Earache occurs commonly in children and is often associated with a high temperature. They are usually caused by a viral infection – if this is the case, your child may also have a runny nose, cough, or sore throat.
- If a few people are unwell in the same household, this also suggests a viral infection (because viral infections are easily spread)
- Viral infections tend to get better on their own and do not need treatment with antibiotics. Antibiotics may cause side effects such as rash and diarrhoea and can increase the risk of them developing antibiotic resistance.
When should I worry and what should I do?
Call 999 or go to A&E now if your child:
- Is going blue around the lips
- Has pauses in their breathing (apnoea) or has an irregular breathing pattern
- Too breathless to talk/eat or drink
- Becomes pale, mottled and feels abnormally cold to touch
- Has a fit / seizure
- Develops double vision or blurred vision
- Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
- Develops a rash that does not disappear with pressure (the ‘Glass Test’)
Call 111 or ask for an urgent GP appointment if your child:
- Has pus coming out of their ear
- Develops swelling behind the ear, causing the ear to push forwards, or increasing pain or redness behind their ear
- Severe headache persisting despite regular painkillers (ibuprofen and paracetamol) or worse on lying down / in the morning
- Develops dizziness or is losing their balance
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with cuddles, toys, TV, or food) – especially if they remain drowsy or irritable despite any fever coming down
- Is complaining of a severe headache and neck stiffness/pain or discomfort with bright lights (photophobia)
- Is having breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breathe in)
- Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
- Has extreme shivering or complains of muscle pain
- Is 3 to 6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
- Continues to have a fever of 38.0°C or above for more than 5 days
- Is getting worse or if you are worried
If none of the above symptoms are present:
What should you do?
To make your child more comfortable, you may want to give them paracetamol (Calpol) and/or ibuprofen. This not only helps with fever but also reduces pain.
Most children with coughs/colds do not require treatment with antibiotics. Antibiotics rarely speed up recovery and often cause side effects such as rash and diarrhoea. They will also promote the development of antibiotic-resistant bacteria in your child.
If your child is having hearing problems or fluid is coming out of their ear, you should contact your GP.
If your child has a fever for more than three days and doesn’t seem to be getting any better, you should also take them to see a GP.
How long will your child’s symptoms last?
The chart below shows how long earaches take to get better in children. The faces represent 10 children who have seen their GP with an earache. Green faces are those children whose earache has got better within that time period.
After a week, more than three-quarters of those with earache will be better whether they take antibiotics or not. Most (14 out of 15) who take antibiotics will get better just as quickly as if they hadn’t taken them.
The diagrams above are taken from When Should I Worry.
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- Or contact you GP practice and a qualified member of the clinical team will assess if your child needs to be seen urgently. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations.