Understanding Ear Pain and Ear Infections in Children in Brampton

A child tugging at their ear, crying more than usual at bedtime and refusing to lie down is a scene many parents know well. Ear infections are extremely common in early childhood, and most children will have at least one before they start school. Some seem to have one after every cold.

Because ear pain can be intense and can come on suddenly, often at night, it tends to leave parents feeling anxious and unsure what to do until they can see a doctor. This article explains why young children are prone to ear infections, what the signs look like, how you can keep your child comfortable, and how treatment decisions are usually made.

The pharmacists at Pharmasave BramNorth, 25 & 26 - 2 Dewside Drive, can help you choose comfort measures and answer questions about any medicine your child is prescribed. Diagnosing an ear infection requires an examination of the eardrum, so that part needs to happen with a doctor or nurse practitioner.

Why little ears are so prone to trouble

The middle ear is a small, air-filled space behind the eardrum. It connects to the back of the throat through a narrow passage called the Eustachian tube, which helps drain fluid and balance pressure. In young children, this tube is shorter, narrower and more horizontal than in adults, so it does not drain as easily.

When a child has a cold, the lining of the nose and throat becomes swollen and produces extra mucus. The Eustachian tube can become blocked, and fluid builds up behind the eardrum. Bacteria or viruses in that trapped fluid can lead to an infection, called acute otitis media. That is why ear infections so often follow a few days after a runny nose.

Other factors can increase the risk, including exposure to second-hand smoke, attending group child care where colds circulate frequently, and drinking from a bottle while lying flat. As children grow, their Eustachian tubes change shape, and ear infections generally become less frequent.

Middle ear infections versus swimmer’s ear

Not every sore ear is a middle ear infection. Swimmer’s ear, or otitis externa, is an infection of the ear canal, the passage leading from the outside of the ear to the eardrum. It is more common in older children who swim regularly, including at community pools and splash pads around Brampton during the warmer months.

With swimmer’s ear, pain often gets worse when the outer ear is pulled or pressed, and there may be itching or discharge. A middle ear infection more commonly follows a cold and may come with fever. The two are treated differently, so it matters which one your child has. A healthcare provider can tell them apart by looking into the ear.

Signs to watch for at different ages

Older children can usually tell you their ear hurts. Babies and toddlers cannot, so you may need to look for other clues:

• Pulling, tugging or rubbing at one or both ears.
• Increased fussiness, especially when lying down.
• Trouble sleeping.
• Fever.
• Reduced appetite, sometimes because sucking and swallowing are uncomfortable.
• Not responding to quiet sounds as usual.
• Fluid draining from the ear.

Ear-pulling on its own is not always a sign of infection. Babies explore their ears out of curiosity, and some tug when they are tired or teething. It is the combination of signs, particularly after a cold, that tends to point toward an ear infection.

Comfort care while you wait

Ear pain is often the most distressing part of an ear infection, and managing it is important whether or not antibiotics are needed. Some measures to consider:

• A pain reliever suitable for your child’s age and weight may help. Read the label carefully, use the dosing device provided, and ask a pharmacist which product is appropriate. Do not give acetylsalicylic acid (ASA) to children or teens.
• Rest with the head slightly raised can sometimes feel more comfortable than lying flat. Do not use pillows for infants under one year, since safe sleep guidelines recommend a firm, flat surface without soft bedding.
• Offer fluids regularly. Swallowing can help open the Eustachian tubes.
• A warm, not hot, cloth held against the outer ear may feel soothing for an older child.

Do not put anything inside your child’s ear, including oils, drops or cotton swabs, unless a healthcare provider has recommended it. If the eardrum has a hole in it, some drops could cause harm.

How doctors decide about antibiotics

Many parents expect an ear infection to be treated with antibiotics right away, but the approach has changed over the years. Many ear infections improve on their own within a few days as the body clears the infection. For this reason, a doctor may recommend a “watchful waiting” approach for some children, with pain relief and close follow-up, and an antibiotic if symptoms do not improve or get worse.

Antibiotics are more likely to be recommended for younger infants, for children who are very unwell, for those with a high fever, or when there is drainage from the ear. The decision depends on your child’s age, symptoms and history, and it is made by the prescriber after examining the ear.

If an antibiotic is prescribed, give it exactly as directed and for the full length of time on the label, even if your child seems better after a couple of days. Our article on measuring children’s liquid medicine has tips on getting each dose right. If your child develops a rash, diarrhea that is severe, or any sign of an allergic reaction such as swelling or difficulty breathing, contact a healthcare provider promptly and call 911 for any breathing difficulty.

When to seek medical care

Contact your doctor or visit a walk-in clinic if your child:

• Has ear pain along with a fever.
• Is younger than six months and seems to have ear pain.
• Has fluid, pus or blood draining from the ear.
• Has symptoms that are not improving after two or three days.
• Seems to have hearing loss.

Seek urgent care if your child has swelling, redness or tenderness behind the ear, if the ear seems to be pushed outward, if they have a severe headache, a stiff neck, or appear very drowsy or confused. These can be signs of complications that need prompt assessment.

If you are not sure what to do, Health811 offers free advice from a registered nurse. In an emergency, call 911.

Frequent ear infections and hearing

Some children have repeated ear infections, or fluid that lingers behind the eardrum for weeks after an infection has cleared. Lingering fluid can muffle hearing temporarily, which may affect speech development or attention in some young children. If your child has frequent infections, or you notice they seem not to hear well, mention it to your family doctor. Further assessment, such as a hearing test or a referral to a specialist, may be recommended.

Reducing the risk at home

You cannot prevent every ear infection, but some habits may lower the chances:

• Keep your home and car smoke-free. Exposure to second-hand smoke is linked with more ear infections.
• Wash hands often, especially during cold season, to reduce the spread of viruses.
• Avoid giving babies a bottle while they are lying flat; hold them in a more upright position.
• Keep your child’s routine vaccines up to date. Some vaccines protect against bacteria that can cause ear infections, and the flu shot can reduce the risk of flu, which can lead to ear infections. Ask us about age requirements for vaccines given at the pharmacy.
• For swimmers, gently dry the outer ear after swimming. Ask a pharmacist before using any drying drops.

How the pharmacy can help after the doctor’s visit

Once your child has been assessed, the pharmacy can help you get the most out of the treatment plan. When you pick up a prescription, ask the pharmacist to show you the correct dose on the syringe, explain how to store the medicine and tell you what side effects to watch for. If a liquid needs refrigeration, we will let you know.

If your child refuses a medicine because of taste, tell us. We can suggest strategies, and in some cases discuss alternatives with the prescriber. For families managing several children’s prescriptions at once, our prescription refill service and home delivery service may make things a little easier; ask us about delivery to your area.

Reach out to our pharmacy team

Ear pain is miserable for children and stressful for parents. If you have questions about comfort care, a new prescription, or whether your child’s symptoms need to be seen, the pharmacists at Pharmasave BramNorth are ready to help.

Find us at 25 & 26 - 2 Dewside Drive, Brampton, ON L6R 3Y5, or call (905) 792-7333. Visit our contact page for directions and details, or book a time to speak with a pharmacist on our booking page.

This information is general and educational. It cannot replace an examination of your child’s ears or the advice of a doctor, nurse practitioner or pharmacist.