What is earache?

The most common cause of earache is an infection in the middle ear – the space between the eardrum and the inner ear – leading to inflammation. This is known as otitis media. A cold or sore throat can make the tubes between the ear and the throat swell and make catarrh. A blockage can form causing fluid to build up in the middle ear. This ‘stagnant’ fluid is vulnerable to infection by bacteria and viruses, causing fever, swelling and pain.

Children are more vulnerable to ear infections because their ‘eustachian tubes’ (the tubes connecting the ear and the throat, which ‘pop’ when you go up in an aeroplane) are smaller and lay flatter than in adults. This means that infection can spread up to the middle ear from the throat more easily and it’s also more difficult for fluid to drain away. The tube grows and develops so that by five or six years, ear infections become less common.

How will I know if my child has earache?

An older child will let you know exactly where their pain is coming from but in babies it can be difficult to read the signs-but there may be a few clues to help you:

• Typically ear infections come on three to four days after a cold or sore throat.
• Your baby may be crying and tugging her ear.
• The ear may appear red.
• There may be yellowish fluid leaking out if the eardrum has burst; this will bring a welcome drop in pain.
• The infected fluid may affect his hearing; so get a check up if he asks you to repeat things or stares at your mouth while you’re talking. But often he won’t localise the pain and all you’ll see is a feverish, miserable child who can’t be comforted.

If you’re worried see your GP who can look at the eardrum and make the diagnosis.

How do I treat earache?

You should always have your child’s ears checked by a doctor if he develops severe earache. This can often wait until the daylight hours, although you should treat the pain and fever straight away:

• If your doctor has diagnosed an infection, it’s worth making an appointment for ten to fourteen days later to check that the fluid has cleared and any holes in the eardrum have healed.
• Green or yellow fluid coming out of the ear suggests that the eardrum has burst. Your doctor may want to prescribe antibiotic medication (either by mouth or as drops) and take a swab of the fluid.
• If you’re worried: Complications are much less common since antibiotics became widely available but rarely the infection can spread to the mastoid bone behind the ear. It can also inflame a nerve in the area leading to temporary numbing of the face and in very rare cases severe infections can spread leading to meningitis.
• If the hearing is affected: If your child is trying to read your lips or mishearing you, it’s vital to get a check up.
• Prop your baby up during a breast or bottle-feed; lying flat increases the risk of ear infections.

It’s also important not to smoke at home, it doesn’t just affect children’s breathing it can also make them more likely to get middle ear infections.