 

Applying warm compresses to the ear for 5 minutes at a time a few times a day can help relieve ear pain & pressure within the ear.

Medication

Tylenol or Ibuprofen are extremely helpful to reduce pain from inflammation (get correct dosing based on age & weight from your pediatrician). 

If your child has been prescribed oral antibiotics or ear drops, complete the course as prescribed to prevent small amounts of bacteria from remaining & re-kindling infection. 

Position your child

Lying flat may cause more pressure/pain, so elevating the head of the bed in children over 1 year of age might improve rest at night.

When to seek medical attention for an Earache 

Fever

If your child has Earache accompanied by a fever > 100.4 degrees Fahrenheit, it is possible they have an infection that warrants antibiotic management.

Age 0-2 Years

If your child is under 2 years of age and you’re concerned they may have an earache, see your doctor. Your child is more likely to need antibiotics for ear infections at this age because of their horizontal Eustachian Tubes & more naive immune systems.

Appearance of Ear

If there is redness or swelling of the ear, pain with touch or motion of the ear, or the canal is swollen shut causing hearing difficulties, you want to have the ear evaluated as soon as possible.

Lack of Improvement

If the pain is not getting better, though it may not be getting worse either, see your doctor.

Seek IMMEDIATE attention for an Earache if:  

  • There are accompanying severe headaches, dizziness, vomiting, neck stiffness or lethargy
  • There is pus/blood draining from ear
  • An infant (especially under 6 months of age) is inconsolably fussy and won’t calm down

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