My Child Wakes Up With Pain in the Ear - What To Do

Acute Pain causing extreme discomfort to the Child will happen because of many reasons,one of  the commonest of these is Otitis media which is a build up of fluid in the middle ear, the space between the eardrum and the inner ear. The middle ear is usually filled with air. Sometimes it gets filled with fluid or mucus, for example during a cold. 

Symptoms

• severe earache, due to the pressure of the mucus on the eardrum, 
• fever; 
• flu-like symptoms in children, such as vomiting and lethargy;  
• slight deafness.

Babies with ear infections will be hot and irritable. They cannot point to the source of discomfort so it can be hard to tell what is wrong with a baby, but an ear infection is one possibility to consider if your baby is unsettled in this way.

In rare cases the eardrum will become perforated (a hole will form in it), and pus will then be seen running out of the ear.  This sometimes helps to relieve pain, by releasing the pressure on the eardrum, but can lead to reinfection.

Not all earaches are caused by ear infections - especially if there are no other symptoms. Earache may also be caused by build up of uninfected mucus after a cold, or toothache.

Causes

The infection spreads from the nose or throat through the Eustachian tube, a passage between the throat and the middle ear.

Any fluids in the ear usually run out through the nose, via the Eustachian tube. If this tube gets blocked it can lead to otitis media. Enlarged adenoids or tonsils, which are at the back of the throat, may block the Eustachian tube.

A perforated eardrum may get infected if water enters a child's ear during bathing or swimming.

Treatment

Around 80% of cases of acute otitis media clear up within three days without any treatment. Perforated ear drums also usually heal by themselves.

While antibiotics may help with the short-term symptoms, there is no evidence that they make otitis media clear up faster or reduce the chance of complications happening.

Pain killing drugs like paracetamol or ibuprofen may be used to control the symptoms of otitis media (pain and fever).

Nose drops containing decongestants or antihistamines may be used to reduce the swelling of the mucous membranes in the nose and back of the throat. In theory, this will help to keep the Eustachian tubes clear and allow mucus to drain from the middle ear, but again, this has not been proved to be an effective treatment for otitis media.

Removal of the adenoids and tonsils may help if they are blocking the entrance to the Eustachian tube.

Prevention

There is little evidence that any specific measures prevent otitis media.

If acute ear infections are treated quickly, and there is a follow up examination to check that the infection is completely cured, this reduces the chances of chronic (recurring) infection developing.

Dr.Kumaresh Krishnamoorthy, M.S (ENT)

Head and Neck Surgery Fellowship (Buffalo, USA)

Neurotology & Skull Base Surgery Fellowship (Cincinnati, USA)

Senior Consultant in ENT - Head and Neck Surgeon and Skull Base Surgeon

patients@drkumaresh.com