Earache
Lots of children get earache and often this is with a high temperature. It is usually due to a viral infection. Your child may also have a runny nose, cough, and sore throat.
Viral infections spread very quickly and often affect other people in your house.
Viruses get better on their own and do not need treatment with antibiotics.
Antibiotics may cause side effects such as rash and diarrhoea. The more antibiotics we use the more chance of antibiotic resistance.
Please see Red-Amber-Green tables for advice on when and where to seek care for your child.
Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)
Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)
Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)
The diagrams above are taken from www.whenshouldiworry.com
The diagrams above are taken from www.whenshouldiworry.com
Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)
When should you worry?
If your child has any of the following:
- Breathing very fast, too breathless to talk, eat or drink
- Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
- Breathing that stops or pauses
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched cry or can’t be settled
- Has a fit (seizure)
- Has a rash that does not go away with pressure (the glass test)
- Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or contact 999.
If your child has any of the following:
- Has pain, redness or swelling behind the ear
- Severe headache persisting despite regular painkillers
- Dizziness or is losing their balance
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Is 3 to 6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C in those over 3 months
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please contact your GP surgery or call NHS 111 - dial 111.
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
If your child has any of the following:
- Pus coming out of their ear
Please use pharmacy first
Please call your local pharmacy. Your local community pharmacist will be able to see and help you. They can prescribe antibiotics if needed through Pharmacy First or if more worrying signs found, help guide you to the most suitable healthcare professional.
If your child is under 1 year or has had antibiotics in the last 2 weeks please call your GP instead.
If none of the above features are present
- Watch them closely for any change and look out for any red or amber symptoms
- If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways.
- Additional advice is also available to young families for coping with crying of well babies.
- If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111.
Advice and Guidance
Self care and Prevention
Most children with earache do not need treatment with antibiotics. Antibiotics rarely speed up recovery and often cause side effects such as rash and diarrhoea. They will also promote the development of antibiotic resistant bacteria in your child.
Antibiotics are usually only considered if your child:
- Is under 6 months of age and has otitis media (a middle ear infection)
- Is between 6 months and 2 years of age with infection in both ears, fever and overwhelming misery
- Has pus draining from their ear
- Has a serious health condition that makes them more likely to get a serious infection
- Complications of a bacterial infection such as spread to another part of the body
If your child has any features of severe infection (amber or red features above), they will need to be urgently assessed by a healthcare professional.
You can help relieve symptoms by:
- Giving your child paracetamol or ibuprofen to help relieve pain (always follow the instructions for the correct dosage)
- Encouraging your child to drink plenty of fluids
- After a week, more than three-quarters of those with earache will be better whether they take antibiotics or not. Most (14 out of 15) who take antibiotics will get better just as quickly as if they hadn’t taken them.
If it is non-urgent, speak to your local pharmacist or health visitor.
If your child has any of the above features, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
You should only call 999 or go your nearest A&E department in critical or life threatening situations.
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