How to make a child ear stop hurting

Ear Pain in Children | CS Mott Children's Hospital

Ear pain (otalgia) can be a common reason children visit a physician. There are several causes of ear pain, including teething, sore throat, ear infection, or blocked Eustachian tubes.

Otitis media with effusion (Fluid behind eardrum)

Otitis media with effusion occurs when the Eustachian tube that connects the middle ear to the back of the nose becomes blocked. This allows fluid to collect behind the eardrum.

Since there is no infection, antibiotics are not beneficial. Treatment is aimed at symptomatic control: acetaminophen or ibuprofen as needed for pain relief. You can also use warm compresses as needed.

Otitis media with effusion generally self-resolves within 3 months.

Temporary mild hearing loss can be associated with otitis media with effusion. Strategies to help with hearing loss, if present, include:

Speak directly to your child in a louder voice than normal; make good eye contact and use gestures.
Reduce background noise when talking to affected individual (lower volume of TV and radio)

If fluid persists longer than 3 months or hearing loss is a concern, your child may be referred to ENT (Ear, Nose and Throat specialist/Otolaryngologist) for further evaluation. The ENT may discuss tympanostomy tubes (ear tubes), which help drain the fluid in the ear.

Ear infection

When the Eustachian tube that connects the middle ear to the back of the nose becomes blocked, and fluid collects in the middle ear space, viruses or bacteria can sometimes grow in the fluid and cause pain (acute otitis media).

Commonly, these ear infections may occur after or during a viral upper respiratory infection. Otitis media is more common in the winter, and occurs more frequently in children who attend daycare (related to the increased number of viral URIs experienced by these children). Otitis media does not occur after getting water in the ear.

Antibiotics are used for some patients with an ear infection. Since ear infections are not always caused by bacteria, antibiotics are not always needed.

Strategies to prevent ear infections include:

Keep your child’s vaccinations up to date, especially pneumococcal and influenza vaccinations
Avoid exposure to second-hand smoke
Breastfeed your child exclusively for the first 6 months of life
Avoid bottle propping in babies

If a child has repeated episodes of acute otitis media (3 episodes in 6 months or 4 episodes in 1 year), the child may be referred to ENT (Ear, Nose and Throat specialist/Otolaryngologist) for evaluation for tympanostomy tubes (ear tubes) to help the fluid drain.

Swimmer’s ear

Swimmer's ear (otitis externa) occurs when there is an infection present in the external ear canal. This can occur if the skin in the ear canal becomes irritated or scratched and then develops an infection.

Topical antibiotic drops are used in the treatment of swimmer’s ear. Ibuprofen or acetaminophen can be used to control pain.

For patients with recurrent swimmer’s ear, preventative measures include:

Wearing ear plugs when swimming
Drying the ear after swimming with hair dryer on low setting and at least 12 inches from the ear
Use of ear drops containing acetic acid or alcohol after swimming

Eustachian tube dysfunction

The Eustachian tube is a tube that runs from the middle ear to the nasopharynx (back of nose and top of throat). This tube helps to equalize pressure across the tympanic membrane (ear drum), protect the middle ear from infection and help clear middle ear secretions.

Symptoms of Eustachian tube dysfunction include ear pain, ear fullness, decreased hearing, tinnitus or popping/cracking in the ear.

Treatment involves treating the underlying cause of the Eustachian tube dysfunction:

Treat any underlying allergic rhinitis, rhinosinusitis, laryngopharyngeal reflux, GERD
Eliminate exposure to second-hand smoke

Temporomandibular joint disorders

Problems with the hinge that connects your jaw to your skull, the temporomandibular joint, can cause referred ear pain. Additional symptoms of temporomandibular joint disorder can include jaw or facial pain, headache, pain with chewing or opening mouth.

Temporomandibular joint disorders are more common in children over age 10 years.

Treatment includes patient education, avoiding triggers, jaw exercises, use of an occlusion splint if grinding teeth is an issue and use of anti-inflammatory pain medications.

Other causes of ear pain

Other less common causes of ear pain include trauma to the ear or ear canal, foreign body in the ear canal, or wax build-up.

Other illnesses that can cause referred ear pain include teething, parotitis, sinusitis, pharyngeal infections, lymphadenopathy / lymphadenitis and cervical spine injury.

When should you seek help for ear pain?

Call your physician or seek medical care if:

Ear pain is worsening, persistent or not controlled with supportive care measures
There is blood or pus draining from the ear canal
The area around the ear starts to swell or become red
Your child gets a new or higher fever

Caring for Ear Pain

Ear pain may be worse when lying down; so try to have child sit or sleep with head elevated.

Warm compresses may help ease ear discomfort. (However, take care not to burn the skin).

Acetaminophen or ibuprofen can be used to help discomfort; following instructions on label or given by physician.

Do NOT give aspirin to any person under age 18 years. It has been linked to developing Reye syndrome, an illness that causes swelling in the brain and liver.

Do not insert anything into the ear (including Q-tips). It is ok to clean the outside of the ear with a warm washcloth.

Written/reviewed by Lauren Reed, MD

Updated February 2020

What's the Best Ear Infection Treatment for Kids?

Five tips to help relieve ear infection symptoms at home

If your little one is cranky, unusually fussy and tugging at his or her ear or is feverish and having difficulty sleeping, chances are it may be due to an ear infection.

Ear infections in children often go away on their own or in some cases with antibiotic treatment. The challenge for many parents is knowing what to do, what to watch for and when to call their pediatrician.

Five out of six children experience an ear infection by the time they are 3 years old, according to the National Institutes of Health. The odds are that your child will have an ear infection before kindergarten.

What causes an ear infection?

Ear infections can be caused by either bacteria or a virus, often following a cold. The common cold can cause the middle ear to become inflamed and fluid to build up behind the eardrum. The Eustachian tube, which connects the ears, nose and throat, can also become swollen.

“Children are more susceptible to ear infections than adults because they have shorter and narrower Eustachian tubes, and it is easier for germs to reach the middle ear and for fluid to get trapped there,” says Kara Hutton, MD, a pediatrician at Scripps Clinic Rancho Bernardo. “Babies and children also have weaker immune systems, so it is more difficult for their bodies to fight an infection. ”

The onset of ear infections is often on day three of a cold. Ear infections peak at age 6 months to 2 years, and are a common problem until age 8, according to the American Academy of Pediatrics.

What is the best treatment for ear infection?

Some ear infections require antibiotic treatment, but many can get better without this medicine.

If you suspect your child has an ear infection, your pediatrician can diagnose it and determine the appropriate treatment.

“Common ear infections often do not require antibiotics, except in severe cases or in infants younger than six months,” says Dr. Hutton. “Many ear infections will resolve on their own within a week.”

For mild cases, your doctor might recommend watchful waiting to give your child’s immune system time to fight off the infection or delayed antibiotic prescribing, which gives you time to see if your child is still sick before filling it.

Five tips for ear infection treatment at home

Even when antibiotics are prescribed, they won’t take effect for 24 to 48 hours. Your child need not suffer needlessly. There are simple, effective ways to reduce your child’s discomfort and pain during an ear infection.

1. Fever and pain medicine: based it on age, consult with doctor

Over-the-counter medications can help reduce pain and fever in your child. Based it on age and weight and consult with your pediatrician if necessary.

Read labels and instructions carefully when giving fever-reducing medications. “It’s very important to follow instructions and give the appropriate dosage according to your child’s weight and age,” says Dr. Hutton.

For children younger than 6 months, give only acetaminophen, such as Tylenol.

For children older than 6 months, you may give also give an ibuprofen product, such as Advil, for fever and pain.
Infants younger than 3 months old who have a fever need immediate medical attention even if they appear well and show no other signs of being ill.
Do not give aspirin to children because it can cause Reye’s syndrome, a rare but very serious illness that harms the liver and brain, according to the Centers for Disease Control and Prevention (CDC).

2. Place a cold pack or warm compress over your child’s ear

Put a cold wet washcloth on the outer ear for 20 minutes to help with pain until the pain medicine starts to work.

Some children prefer a warm compress to help alleviate pain. Use a warm washcloth and apply until it becomes cool. “Make sure that the compress is only warm, not hot,” says Dr. Hutton.

3. Keep child hydrated

Make sure to keep your child well hydrated. Give lots of cold fluids.

4. Elevate your child’s head

“Keeping your child’s head elevated can ease some of the pressure,” says Dr. Hutton.

If your child is older than 2 and no longer sleeps in a crib, use a pillow, but never use a pillow with an infant. You can keep an infant upright in a car seat to alleviate pressure.

5. Watch for ear discharge

Pus discharge can be normal with an ear infection. Most often, this heals after the ear infection is treated. Wipe the discharge away. Careful not to plug the ear with cotton as retained pus can cause an infection of the lining of the ear canal.

When to call your doctor

Pediatricians recommend calling your doctor if:

Fever lasts more than two days on antibiotics
Ear pain becomes severe or crying becomes nonstop
Ear pain lasts more than three days on antibiotics
Ear discharge is not better after three days on antibiotics
Your child becomes worse

Talk with your pediatrician if your child suffers recurrent ear infections, especially if you have a family history of allergies and asthma

Preventing ear infections

While you can’t fend off every germ, there are steps you can take to reduce the risk of an ear infection, including by:

Breastfeeding your infant to pass along immunities
Avoiding secondhand smoke
Washing your hands
Keeping immunizations up to date

first aid for acute ear pain

Children often have earaches. Their hearing organs are formed and are more sensitive to infections, hypothermia. Ear pain is debilitating and unbearable. If the baby cries, turning his head, or a preschooler, a teenager complains, you need to figure out what it can be called, provide first aid and consult with an otolaryngologist, pediatrician.

To prevent infection of the ear canal, do not allow babies to swim in open water, pools, the composition of the water in which is not controlled by sanitary services. Do not swim in dubious places and on wild beaches in hot countries, even if the locals rest there. To some microorganisms living in the water, they have immunity, and in small tourists it is only being formed. To protect your ears, choose safe swimming areas and wear rubber caps for babies when they swim in a pool, river, or lake. nine0003

Why does the child have an earache

But pain can also occur for other reasons. If a preschooler complains or is naughty, touches his ear, parents need to examine him, measure the temperature, check for foreign objects, sulfur plugs, and if the lymph nodes are enlarged. Soreness can occur due to external and internal causes.

Fever, swollen lymph nodes, severe pain, nausea, vomiting indicate an acute inflammatory process that should be treated under medical supervision. nine0003

If the pain is caused by a foreign object that got into the ear canal, a sulfur plug, you need to urgently go to the otolaryngologist, without trying to remove them yourself.

External factors

When a child's ear hurts, check if the pain is caused by external causes:

Sulfur plug - you can see it by slightly pulling the lobe down and looking into the ear canal.
Ingress of water containing dangerous microorganisms - when swimming in open water, pools. nine0024
Injury, bruise - check if the baby has fallen.
Ingestion of foreign objects - children often indulge in putting small objects in their ears and cannot get them out, pain is not always felt immediately, it can appear after a few hours, sometimes insects crawl or fly into the ear canal.
Fungal infection - itching appears.
Non-infectious otitis - unlike infectious, it is not accompanied by fever.

Internal Causes

Toothache - Toddlers cannot pinpoint the exact source of pain and complain about the ear when teeth are being cut or they are affected by caries.
Colds - if the child has a fever, a red, inflamed throat, a stuffy nose or snot flowing, pain in the ears may also appear.
Infectious otitis - accompanied by fever, severe pain.
Tumor - to exclude it, the doctor may prescribe additional studies: ultrasound, MRI. nine0024
High or low blood pressure - tinnitus is heard or blocked.
With tonsillitis, sinusitis and other diseases of the nose and throat, pain may also appear in the ears, be sure to tell the doctor about this so as not to miss the spread of the inflammatory process to the hearing organs.

Symptoms

Babies and preschoolers cannot explain exactly what hurts them. The kid can touch, rub his ear or slap it with anger, lie down on the side where he feels pain. He becomes lethargic, whiny or aggressive, does not eat, cannot sleep, cries. Try to lightly feel a small tubercle located near the middle of the shell from the outside. If the child is worried, does not allow touching this place, then you need to find out the causes of ear pain, provide first aid and contact a pediatrician or otolaryngologist. nine0003

Measure the temperature. In infectious and acute inflammatory processes, it rises to 38-40 degrees, the lymph nodes in the neck increase, pus or a clear liquid may be released.

Look for foreign objects in the ear canal. If the child already knows how to speak, ask if he has fallen, hurt himself, inspect for bruises or other injuries.

How to relieve pain?

Ear pain is difficult to bear. It exhausts and causes great suffering. You need to contact a doctor - go to an appointment or consult on the phone. But first aid, which will relieve pain, can be provided at home. nine0003

Measure the temperature. If it is above 38 degrees, give the baby Nimesil, Ibuprofen, or another antipyretic drug.

If the child has a runny nose or stuffy nose, put vasoconstrictor nasal drops in both nostrils. Otrivin, Nazol or others that the pediatrician has already prescribed to a small patient.

If the pain is severe, the child complains, cannot sleep, to reduce pain, drops containing lidocaine or other painkillers can be instilled into the ears: Otipax or other recommended by the otolaryngologist. nine0003

Compresses

In the absence of discharge, fever and suspicions that a foreign body, an insect has got into the ear canal, you can make a warm compress with essential oils with a calming effect or with a decoction of medicinal herbs that relieve inflammation.

Warm compresses help with otitis, colds:

relieve pain;
soothe, help to relax and fall asleep;
activate crop circulation, accelerate the action of drugs taken orally; nine0024
promote the removal of decay products, toxins released by affected cells.

Before applying a warm compress, ask your pediatrician about which herbs or essential oils to use and how long to keep the compress.

How to make a compress?

In order for the treatment to help and not bring harm, you need to choose the right type of compress:

Wet - soft fabric, cotton wool is saturated with a warming composition. Children under 4 years of age should not apply compresses containing alcohol. Choose an oil-based composition with slightly warmed sunflower oil or soak a cotton ball with calendula, almond oil. Acute pain will help relieve a compress with warm mint decoction. nine0024
Dry - if the ear is red, inflamed, warming dry compresses should not be applied to it, but with a cold, otitis media, you can apply a bag of warm salt so that it does not heat the lymph node.
With alcohol-containing substances - it is possible to treat a child with alcohol compresses only after consulting a pediatrician. Alcohol for the compress must be diluted with boiled water in a ratio of 1: 2, you can use boric alcohol tincture.

Do not apply a warm compress if the temperature is elevated. Do not use oils, herbs, or other ingredients that have previously caused allergic reactions. nine0003

What remedies are used in traditional medicine

To alleviate the condition, you can use traditional medicine.

If there is honey in the house, you can melt it in a water bath to a liquid state, dilute it with warm boiled water (1:1) and drip into the ear 3-4 times a day. If there is no temperature, the ear is not red, the drops can be supplemented with a warm wet compress based on propolis, dissolving it in warm boiled water. You need to apply such a compress for 2-3 minutes. nine0003

A compress of tincture of bay leaves helps relieve pain. Dry leaves should be crushed, pour a glass of boiling water, leave for 2 hours and drip 1-2 drops or rinse.

If an older child often suffers from colds, you can prepare a tincture of St. John's wort or mint. Pour 2 tablespoons of chopped vegetable raw materials with 100 g of vodka and leave for 7 days, then strain. In a dark place, the tincture is stored for several months.

What to do if your child has an earache

Many nerve endings are concentrated in the organs of hearing. The bite of a mosquito, wasp, bee can cause severe pain. If there is no acute allergic reaction, the bite site can be wiped with Mirasmistin.

If wax has accumulated in the ear and a wax plug has formed, anesthetic drops can be given to relieve pain and take the child to an otolaryngologist to remove the plug with special tools.

If your child has a stuffy or snotty nose and complains of an ear, use nasal vasodilator nasal drops. If it is cleansed, the pain will disappear. nine0003

If there are no symptoms of a cold, you should visit an otolaryngologist. To treat otitis, you need to establish whether it is infectious or not, whether antibiotic treatment is necessary, which folk remedies are safe to use.

Treatment with drugs

In case of otitis media, colds, infectious diseases, inflammatory processes, after injuries, the doctor will prescribe treatment with pharmaceutical preparations. They are more effective than traditional medicine, but have side effects. Do not risk the health of the child - do not self-medicate. nine0003

Ear drops can quickly relieve pain, reduce inflammation: Otipax, Otofa, Otizol, Otinum.

Inflammation in the sinuses filled with snot or in the throat may also spread to the hearing organs. Be sure to use nasal preparations: children's Naphthyzin, Sanorin, Xymelin. They make breathing easier and prevent the spread of infection.

If the child has a fever, purulent discharge, severe pain, conventional anti-inflammatory drugs are not enough. Otolaryngol after examination, laboratory tests will prescribe antibiotics. To suppress pathogens in the hearing organs, Polydex is used (contains three types of antibiotics that suppress the reproduction and vital activity of most pathogens), Candibiotic (helps with the bacterial and fungal nature of the disease), Sofradex. nine0003

What not to do if your child has an earache

If your child has earache, first aid is needed to reduce pain and other acute symptoms. Even if they have passed, be sure to tell your pediatrician about them, do not refuse the recommended examinations.

When giving first aid to a child with ear pain, be careful and careful. Wrong actions can damage. Common mistakes of parents that lead to the deterioration of the child:

if the ear canal is plugged, you can not remove it yourself with an ear stick or sharp objects;
do not rinse the ears with large amounts of water, filling it with a syringe or in any other way;
if there is discharge, nothing should be dripped into the ear canal, dry or wet warm compresses should be applied.

Do not give your child antibiotic tablets or drip pharmaceutical antibiotics without a doctor's prescription. Uncontrolled use of antibiotics causes resistance to pathogens. To suppress inflammation, stronger drugs with more side effects will be required. Follow your doctor's instructions. Do not stop antibiotic treatment after symptoms disappear. nine0003

What to do if your child has an earache

October 2, 2019 Likbez Tips

These four steps will help you quickly alleviate the condition and prevent unpleasant consequences.

So, you are a parent with a crying baby in his arms complaining of a sore ear. Without wasting time, let's get down to business.

1. Calm down

Firstly, because the child is not feeling well and at such a moment he especially needs the reliable, calm, confident shoulder of his father or mother. And not in this disturbing: “Ah, what to do ?!” nine0003

Secondly, ear pain in children is common and occurs much more often than in adults.

According to the National Institute of Deafness and Other Communication Disorders (USA), five out of six children will develop an ear infection at least once before they are 3 years old.

There are quite natural reasons for this.

Physiological

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In this picture, we are most interested in the Eustachian tube - the cavity that connects the ear to the nasopharynx. Normally, it serves to equalize pressure from the outside and in the middle ear cavity and is generally extremely useful. But sometimes it can be harmful. nine0003

The classic case is any SARS accompanied by snot. When we sniff (whether in or out of ourselves), mucus enters the Eustachian tube. And he can block it. The natural pressure equalization mechanism is disrupted, the eardrum arches due to the pressure difference. So there is a sharp pain.

The second point: along with mucus, viruses and bacteria can enter the ear, which caused a respiratory disease. There is inflammation - otitis media.

The Eustachian tubes are shorter and straighter in children than in adults. That is why they are especially easily blocked by mucus, and microbes are within easy reach of the middle ear cavity. nine0003

Immune

The immune system of a child is not yet as effective as that of an adult. Because of this, the body is not always able to fight the infection in time and otitis occurs more often.

Doctors are well aware of these features of the child's body and have a well-established practice of treating otitis in children. In most cases, hospitalization is not required: you can help the baby cope with the disease at home. But sometimes there are difficult cases.

2. Make sure the situation does not require an ambulance

Contact your pediatrician as soon as possible or even call an ambulance if:

symptoms of an ear infection (crying, fussiness, fever, attempts to hit the ear with hands) are observed in a child younger than 6 months;
baby cries incessantly, complains of severe pain;
its temperature is over 38.8℃;
the ear is swollen and/or leaking fluid.

In these conditions, you may have to take your child to a hospital. nine0003

If there is soreness, but there are no dangerous symptoms, tell your pediatrician about the situation anyway (it is better to call him at home). Only a doctor will make an accurate diagnosis and prescribe the necessary treatment.

But before he arrives, you can alleviate the baby's condition yourself.

3. Help your child get rid of an earache

Let's mention two important "don'ts" right away:

Do not give your child an antibiotic unless the medicine is prescribed by a doctor! First, the self-prescribing of such drugs is evil. Why - Lifehacker wrote in detail here. Second, a review of studies published in the Journal of the American Medical Association notes that 80% of children with ear infections recover in about three days without antibiotics. Whether your child belongs to the remaining 20% can only be determined by a pediatrician. nine0024
Do not put anything in your ears unless the drops are prescribed by a doctor! In some cases, this can worsen the condition of the baby.

And here's what you can do, even if the pediatrician has not reached you yet.

Apply a warm, moist compress to the ear.

This can be a heating pad wrapped in a thin napkin. Or a soft cloth dipped in warm water. The compress will relieve pain and soothe.

Give painkillers

Over-the-counter paracetamol or ibuprofen is suitable for children over 6 months of age. Strictly follow the recommendations that are given in the instructions for a specific tool! nine0003

And don't give children under 14 (some sources insist even 16) aspirin.

Water your baby more often

It's the same as: water, milk, compote, juice, fruit drink. The main thing is that the child drinks. Swallowing helps clear mucus from the Eustachian tube and may relieve pain.