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Earache - Allied Physicians Group - Pediatric Medicine
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  • Earache


    • Pain or ache in or around the ear
    • The older child complains about ear pain
    • Younger child acts like he did with last ear infection or cries a lot
    • Not caused by an ear injury


    • Usually due to an ear infection
    • Ear infections can be caused by viruses or bacteria. Usually, can tell the difference by looking at the eardrum.
    • Ear infections peak at age 6 months to 2 years
    • The onset of ear infections is often on day 3 of a cold

    Return to School

    • An earache or ear infection cannot be spread to others. No need to miss any school or child care.

    When to Call Us for Earache

    Call 911 Now (your child may need an ambulance) If:

    • Not moving or too weak to stand
    • You think your child has a life-threatening emergency

    Call Us 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 and can’t touch chin to chest
    • Pointed object was put into the ear canal. (Such as a pencil, stick or wire)
    • Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
    • Fever over 104° F (40° C)
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • Earache, but none of the symptoms above (Reason: Could be an ear infection)
    • Pus or cloudy discharge from ear canal

    Care Advice for Earache (Use this until you talk with your doctor)

    What You Should Know:

    • Your child may have an ear infection. The only way to be sure is to look at the eardrum.
    • It is safe to wait until your doctor’s office is open to call. It is not harmful to wait if the pain starts at night.
    • Ear pain can be helped with pain medicine and eardrops.
    • Here is some care advice that should help until you talk with your doctor.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.

    Cold Pack:

    • Put a cold wet washcloth on the outer ear for 20 minutes. This should help the pain until the pain medicine starts to work.
    • Note: Some children prefer heat for 20 minutes.
    • Caution: A hot or cold pack kept on too long could cause a burn or frostbite.


    • If pain medicine does not help the pain, try eardrops. You can use plain olive oil or mineral oil (baby oil).
    • Use 3 drops every 4 hours.
    • There are also prescription eardrops for pain that you can use. (Same dose). Ask your child’s doctor about these during office hours.
    • Caution: Don’t use eardrops if has ear tubes or a hole in the eardrum.

    Ear Drainage:

    • If pus is draining from the ear, the eardrum probably has a small tear. Usually, this is from an ear infection. Discharge can also occur if your child has ear tubes.
    • The pus may be blood-tinged.
    • Most often, this heals well after the ear infection is treated.
    • Wipe the discharge away as you see it.
    • Do not plug the ear canal with cotton. (Reason: Retained pus can cause an infection of the lining of the ear canal)


    • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. See Dose Table. Note: Lower fevers are important for fighting infections.
    • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
    • For babies, dress lightly. Don’t wrap in too many blankets. Reason: Can make the fever higher.

    Return to School:

    • Ear infections cannot be spread to others.

    Call Your Doctor If:

    • Pain becomes severe
    • Your child becomes worse

    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.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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