My Child Has Ear Pain—Is It an Ear Infection?

🩺 Written & Medically Reviewed by Dr. G
Board-Certified Pediatrician

Ear pain is commonly caused by a middle ear infection, especially after a cold. However, ear pain can also result from swimmer's ear, pressure changes, earwax buildup, teething, sore throats, or jaw discomfort. Because many conditions can cause similar symptoms, a physical examination by your child's pediatrician is often needed to determine the exact cause.

Although ear infections are common, they are only one possible cause of ear pain.

Middle Ear Infection (Acute Otitis Media)

The most common cause of ear pain in young children is a middle ear infection.

These infections often develop several days after a cold, when fluid becomes trapped behind the eardrum and becomes inflamed.

Children with a middle ear infection often experience:

• Ear pain
• Fever
• Fussiness
• Difficulty sleeping
• Temporary hearing changes

Swimmer's Ear

Swimmer's ear is an infection of the outer ear canal rather than the middle ear.

Unlike a middle ear infection, the pain usually becomes worse when the outer ear is touched or gently pulled.

Children often develop swimmer's ear after spending time in pools, lakes, or the ocean.

Pressure Behind the Eardrum

Sometimes the eustachian tube becomes blocked after a cold or allergies without developing a true infection.

Fluid trapped behind the eardrum can create pressure that causes discomfort, muffled hearing, or a feeling of fullness.

Many children improve as the congestion gradually resolves.

Earwax Buildup

Although earwax usually protects the ear, excessive buildup can occasionally cause discomfort, pressure, or temporary hearing loss.

Parents should avoid inserting cotton swabs or other objects into the ear, as these often push wax deeper into the ear canal.

Teething

In babies and toddlers, teething pain sometimes seems to radiate toward the ears.

Children may tug at their ears even though the ears themselves are completely healthy.

Sore Throat or Tonsillitis

The nerves that supply the throat also communicate with the ears.

Because of this shared nerve pathway, children with strep throat or other throat infections sometimes complain of ear pain even though the ears are normal.

Jaw or Dental Problems

Occasionally, dental problems or jaw discomfort can cause pain that seems to come from the ear.

Older children may notice pain while chewing or opening their mouths.

Although only an examination can confirm the diagnosis, ear pain is more likely to be caused by a middle ear infection when your child has:

• Recently had a cold
• Fever
• Ear pain that becomes worse at night
• Increased fussiness
• Difficulty sleeping
• Pulling at the ear (especially in infants)
• Temporary hearing changes

These symptoms often occur together.

For a complete discussion of these warning signs, read our article: Ear Infection Symptoms in Children: What Parents Should Watch For.

While waiting to see your pediatrician—or if observation has been recommended—you can help your child feel more comfortable by:

• Encouraging fluids.
• Allowing extra rest.
• Using acetaminophen or ibuprofen (when appropriate for your child's age and as directed by your healthcare provider) to relieve pain.
• Monitoring symptoms closely.

Avoid placing oils, herbal remedies, or over-the-counter ear drops into your child's ear unless specifically recommended by your pediatrician.

You should contact your child's pediatrician if:

• Ear pain is severe or worsening.
• Your child develops a fever.
• Pain lasts longer than 24 to 48 hours.
• Fluid or pus drains from the ear.
• Your child seems unusually sleepy or difficult to comfort.
• Your baby is younger than 6 months and may have an ear infection.

Your pediatrician can examine the eardrum to determine whether your child has an ear infection or another condition causing the pain.

Seek immediate medical attention if your child:

• Has significant swelling or redness behind the ear.
• Develops ear pain after a serious head injury.
• Has severe pain with a high fever and appears very ill.
• Has sudden hearing loss.
• Has persistent bleeding from the ear after an injury.

Fortunately, these situations are uncommon.

Ear pain is common during childhood, but it doesn't always mean your child has an ear infection. Several conditions—including swimmer's ear, pressure behind the eardrum, sore throats, and even teething—can cause similar symptoms.

Because the causes of ear pain vary, a physical examination is often the best way to determine exactly what's causing your child's discomfort. When in doubt, your pediatrician can help identify the problem and recommend the most appropriate treatment.

• Ear Infection Symptoms in Children: What Parents Should Watch For
• Does Every Ear Infection Need Antibiotics?
• Why Does My Child Keep Getting Ear Infections?
• Do Ear Drops Help Ear Infections? (Coming Soon)
• Swimmer's Ear vs. Ear Infection: What's the Difference? (Coming Soon)

Want a more complete understanding of ear infections?

Our comprehensive guide explains:

• Why ear infections happen
• When antibiotics are necessary
• How ear infections are treated
• Why some children experience repeated infections
• When ear tubes may be recommended
• Answers to the most common parent questions

➡️ Read our complete guide: Understanding Ear Infections: A Parent's Guide

This article is provided for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your child's healthcare provider regarding medical concerns. If you believe your child is experiencing a medical emergency, seek immediate medical attention.