I can’t count how many times I’ve had families walk in to the ER in the middle of the night because a child woke up with an ear pain. They describe it as being bad enough to wake the child up from sleep crying and the child is unable to go back to sleep

I get it, no one loves their sleep interrupted and nothing makes a parent more worried or sad than a sick child especially when it’s really sudden.

But believe me, all ear pain isn’t an emergency, even if it wakes them up at night. You can still give your child some pain medication and have it checked out in the morning.

The ear has 3 different parts: the outer ear, middle ear and the inner ear and you can have abnormality in any of the different parts. The most common ones families are stressed about are Otitis media (commonly known as Ear Infection) and Otitis Externa (or Swimmers ear). These usually need oral antibiotics and ear drops respectively . 

But here are some other reasons why your child may have ear pain:

Impacted (Hard) Ear Wax: 

The normal ear makes wax to help get rid of bacteria and the hair cells in the ear also has a process of getting rid of the wax (reason why we don’t recommend aggressive cleaning). If for some reason the ear cleaning functionality isn’t working well, your child’s ear wax may build up and become hard and then cause pain. Your doctor can try to irrigate (wash it out) or give some drops to make them dissolve.

DO NOT TRY TO USE COTTON SWABS OR OTHER OBJECTS TO ATTEMPT TO BRING THEM OUT, YOU ONLY PUSH THEM FURTHER IN AND CAUSE MORE PAIN.

 

Fluid in the middle ear: 

Firstly, you must know that the Ear, Nose and Throat are connected. Hence while the specialists are called ENT. When your child has a cold, the tube (called Eustachian tube) that helps drain from your ears to the back of the throat becomes clogged or doesn’t function well and the fluid can accumulate in the middle ear and cause pressure and pain.  This can last a few days to weeks but will slowly resolve with pain control. Although adults can have this, it’s more common in children because their tubes are shorter and more horizontal and also because children have more colds and viral illness.

 

Air Pressure in the ear:

If you’ve ever been on a plane, you’ll remember the popping sensation that occurs with taking off or landing or even with being in the air. This is due to quick changes in air pressure. While your ear does a good job balancing the pressure on both sides of the ear drum, some of these changes can cause a lot of pressure imbalance and cause a lot of pain.

Believe me, I have it often when i fly and when you have a cold in addition to that, it’s so much more uncomfortable. 

Swallowing, chewing on hard candy or gum can help. Also, pinching your nose real hard and trying to blow (medically called Valsalva) maneuver usually relieves it. What you’ll try will depend on how old your child is. Remember younger kids can choke so be careful what you give them.

 

Object stuck in the ear:

This is very typical of toddlers. They try to stick objects in any hole they can reach. This can cause a lot of pain. I’ve removed my fair share of things from the ear- beads, corn kernel, roaches, peas, etc

Most of these can be removed in your doctor’s office or emergency room. But if not, no need to be stressed out, the ENT specialists can remove it. 

And contrary to most beliefs, they do not make their way into your child’s brain.

Referred Ear Pain:

This means pain from other places making your child’s ear hurt.

Remember we said the Ear Nose and Throat are related , so referred pain includes sore throat, mouth sores, toothache or cavities or, teething (for younger kids), tooth or gum abscesses, swollen salivary glands (Parotitis).

So now you know Ear pains are not always an emergency. Start with the basics:

  • Give some pain medications – acetaminophen or ibuprofen (NO ASPIRIN IN KIDS PLEASE). That’s actually  the first thing we do when you bring your kids to be seen
  • Apply some warm compresses on the discomforting ear
  • Soothe your child and try to encourage them to sleep
  • You can take a look at the ear and make sure there is no trauma or cuts or bugs that need to be seen right away
  • If none of those, GET YOUR SLEEP and call you doctor in the morning to make an appointment to be seen.

 

Even when the doctor sees your child, they may not always need antibiotics because it depends on what they see when they check your child.

 

 

 

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