Earache and Ear Infection Symptoms in Kids

What Causes Ear Pain in Children

“Earache” is a catch-all term for ear pain. Pediatricians usually think about it in three ways:

Ear pain without an infection (otalgia): This can happen without fever and may be related to teething, skin irritation (like eczema), or referred pain from the throat (for example, a sore throat can sometimes feel like ear pain).
Middle ear infection (otitis media): This is an infection behind the eardrum. You can’t see it from the outside. Kids often have a fever plus changes in sleep, appetite or behavior.
Swimmer’s ear (otitis externa): This is an infection in the ear canal and often follows prolonged water exposure (baths usually aren’t the culprit). It tends to be very painful and may come with drainage.

Understanding When Ear Pain Needs Care

Home Care
These symptoms may improve with simple care and time:

Ear pain without fever
Mild ear tugging, but your child is otherwise comfortable, eating and drinking well
Symptoms that start improving within 24–48 hours

Contact the Clinic
We want to talk with you and see your child within the next 24–48 hours if:

Ear pain isn’t improving after 24–48 hours
Your child is crying from ear pain, or still in pain even after ibuprofen (Motrin)
You notice fluid draining from the ear
Your child is under two years old
They have a history of recurrent ear infections (often best to be seen rather than wait it out)

A note on timing: Early on, the ear may look normal during an exam, and then change a day later. Sometimes the body just needs a little time to show which direction things are going. Waiting 24 hours can help symptoms show up, leading to a better diagnosis from your pediatrician.

Seek Emergency Care
Ear pain rarely requires an ER visit by itself. But do seek urgent or emergency care for:

Ear trauma or a significant injury
Bruising and swelling on the outer ear after an injury

Age matters

Kids under two years old are more likely to need prompt evaluation and treatment if they have a middle ear infection. That’s partly because they’re at higher risk of repeat infections and are not fully immunized yet, increasing the chance of bacterial infection and complications.

Recent water exposure

Swimmer’s ear usually follows prolonged exposure to pool, lake, or ocean water — not a quick bath.

Recurrent ear infections

If infections keep coming back (or you’ve had multiple close together), your pediatrician may be quicker to evaluate, treat and consider an ENT referral.

Speech or developmental concerns

Kids with speech delays or developmental differences often need a more careful approach. We want to avoid anything that could add risk to hearing and speech development.

Home Remedies That Can Ease Earaches

Parents often ask, “What can I do right now?” These steps can make a big difference while you’re watching symptoms or waiting to be seen.

Focus on pain control first
Ibuprofen (Motrin) often works especially well for ear pain, including swimmer’s ear. Acetaminophen (Tylenol) can also help, especially if the pain is more related to teething or general discomfort. Be sure to use the right dosage for your child.

Warm compresses over the outer ear can provide extra relief.
Support drainage if congestion is part of the picture
Many ear pain episodes start during a cold, when mucus and pressure build up.
- Keep your child upright when possible to help drainage.
- Use nasal saline, then suction (for babies) or help your child blow their nose (for older kids).
- Ginger tea can be soothing for older kids, and some families find small amounts of “spicy” foods (like ginger, horseradish, or wasabi) help trigger drainage.
What not to do
- Avoid decongestants like Sudafed or Mucinex in young children. These are not always safe in young children and may come with unexpected side effects.
- Don’t put random liquids or home remedies into the ear unless a clinician has confirmed they are safe.
A note on ear drops
For swimmer’s ear, over-the-counter swimmer’s ear drops may be part of anticipatory guidance after treatment. But be cautious about using any drops when you can’t see what’s going on inside the ear.

Why do younger kids get ear infections more often?

When kids are little, the middle ear drains into the throat through a tube that’s flatter and doesn’t drain as efficiently. As children grow, the angle improves and fluid drains more easily. Think of how a flat roof might collect water, while a steep one lets it roll right off.

What “watch and wait” means (and when it’s used)

For kids over two years old, most middle ear infections are viral and may improve without antibiotics. Your pediatrician might recommend a “watch and wait” approach for mild ear pain. This can involve checking in after a couple of days, or having a prescription on hand to start only if symptoms worsen.

What to expect if it’s swimmer’s ear

Swimmer’s ear is often treated with prescription antibiotic ear drops. Improvement is often seen within 24–48 hours, but treatment commonly lasts about 7 days.

What if there’s ear drainage or a ruptured eardrum?

Drainage can happen with a swimmer's ear and sometimes with middle ear infections. If there’s concern for a ruptured eardrum, your clinician may want to follow-up in a week to make sure it’s healing well. You can’t see the middle ear at home, and will need an exam in the clinic. The reassuring news: it typically heals on its own in the vast majority of cases.

When an ENT referral might come up

If your child has repeated infections, your child may need extra support and a referral to an Ear, Nose, Throat (ENT) specialist.