How to relieve earache pain in child

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

What to do if your child’s ear hurts

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 ?!”

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

nhl.com.ru

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.

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.

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 under 6 months old;
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.

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 just mention two important "don'ts":

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.
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 pain reliever

For children older than 6 months, over-the-counter paracetamol or ibuprofen will work. Strictly follow the recommendations that are given in the instructions for a specific tool!

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.

Raise his bed at the head

So that his head is higher than his body. This will improve the drainage of the sinuses and the Eustachian tube.

Don't put a pillow under your child's head - better put a couple of pillows under the mattress at the head of the bed.

4. Wait for the doctor and strictly follow his prescription

Let us remind you once again: in any case, it is necessary to consult a pediatrician if you suspect an ear infection. Perhaps the doctor will prescribe medications for the child - vasoconstrictor, ear drops, or even an antibiotic. Strictly follow all doctor's recommendations.

Within 3-4 days after the onset of the disease, the baby will feel practically healthy. If the ear pain continues, contact your pediatrician again as soon as possible so as not to miss the development of possible complications.

what to do, first aid, how to treat

Most often, earaches begin suddenly - at night, on holidays or during rest, so they take the family by surprise. The problem can be caused by various internal and external factors. Most often, it is not possible to immediately determine the cause of pain in the ear, you have to act intuitively, rely on the help of a doctor or call an ambulance. It is important for parents to understand how to alleviate the condition of the baby. Learn how to competently and without harm to health to help a child if his ear hurts.

What you need to know about ear pain in children

Functions of the human ear	Ears are complex organs. They allow us not only to hear speech, sounds, but also help us navigate in space, maintain coordination of movements, determine where sounds come from, activate the cerebral cortex and brain centers.
How often do children get otitis media	By the age of 7, 95% of children suffer from acute otitis media at least once (1). More than 50% of cases occur in children under 5 years of age (2).
Otitis in children of the first year of life	Acute otitis media is a common disease in children of the first year of life, and in newborns it occurs 2 times more often than in older infants, and with a higher frequency in boys than in girls. In 31% of cases in newborns and in 26.5% of infants, acute otitis media occurs latently (that is, imperceptibly) (3).
Signs of ear pain in babies	At an early age it is difficult for a child to explain what is bothering him. When the ear hurts, the baby touches, rubs it and even pats it in annoyance. He lies on his side, where he hurts, cannot sleep, cries, is naughty, becomes lethargic and loses his appetite.
What not to do if your child has an earache	To avoid harm, never remove the wax plug with sharp objects or an ear stick. It is forbidden to rinse the ears with large amounts of water with a syringe and use antibiotics without consulting a doctor. If there is a discharge, you can not use ear drops and apply warm compresses to the sore spot.

How to understand that a child's ear hurts

- Recognizing the problem can be difficult, especially if the child is too young to tell his parents what is bothering him. Older children usually report sharp pains themselves. - The easiest way to determine the pain in the baby's ear is to lightly press on the tragus. This is a small cartilaginous protrusion on the outer ear, in front of the pinna. In case of pain, the child will definitely respond, advises Daniil Karpichev, lecturer in medical disciplines at the Cherepovets Medical College. N. M. Amosova .

Why a child may have an earache

Ear pain usually occurs at night, since the horizontal position promotes infection in the Eustachian tube and middle ear cavity. First of all, you need to find out the reason why the child has an earache. Consider the possible options.

Infections and anatomy

Most children experience ear infections at an early age. According to Russian scientists, more than 35% of babies already in the first year of life suffer from acute otitis media 1-2 times, and by the age of 3 years this diagnosis usually appears in the medical records of 71% of children (2).

The causes of the disease are the anatomical features of the location of the Eustachian tube. In babies, it is wide and short, so the infection easily gets from the nasopharynx into the Eustachian tube, and then into the middle ear cavity. In addition, when breastfeeding, milk can be thrown into the Eustachian tube. To avoid this, after feeding, the baby should be held upright for some time.

Foreign body in the ear

While playing, children can put buttons, small sweets, parts of the designer, beads, seeds, peas, pieces of cotton wool into the external auditory canal. In more rare cases, ENT doctors find insects in the child's ear: ticks, cockroaches, bedbugs and flies. It most often occurs between the ages of 2 and 5.

Foreign bodies cause discomfort and pain. With a long stay in the ear canal, complications can develop. It is not worth taking out a foreign body on your own - even if it is visible. It is better to trust a specialist who has everything necessary for the procedure.

Trauma to the ear or pinna

Mechanical trauma to the ear is a common problem in children. A child may experience pain after a burn or an insect bite, such as a bee. During sports training and games, with a strong blow, the ear may swell, sometimes blood appears from the ear canal. If this happens, close the ear canal with a sterile bandage or cotton, apply a bandage and go with the child to the emergency room.

Hypothermia

Hypothermia during windy weather sometimes causes ear pain. The people say about it "blown away".

Water in the ear

It happens that when swimming in a pool, river, sea or in the shower, water gets into the ear. If moisture has reached the middle ear, the child feels backache and congestion. Older children can be taught to hop on one or two legs by tilting their head towards the blocked ear. With kids who still do not know how to jump or do not understand how to do it, they act differently. An adult puts his hand to the blocked ear of the child, presses it with force, and then abruptly removes it. The air flow destroys the water plug.

Large buildup of earwax

Wax plug is a common problem in children. The fact that it exists is indicated by the absence of reactions to sounds, tinnitus, a feeling of congestion, coughing and other signs. The child may often rub his ear. It is better to solve the problem not at home, but with the help of a doctor.

Side effect from an infectious disease

Angina, laryngitis, pharyngitis, SARS can lead to complications in the form of ear pain. As a rule, discomfort disappears after the child gets rid of the underlying disease.

Ear canal abscess

The ear canals, like the skin in general, have their own hair follicles. If for some reason the hair follicle becomes inflamed, ear pain appears.

What to do if your child's ear hurts: first aid at home

First aid can be provided at home, but then the child must be shown to a pediatrician or ENT doctor. After the examination, the doctor will give recommendations and prescribe the necessary drugs. Further treatment can take place on an outpatient basis, and with the development of complications of otitis media - in a hospital. If you called an ambulance, you should not give medicines and carry out any manipulations on your own. The doctor will examine the child, ascertain the symptoms and give recommendations.

If there is a temperature

If the temperature rises to 38°C or more, antipyretics based on ibuprofen or paracetamol can be given. These medicines also relieve ear pain. With severe unbearable pain, drops help (for example, Otipax, Otinum), but they can be instilled when there is no purulent discharge.

If there is no temperature

Seat the child. In an upright position, the mucus will more easily come out of the Eustachian tube, and the pain in the ear will decrease. If the nose is blocked, free it from mucus and drip vasoconstrictor drops.

In the absence of purulent compartments, you can apply an alcohol compress to the ear: moisten gauze with alcohol, wrap around the ear, cover with wax paper and a layer of cotton. Wrap a scarf or scarf on top and leave for several hours.

Prevention of ear pain in children

Physicians cite regular viral illnesses, nearby adults smoking, infections in day care centers, and family history of acute otitis media as risk factors (2). What can be done to avoid ear pain in children? Protect babies from hypothermia, infectious diseases, strengthen immunity. Kids need to be taught to play carefully with small objects, to explain that pencils, brushes, toothpicks, and other objects should not be put into their ears - anything that can cause injury to the auricles and eardrums. Do not let children swim without a rubber cap.

These are the basic rules for preventing injuries and otitis media. When it comes to health, it's better to be over-indulgent than under-indulgent.

Expert comments

Daniil Karpichev, Lecturer in Medical Sciences, Cherepovets Medical College. NM Amosova:

— Pain in the ears is a fairly common symptom, most often occurs with acute respiratory viral infections (rhinitis, nasopharyngitis). Pain in the ears against the background of high temperature may indicate the onset of the inflammatory process - otitis media. There is otitis externa, internal, with purulent discharge from the ear and without it. With timely treatment, the prognosis of the course of the disease is favorable. If it is not possible to see a doctor right now and there is no discharge from the ear, you can use drops with anti-inflammatory and analgesic effects. If the temperature persists for more than 4 days with pain in the ear, you may need antibiotic therapy, so you should not postpone visiting a specialist.

Elizaveta Gammel, pediatrician, functional diagnostician:

- The outer ear is a canal that runs from the auricle to the entrance to the middle ear, tightly closed by the tympanic membrane. Inflammation in the outer ear, called "otitis externa", can occur after a microtrauma, such as a scratch, or after hypothermia. This happens after swimming in the pool, or if you jump out without a hat on a cold street. The pain in this case is not very pronounced, but noticeable. The ear itches unbearably, and if you touch it or, moreover, look inside, it causes a sharp increase in pain. Sometimes there is discharge from the ear.

The middle ear is an isolated chamber. From the "street" it is closed by a thin eardrum. However, to maintain optimal pressure inside, the middle ear cavity is connected to the nasal cavity and pharynx by a thin tube - the Eustachian tube. When the pressure in the middle ear changes, the person feels stuffy in the ears and hearing is reduced. This happens, for example, when taking off in an airplane, going up in a high-speed elevator, or when the atmospheric pressure changes before it rains.

In inflammation of the middle ear, the tympanic cavity is filled with mucus - exudate. The pressure in the tympanic cavity rises, affecting the ear nerve. The pain is unbearable, it is comparable to the pain experienced by a woman during childbirth. On examination, the specialist will see redness of the eardrum, its bulging, and sometimes rupture. He will also determine that behind the eardrum is just exudate or pus. Pain in otitis media is throbbing, sharp, aggravated by any sound.

There is also such a thing as tubo-otitis. This is when, due to swelling in the nose during a runny nose, the lower part of the Eustachian tube is blocked, and a vacuum is created in the middle ear. In this case, the tympanic membrane is retracted. With tubo-otitis, a person feels a slight itch in the ear or as if something is tickling inside. There is no pain in this.

Lidocaine drops and pain relievers based on ibuprofen or paracetamol are used for any ear pain. The child should immediately be shown to a doctor: a pediatrician who owns otoscopy, or an ENT doctor, since the treatment of different types of otitis media depends on the cause.

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