Reviewed by a GPhC-registered pharmacist at Priory Pharmacy. 3 min read
Quick answer: Earache in children is common during winter and is often caused by an ear infection, particularly after a cold or flu. Symptoms may include ear pain, pulling or rubbing the ear, a high temperature, irritability, difficulty sleeping or reduced appetite. Most ear infections improve on their own within 2 to 3 days. To ease discomfort, give your child age-appropriate paracetamol or ibuprofen, encourage plenty of fluids and use a warm flannel against the affected ear. Avoid putting cotton buds or anything else inside the ear. Antibiotics are not usually needed, as most childhood ear infections clear up without them. Contact your GP if the earache lasts longer than 3 days, symptoms are getting worse or your child is under 12 months old. Seek urgent medical advice if your child develops swelling around the ear, fluid coming from the ear, hearing loss, dizziness or a very high temperature. If your child seems seriously unwell, seek immediate medical attention.
Few things are more upsetting than a child in pain in the middle of the night, and earache is one of the most common reasons. Ear infections are especially common in young children and often follow a cold. Most get better on their own within a few days, but it helps to know how to ease the pain and when to get help.
Under the NHS Pharmacy First service, pharmacists at The Priory Pharmacy in Acomb can assess earaches caused by a middle ear infection in children aged 1 to 17, without a GP appointment.
Why do children get ear infections?
The middle ear is connected to the back of the nose by a small tube called the Eustachian tube. In young children, this tube is shorter and more level, so it gets blocked more easily during a cold. Fluid builds up behind the eardrum and can become infected, causing pain and pressure.
Signs of an ear infection
Older children can usually tell you their ear hurts. In younger children, look out for:
- pulling, tugging or rubbing an ear
- a high temperature
- being irritable, crying more than usual or not sleeping well
- not responding to quiet sounds
- losing balance
- not wanting to eat
- fluid coming out of the ear
How long does it last?
Most middle ear infections start to get better within 3 days, although some can last up to a week. Many children don’t need antibiotics, as their immune system clears the infection on its own.
Easing the pain at home
- Pain relief. Give children’s paracetamol or ibuprofen, following the dose on the label for your child’s age. Don’t give aspirin to children under 16.
- A warm or cold compress. Hold a warm or cold flannel gently against the ear.
- Rest. Let your child rest, and raise their head slightly with an extra pillow if they’re over 1.
- Fluids. Keep them drinking, especially if they have a high temperature.
Don’t put anything inside your child’s ear, such as cotton buds, oil or drops not recommended by a pharmacist or doctor, particularly if there’s discharge.
How Pharmacy First can help
- Bring your child to The Priory Pharmacy. No appointment is needed.
- The pharmacist will ask about their symptoms and may look in their ear with an otoscope.
- They’ll recommend pain relief and self-care, and may supply ear drops or antibiotics if needed.
- If your child needs to see a GP, they’ll tell you.
Prescription medicines for children are free on the NHS.
When to see a GP or call NHS 111
- your child is under 1 and has earache
- symptoms haven’t started to improve after 3 days
- your child has a very high temperature, or feels hot and shivery
- fluid is coming out of the ear
- your child keeps getting ear infections
- you think your child’s hearing has changed
- your child has a long-term condition or weakened immune system
Get urgent help if your child has
- swelling, redness or pain behind the ear, or the ear is sticking out
- a stiff neck or dislike of bright lights
- a rash that doesn’t fade when you press a glass against it
- unusual drowsiness or is hard to wake
- weakness in their face
Call 999 or go to A&E straight away.
Glue ear
Sometimes fluid stays behind the eardrum after an infection has cleared. This is called glue ear. It can cause temporary hearing loss and may affect speech and learning. It often clears on its own within 3 months. Talk to your GP if you’re worried about your child’s hearing.
Reducing the risk
- keep your child away from cigarette smoke
- make sure their vaccinations are up to date
- avoid using a dummy after 6 to 12 months of age
- if you bottle-feed, try not to feed your baby lying flat
- wash hands often to reduce colds
Earache is common in children and usually clears up quickly with pain relief and rest. If you’re worried, or your child is aged 1 or over and in pain, bring them to The Priory Pharmacy at Priory Medical Centre, Acomb, or call 01904 404101.
This article is for general information only and isn’t a substitute for professional medical advice. If you’re concerned about your health or the health of someone you care for, speak to a pharmacist or GP, or call NHS 111.
Frequently Asked Questions
Earache in children is commonly caused by an ear infection, particularly after a cold or flu. Viruses and bacteria can cause fluid to build up behind the eardrum, leading to pain and inflammation. Other causes include glue ear (fluid in the middle ear), a build-up of earwax, or irritation in the ear canal. Ear infections are particularly common in young children because their Eustachian tubes are smaller and more easily blocked.
Common symptoms include ear pain, pulling or rubbing the affected ear, a high temperature, irritability, difficulty sleeping and reduced appetite. Younger children who cannot explain what hurts may cry more than usual or seem unsettled. Some children may also experience temporary hearing difficulties, fluid coming from the ear or a feeling of pressure inside it.
Ear infections are more common during winter because colds, flu and other respiratory infections spread more easily. These illnesses can cause swelling and blockage in the Eustachian tubes, which connect the middle ear to the back of the nose and throat. When fluid cannot drain properly, it can build up behind the eardrum and sometimes lead to an ear infection. Close contact at schools and nurseries can also increase the spread of infections.
Most childhood ear infections improve on their own within 2 to 3 days, although some symptoms can take up to a week to settle completely. If your child’s earache lasts longer than 3 days, gets worse or keeps coming back, contact your GP for advice. Hearing difficulties caused by fluid in the middle ear can sometimes take longer to resolve.
You can help ease your child’s discomfort by giving age-appropriate paracetamol or ibuprofen, following the instructions on the packaging. Encourage them to drink plenty of fluids and allow them to rest. Holding a warm flannel against the affected ear may also provide some relief. Avoid putting cotton buds, oil or other objects inside the ear, and do not use ear drops unless recommended by a healthcare professional.
Not usually. Most ear infections in children are caused by viruses and clear up without antibiotics. Antibiotics may sometimes be prescribed if the infection is severe, symptoms are not improving or there is a higher risk of complications. A GP or other healthcare professional can assess your child and decide whether antibiotics are necessary. Never give your child leftover antibiotics from a previous illness.
Contact your GP if your child’s earache lasts longer than 3 days, is getting worse or keeps returning. You should also seek medical advice if your child is under 12 months old and you suspect an ear infection, or if they have fluid coming from the ear, changes in hearing or a high temperature. Children with symptoms that are causing significant distress should also be assessed.
Seek urgent medical advice if your child develops swelling or redness behind the ear, the ear starts sticking out, or they become very unwell. These symptoms can indicate a serious complication such as mastoiditis. Also seek urgent help if your child develops a severe headache, a stiff neck, unusual drowsiness or difficulty waking. Call 999 if your child is seriously ill or difficult to wake.