Knowing the signs of earache, and noting how often it happens, can help you and your GP decide on the best treatment for your child. We ask ENT specialist, Mr Andrew McCombe, for his advice for parents worried about earache.
Young children often seem to suffer with earache, caused by the ear infection otitis media.
Acute otitis media appears quickly and then goes almost as quickly – the trigger is usually related to the Eustachian tube.
This is a small tube that goes from the back of your throat to your ear. When it’s working properly it helps to equalize the pressure on either side of your ear and to drain any mucus from the ear.
Why do young children have frequent ear infections?
The reason that babies and small children have earache is because their physical structure prevents the Eustachian tube from working properly.
Young children also often have large adenoids (tissue at the back of the nose) that can block the Eustachian tube.
“When this happens you can get an alteration in the pressure, and a build-up of fluid,” says Mr Andrew McCombe, Ear Nose and Throat surgeon at Frimley Park Hospital in Surrey. “If bugs get into the fluid, you can get an acute ear infection.”
What are the symptoms of earache?
The symptoms include a high temperature of 38 degrees Celsius (100.4 Fahrenheit) or more.
You should watch out for signs of lethargy, poor feeding, a runny nose, coughing and pulling at the affected ear, as these may also indicate earache.
How can I make my child more comfortable?
You can help make your child more comfortable with painkillers (such as Calpol, or Nurofen, depending on your child’s age) and fluids.
It’s a good idea to give your child something to drink or suck to encourage them to swallow, which can help the Eustachian tube function better.
Why is my child’s earache worse at night?
“This is because when they’re asleep your child doesn’t swallow as much as when they’re awake,” says Mr McCombe. Their salivary production decreases, and so does the number of times they swallow and yawn, therefore the Eustachian tubes don’t work as efficiently.
If your child wakes in the night, try giving them a drink, as the swallowing involved may help.
How long will the earache last for?
In most cases children are likely to have one or two episodes of otitis media a year.
“We would expect most children to have some ear infections as part of their natural growing-up process,” says Mr McCombe. “You probably can’t avoid otitis media. But for most children it’s a pretty short-lived episode that tends to cause 24 to 48 hours of earache.
If, after a day or two, their earache hasn’t improved and it’s obvious that your child is clearly not well and they are flushed, listless, not eating or in pain, you may wish to consider talking to your GP about antibiotics.
“For a very small number of children otitis media can be a regular problem,” says Mr McCombe. “They may have frequent ear infections, burst eardrums (with fluid oozing from them) more than once, and some hearing loss. The frequency with which this happens is important. If they are unwell for one week out of every four or five, for instance, you need to see your doctor.”
In these cases your child might be suffering from otitis media with effusion – also known as glue ear. At this point you need to discuss referral to a specialist with your GP.
In more serious cases, specialists may carry out a small operation to insert grommets. “In this situation grommets work really well,” says Mr McCombe. “They bypass the Eustachian tube and prevent the build-up of fluid in the ear. You would start thinking about it when the child is two to three years old, not before.”
Could it be something else?
Some symptoms of otitis media can be caused by other conditions. “Teething can cause similar symptoms,” says Mr McCombe. “As can a sore throat and tonsillitis – all can cause pain in the ear. Problems with the temporomandibular joint – the jaw joint just below the ear – can also cause pain in the area near the ear. This is more likely to happen with an older child.
“Mumps can cause swelling of the parotid salivary glands, just below the ears. Other common symptoms of mumps include a high temperature, tiredness and loss of appetite. If you are concerned about any of these symptoms, or worried about a misdiagnosis, check with your GP.”
Find out more about the child health care options available to your family. You can also discover more information in our Pregnancy and Childcare Centre or if you have a specific question, you can ask our experts.