Definition:

* Pain or discomfort in or around the ear

* Child reports an earache

* Younger child acts like she did with previous ear infection (eg, crying, fussy)

Cause:

* Usually due to an ear infection

* Ear infections can be caused by viruses or bacteria. Usually, your child’s doctor can tell the difference.

* Ear infections peak at ages 6 months to 2 years

* The onset of ear infections peaks on day 3 of a cold

Return to School:

* An earache or ear infection is NOT contagious. There is no need to miss any school or child care.

Call 911 Now (Your Child May Need an Ambulance) If:

Not moving or very weak

Call Your Doctor Now (or in Alberta, Canada call 780-408-LINK)) If:

* Your child looks or acts very sick

* Earache is severe and not improved 2 hours after taking ibuprofen (eg, Advil)

* Pink or red swelling behind the ear

* Stiff neck (can’t touch chin to chest)

* Pointed object was inserted into the ear canal (eg, pencil, stick, wire)

* Weak immune system (eg, sickle cell disease, HIV, chemotherapy, organ transplant, chronic steroids)

* Fever above 104°F (40°C) and not improved 2 hours after fever medicine

Call Your Doctor Within 24 Hours (Between 9:00 am and 4:00 pm) If:

* Earache, but none of the symptoms described previously (Reason: possible ear infection)

* Pus or cloudy discharge from ear canal

Home Care for suspected ear infection (until your child can be seen):

1. Reassurance:

* Your child may have an ear infection. The only way to be sure is to examine the eardrum.

* Diagnosis and treatment can safely wait until morning if the earache begins after your child’s doctor’s office is closed.

* Ear pain can be controlled with pain medicine and ear drops (eg Auralgan)

2. Pain or Fever Medicine: Give acetaminophen (eg, Tylenol) or ibuprofen (eg, Advil) as needed for pain relief or fever above 102°F (39°C)

3. Local Cold: Apply a cold pack or a cold, wet washcloth to the outer ear for 20 minutes to reduce pain while the pain medicine takes effect (Note: some children prefer local heat for 20 minutes).

4. Ear Drainage:

* If pus or cloudy fluid is draining from the ear canal, the eardrum has ruptured from an ear infection.

* Wipe the pus away as it appears.

* Avoid plugging with cotton (Reason: retained pus causes irritation or infection of the ear canal)

5. Ear Drops: pain numbing ear drups (eg Auralgan) will usually relieve pain not helped by pain medicine (available over the counter). If your child has ear tubes or a hole in the eardrum, don’t use them.

6. Contagiousness: Ear infections are not contagious

7. Call Your Doctor If:

* Your child develops severe pain

* Your child becomes worse

Based on recommendations/advice in “My Child is Sick; Expert Advice for Managing Common Illnesses and Injuries”, 14th Edition, by Barton D. Schmitt