Ear Pain in Children: Causes and Treatment

Author: Preeti Prangya Panda, MSc Biotechnology

Medical Reviewer:  Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

• Babies and young children get ear pain more easily because their ears are not fully developed yet.
• Ear pain in children is common and often linked to infections or pressure changes.
• Signs of ear pain may include ear pulling, poor sleep, fever, hearing difficulty, or balance problems.
• Most mild ear pain can be managed safely at home with comfort care and pain relief.
• Mild ear pain can often be relieved with safe home care like warm compresses and age-appropriate pain medicines.
• Seek medical care if ear pain lasts more than 2–3 days or if fluid drains from the ear.

Introduction

When you see your child pulling their ears, crying, and unable to sleep, it can be overwhelming and frightening for you. You may search in the middle of the night for what is happening, whether it is serious or what I can do for my child to alleviate their pain. 

Ear pain in children is common, especially in babies and young children.  But that does not make it any less distressing when it happens to your own child. Up to 85% of babies experience middle ear pain in their first year of life and nearly 99% by age two, with the highest occurrence between 6 months and 2 years of age.

While ear pain can be uncomfortable for your little one, in most cases, it has a clear cause and can resolve on its own. If not, it can be treated or managed safely with home remedies or medical assistance. Understanding why children get ear pain is the first step towards easing their discomfort and knowing when it is time to seek medical help.

Understanding Ear Pain in Children

Ear pain occurs due to inflammation in the tubes connecting the ear and throat, increased pressure, or fluid build-up in the middle ear due to infections or other secondary causes. 

Before exploring the reasons for ear pain, it is essential to understand the structure of the ear. The ear consists of three parts [1]:

• Outer ear: This is the part of the ear we can see from the outside. It includes the pinna, which helps collect sound, and the earlobe, which is the soft lower part of the pinna. The outer ear also includes the ear canal, which carries sound to the eardrum. When sound reaches the eardrum, it makes it vibrate.
• Middle ear: It is the layer between the eardrum and the inner ear. It consists of three bones that send the sound waves from the eardrum to the inner ear. Another tube called the eustachian tube connects the middle ear to the upper part of the throat. This tube helps supply fresh air to the middle ear, drain out excessive fluid, and maintain a steady pressure in it.  
• Inner ear: It consists of a snail-shaped cochlea for hearing and the vestibular system for balancing. Sound waves from the middle ear are converted to electrical signals and are received by the brain via the auditory nerve. 

Children are more prone to ear pain because [1]:

• Their eustachian tubes are shorter, narrower, and more horizontal, making drainage less effective.
• Their immune systems are still developing, increasing susceptibility to infections.
• Adenoids (immune tissue behind the nose) are larger in children and can block the eustachian tubes when inflamed, allowing fluid and germs to build up in the middle ear.

Common Causes of Ear Pain in Children

Ear pain is common in infants and toddlers; however, there are different causes. These include:

• Bacterial and Viral Infections 

Bacterial infections can either occur in the outer ear (otitis externa) or the middle ear (otitis media). 

• Outer ear infections can occur when water remains in the ear canal, allowing bacteria to multiply. This is also called primary bacterial infections.
• Middle ear infections are very common in young children, often following a cold or upper respiratory infection. Viruses can cause swelling that traps fluid, creating an environment where bacteria may grow [2]. This is a secondary bacterial infection. 

Some common mcroorganisms iinclude: Streptococcus pneumonia,    Haemophilus influeza and Respiratory syncytial virus (RSV

• Allergies

Allergic reactions in the body can induce inflammation and fluid build-up in the eustachian tubes, which cannot drain easily, causing a risk of ear infections.

• Glue Ear

The deposition of fluid in the middle ear with active infection, causing temporary hearing loss, is called glue ear or otitis media with effusion. It can cause feelings of fullness and balance problems [3]. 

• Ear Wax Buildup

Ear wax blockage plays an important role in keeping the ear clean and healthy. However, if the earwax builds up without removal, it can cause earaches, itchiness, hearing issues, and ringing in the ear.

• Teething

Ear pain can also occur if your baby starts getting their first teeth. In this case, you may also encounter some other symptoms like rubbing of the ears, slight fever, and redness in the area where the teeth are coming. 

• Exposure to Smoke or Air Pollution

Dust particles, smoke, and tiny particulates can irritate the eustachian tube, causing it to get inflamed. Again, the fluid gets trapped in it and is difficult to drain. 

• Increase in Air Pressure due to Altitude

Ear pain can also occur when pressure in the ears increases. This most commonly happens during air travel. As the plane climbs to a higher altitude, changes in air pressure can put pressure on your baby’s ears, causing discomfort or ear pain. 

Symptoms of Ear Pain in Children You Should Watch For

As ear pain is most common in children, it may occur even before your child can talk. In that case, you have to be aware of the following signs and symptoms that can help you know and understand their discomfort and treat it accordingly [1]. 

• Irritability
• Pulling of the ear
• Poor sleep
• Ear discharge 
• Balance issues while crawling or walking
• Refusing to feed due to pain
• Ear blockage
• Temporary hearing loss
• Fever
• Fatigue
• Headaches
• Vomiting, in some cases

Home Treatments That Help Relieve Ear Pain in Children

Sporadic pain in the ears can be highly discomforting for your baby. It becomes difficult to figure out when they get a sudden pain at midnight. Don’t panic! You can try some home remedies to make your baby feel better from throbbing pain.  

• Alternating warm and cold compresses helps in reducing swelling and soothing pain effectively.
• Certain over-the-counter pain relievers like Acetaminophen and Ibuprofen help in reducing pain and fever. However, always follow age-specific and dose weightage instructions. Do not give aspirin to the child, as it is linked to a rare but serious condition called Reye’s syndrome, which causes swelling of the liver and brain [4], [5]. 
• Keeping the upright position can reduce pressure in the ear and alleviate the situation
• Feeding the infant frequently can also help, as it reduces inner ear pressure.
• Staying hydrated helps thin the mucus. This promotes drainage from the eustachian tubes, alleviating pressure in the ears.
• Salt water gargling can also relieve throat pain linked to the ear, thereby reducing pain.
• Avoid using home remedies like vinegar or any natural products without medical advice.

Medication Safety Guide for Children

Here is an age-specific medication safety guide for children [4].

When to Seek Medical Help for Ear Pain in Children

While the symptoms of ear pain may go away easily with some medical and home remedies, it can sometimes be a matter of concern. This is when you need to seek medical help:

• Ear infections usually improve within 2-3 days. If the ear pain lasts or worsens beyond 3 days without any improvement, consult a doctor. 
• If pus is draining from the ear, it indicates a problem with the eardrum. This needs attention.
• If your child gets a fever of 102.2°F (39°C) or higher, feels drowsy, and has difficulty waking up with a severe headache, go for a checkup [4]. 
• Tender swelling or redness around the ear can be a sign to seek help.
• If the hearing and balancing problems are prominent, such as when the child stops responding to sound, attention is needed.
• Infants or children with other health issues or weakened immunity 
• If there are recurrent ear aches or infections every 3 to 6 months, you should seek a specialist opinion. 

How to Prevent Recurrent Ear Infections in Children

Recurrent ear infections can be prevented by following these things [1]:

• Get your baby a flu vaccination
• Wash your hands frequently
• Keep their nose clear
• Control allergies by seeking medical help
• Continue breastfeeding your baby at least up to 12 months 
• Bottle feed upright to reduce pressure in the ears
• Limit pacifier use
• Keep your baby away from pollution or smoking areas

Conclusion

Ear pain in children is usually caused by treatable conditions and can improve with simple care. It becomes essential for you to monitor the symptoms closely and provide some home treatments, like warm compresses, to ease the ear pain. You should stick to proper dosage instructions while dealing with pain relievers. 

If a persistent pain or high fever situation occurs,  seek medical attention. With attentive home care and prevention, you can find that your child’s pain becomes less frequent and severe. 

Always feel free to check with your doctor, as the right advice can make a big difference in helping your child feel better. 

References

1. Ear Infections in Children, Babies & Toddlers | NIDCD [Internet]. 2022 [cited 2026 Jan 14]. Available from: https://www.nidcd.nih.gov/health/ear-infections-children.
2. Worrall G. Acute earache. Can Fam Physician [Internet]. 2011 [cited 2026 Jan 14]; 57(9):1019–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3173423/.
3. Glue ear. NHS.uk [Internet]. 2017 [cited 2026 Jan 14]. Available from: https://www.nhs.uk/conditions/glue-ear/.
4. CDC. Ear Infection Basics. Ear Infection [Internet]. 2024 [cited 2026 Jan 17]. Available from: https://www.cdc.gov/ear-infection/about/index.html.
5. Macdonald S. Aspirin use to be banned in under 16 year olds. BMJ [Internet]. 2002 [cited 2026 Jan 18]; 325(7371):988. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1169585/.

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published January 19, 2026