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Earache

Earache occurs commonly in children and is often associated with a high temperature. They are usually caused by a viral infection – if this is the case, your child may also have a runny nose, cough or sore throat.

  • If a number of people are unwell in the same household, this also suggests a viral infection (because viral infections are easily spread)
  • Viral infections tend to get better on their own and do not need treatment with antibiotics. Antibiotics may actually cause side effects such as rash and diarrhoea and can increase the risk of them developing antibiotic resistance

When should you worry?

If your child has any of the following:

  • Is going blue around the lips
  • Has pauses in their breathing (apnoeas) or has an irregular breathing pattern
  • Too breathless to talk or eat or drink
  • Is pale, mottled and feels abnormally cold to touch
  • Has a fit or seizure
  • Is complaining of a severe headache and neck stiffness or pain or discomfort with bright lights (photophobia)
  • Has a swelling behind the ear, causing the ear to push forward
  • Is extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 3 months of age with a temperature of 38°C or 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Has pus coming out of their ear
  • Develops dizziness or is losing their balance
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Is have breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breath in)
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
  • Develops pain or redness behind their ear
  • Has shivering or complains of muscle pain
  • Is 3-6 months of age with a temperature of 39°C or 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

You need to speak to a doctor or a nurse today

Please call your GP surgery or contact NHS 111 - Go to 111.nhs.uk or call 111.(111 online does not currently take questions about children aged under 5, so if your child is 4 or younger,  please call 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 none of the above features are present

 Additional advice is also available for families to help cope with crying in otherwise well babies – click here 

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

What should you do?

  • To make your child more comfortable, you may want to give them paracetamol (calpol) and or ibuprofen. This not only helps with fever but also reduces pain

  • Most children with earache do not require 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

  • If your child is having hearing problems or fluid is coming out of their ear, they should see a GP

  • If your child has a fever for more than 3 days and doesn’t seem to be getting any better, you should also take them to see a GP

 

Prevention

   It is not possible to prevent ear infections; however, you can do things that may reduce your child’s chances of developing the condition. 

  • Avoid cleaning your child’s ears with cotton buds – this may damage and irritate the ear canal and pushes wax further into the ear. Wax is designed to come out by itself 

  • Try not to let soap or shampoo get into your child’s ear canal 

  • Try to keep your child’s ears dry; if water gets in, tip it out as soon as possible. However, this can be extremely challenging in young children! 

  • Ensure your child is up-to-date with their immunisations 

  • Avoid exposing your child to smoky environments (passive smoking) 

How long will your child’s symptoms last?

  • The chart below shows how long earaches take to get better in children. The faces represent 10 children who have seen their GP with an earache. Green faces are those children whose earache has got better within that time period
  • 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
The chart shows that 5 children will have recovered after 3 days of having an earache, and 9 children will have recovered after 1 week

The diagrams above are taken from www.whenshouldiworry.com

Where should you seek help?

For wear and tear, minor trips and everything in between

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  • Visit a pharmacy if your child is ill, but does not need to see a GP
  • Remember that if your child's condition gets worse, you should seek further medical advice immediately
  • Help your child to understand - watch this video with them about going to the pharmacy

For information on common childhood illnesses go to What is wrong with my child?

The 0-19 Service for children and young people is delivered by Oxford Health NHS Foundation Trust and offers a single point of access for Health Visiting, School Nursing and the Family Nurse Partnership. You can contact the teams using the details below:

Single Point of Access (SPA): 01865 903 800

Email: cyp0-19@oxfordhealth.nhs.uk

Chat Health Parentline

Text us any time for confidential advice and support and you will have a response the next working day (Monday-Friday exluding Bank Holidays).

Parents and carers for children aged 0-4: Text 07312 263 081

Parents and carers of children aged 5-11: Text 07312 263 227

Young people aged 11-19 and their parents and carers: Text 07312 263 08

Health Visitors

Health visitors are registered nurses or midwives who have additional training in community public health nursing. They provide a universal service, targeted to individual needs for children aged 0-5 years. Learn more about the Oxfordshire Health Visiting Service here!

School and college Health Nurses

School Health Nurses are specialist public health nurses and have offices across Oxfordshire. They work very closely with Health Visitors to support school aged children. They are available for young people to access in secondary schools and colleges, and offer a service to children who are home educated. They work closely with children, young people and their families to support and promote health and wellbeing. Learn more about the Oxfordshire School and college Health Nursing Service here!

Family Nurse Partnership

The Family Nurse Partnership service supports parents who are aged 19 years or under at conception, or under 21 years if they have been in care. The Family Nurse works alongside younger parents in their home, offering health, wellbeing and development support and information from the early stages of pregnancy, usually up until your child is two. Learn more about the Family Nurse Partnership service here!

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  • Doctors or GPs can treat many illnesses that do not warrant a visit to A&E
  • Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, you can call 111 or use 111 online.

Please note that 111 online is for people aged 5 and over. Call 111 if you need help for a child under 5.

An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services

For information on common childhood illnesses go to What is wrong with my child?

Emergency Departments (A&E) provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  • Many visits to A&E and calls to 999 could be resolved by any other NHS services
  • If your child's condition is not critical, choose another service to get them the best possible treatment
  • Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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