Ear Pain or ‘Earache’ is the sensation of discomfort or pain located in or around a child’s ear. It is a common childhood symptom, particularly in babies, toddlers, and young children, and can affect one or both ears. It can be painful, but it’s not usually a sign of anything serious.
What Are The Symptoms of Earache?
Recognising the signs of ear pain early can help make your child more comfortable and decide the best treatment options available.
Symptoms of an ear infection may include:
- Pulling or tugging at their ear
- Fussiness, irritability or trouble sleeping
- Fever or very high temperature – 38C or above
- Trouble hearing
- A feeling of pressure or fullness inside the ear
- Balance issues, being off their food or generally off-colour
In babies just months old, you may also notice:
- Not reacting to familiar sounds
- Restlessness, off their food and unsettled behaviour
Treating Ear Pain
In most cases, ear infections improve within 3 days, but symptoms of ear pain can last up to a week. If it lasts longer than this or deteriorates, you should book an appointment with your local paediatrician or seek advice from a pharmacist.
For children under 12 months who have pain in both ears, you should request an urgent appointment with your GP or get help from NHS 111 (1).
Age-appropriate pain relief, such as Paracetamol or Ibuprofen, can be offered to your child at home to help soothe discomfort and reduce fever. Never give your child aspirin if they are under 16.
Ensuring they get plenty of fluids and rest, as well as sleeping with their head elevated, can help to alleviate pressure in and around the ear.
Avoid putting anything inside your child’s ear (such as cotton buds) or removing earwax, as this can lead to earwax impaction or eardrum damage.
For children aged 1 to 17, they can receive assessment and treatment from local pharmacists under the NHS “Pharmacy First” scheme (2), with no GP appointment needed. They can offer eardrops, if required, and advice on managing pain.
Most ear infections are caused by a viral infection, accompanied by a runny nose, cough or sore throat. Therefore, to avoid the development of antibiotic resistance and potential side effects, the use of antibiotics is reserved for specific cases, such as babies under six months with middle ear infections and young children with severe pain.
When Should You Worry About a Child’s Earache
In some cases, certain types of ear infections require immediate attention. If your child has any of the following symptoms with ear pain, you should seek attention from a healthcare professional:
- High fever, vomiting and feeling generally unwell
- Fluid or pus draining from the ear
- Swelling around the ear or redness behind it
- Hearing loss or difficulty hearing
- Balance problems, dizziness or severe sore throat
- Children under 12 months with an earache in both ears
- Babies under 3 months with a fever over 38 °C
In such cases, arrange an urgent GP appointment or contact NHS 111.
Common Symptoms and Causes
| Symptom | Common Cause |
|---|---|
| Tugging or pulling at the ear | Middle ear infection, teething |
| Trouble sleeping | Ear pressure or discomfort from infection |
| Fever or high temperature | Viral or bacterial ear infection |
| Hearing difficulties | Glue ear, fluid buildup, or blocked eustachian tubes |
| Fluid or pus from the ear | Perforated eardrum due to infection |
| Pain when touching the ear | Outer ear infection (otitis externa) |
| Irritability or crying more than usual | General pain or discomfort |
Summary of Treatment Options
| Treatment | Your Role | When Clinic Helps |
|---|---|---|
| Home care | Paracetamol/Ibuprofen, warm flannels, rest, hydration | First response for mild cases |
| Pharmacy First | Quick access to eardrops and advice | For children aged 1–17 |
| GP / Paediatrician Appointment | If symptoms last > 3 days, recurrent, or in infants under 12 months | Guidance, diagnosis, and possible hearing tests |
| ENT referral | For glue ear, speech delays, and tympanostomy tube placement | Specialist hearing support |
| Emergency care | If red flags are present | Urgent assessment needed |
Supporting Your Child’s Health
Ear pain in young children can be distressing, but most cases are mild and improve with simple measures.
If you’re concerned about your child’s ear pain, whether they’re months old or an older child, we’re here to help with tailored, compassionate care. We support families across Hertfordshire with expert-led care in children’s health.
If you are based in the Harpenden and St Albans area, you can book a Prompt-Response Appointment with Consultant Paediatrician Dr Felicity Taylor. She will take the time to listen, carry out a full assessment including history and examination, and present a treatment plan to get your child back to normal activities as quickly as possible.
Appointments are for children from birth to 17 years inclusive and are available at Harpenden Medical.
You will receive a thorough explanation of any diagnosis made, a plan for further tests, and a follow-up appointment (if any) will be agreed with you.
If onward referral to another tertiary specialist is required (e.g. paediatric ENT, paediatric neurology), Felicity can provide advice and facilitate referrals to the most appropriate specialists.
Disclaimer: This article is intended for educational purposes only and is not a substitute for professional medical advice. For personalised guidance and recommendations, please consult a qualified healthcare professional.
NHS Guidance:
https://www.nhs.uk/symptoms/earache/
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Image by Daniela Dimitrova from Pixabay
