Understanding your child’s earache

Help with diagnosing and dealing with your tot’s sore ears

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  • Earache in babies and toddlers is very common and usually signals an ear infection. “More than three quarters of diagnosed ear infections are seen in children under 10,” says Dr Roger Henderson, GP and adviser for netdoctor (www.netdoctor.co.uk). There are two types of ear infection – middle ear and outer ear, and, not surprisingly, they’re more common during the winter months.

  • Middle-ear infection

    “This is the most common type of ear infection and it happens because of a build-up of fluid in the middle ear that’s become infected with bacteria,” says Dr Henderson.

    If it’s an acute infection it’s short term and comes on suddenly, but a chronic one has less severe symptoms, lasts longer and keeps returning. Whatever the infection, it hurts – a lot. Dr Henderson explains why: “The infection causes pressure in the ear, which affects the nerves and causes pain.”

  • Outer-ear infection

    This is when the external ear canal has become inflamed as a result of an infection. It can sometimes be caused by getting water inside the ear or by an allergic reaction to something that has come into contact with the ear.

    Eczema sufferers are susceptible to getting this type of ear infection,” says Dr Henderson. “This is because they’re prone to developing patches of dry, red, itchy skin, which can sometimes happen in the ear and become infected and painful.”

  • Spotting the signs

    “If your little one is suffering from an ear infection you might notice him pulling at his ears, which might look more red on the outside than usual,” says Dr Henderson. He may also have a temperature, or attacks of screaming – where one minute he’s as happy as Larry and the next he’s wailing like a banshee. Also look out for general signs of sickness, including vomiting, being off his food, irritability and tiredness.

    The worst-case scenario? “Occasionally an eardrum will burst and the fluid will come out, but it’s not that common, as usually ear infections are treated before they get to this stage,” adds Dr Henderson.

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  • Getting help

    “Most ear infections settle down on their own, particularly if they’re viral, but if they’re bacterial and don’t clear up, your child will be prescribed antibiotics,” says Dr Henderson. If it’s an outer-ear infection he may also be given ear drops.

    In the meantime, give him infant paracetamol or ibuprofen for the pain but avoid swimming and hair washing as his ears must be kept dry until he’s better.

  • Glue ear

    Repeated ear infections mean your child can have mucus in his ears for several weeks. “This causes a blockage which can make your child temporarily deaf, but unlike an ear infection there are usually no symptoms or signs of infection,” says Dr Henderson.

    This is what’s known as glue ear. If your child has it, first he’ll be monitored to see if things clear up on their own. If they don’t, your GP will refer him to a specialist. Most children are free of glue ear by the age of seven or eight.

  • Grommets

    “If your child suffers continuously from glue ear, your GP may refer you to a specialist to discuss the option of having grommets fitted,” says Dr Henderson. These are tubes that are placed, under general anaesthetic, into the eardrum so any fluid can be drained away, preventing further infections from developing.

    The operation is a minor procedure and most patients go home the same day. Some children get earache for a bit after the op', and you might find your child is startled by everyday noises that he couldn’t hear before the operation.

    Most doctors use tubes designed to stay in the eardrum for nine to 12 months but the grommets usually just fall out on their own after a few months and your child won’t even know it’s happened.

  • Mums’ stories

    “Anusha began getting ear infections when she started nursery at eight months old. She had a high fever, was irritable and went off her food. But because she wasn’t pulling at her ears we never suspected an ear infection. My advice would be to take your child to the doctors as soon as you suspect something and get your GP to check their middle ear, as Anusha was fine once she had some antibiotics. Also, if you can, put your child into nursery a few months before you go back to work so you can be there for them if they get unwell.”

    Ipshita Chatterjee, 35, from Surrey, mum to Anusha, 3

    “Monty’s suffered from ear infections since he was a baby and by the time he was one he’d had four. He continued to get them and other symptoms, including sleeping and eating problems and a runny nose, so he was referred to a specialist when he was two. A hearing test diagnosed glue ear – his symptoms were classic as his hearing was patchy. The specialist decided he needed grommets and, as his tonsils and adenoids were enlarged, the specialist said they needed to come out, too. The op' is set for a month’s time and although I’m nervous, I’m hoping it’ll put an end to his constant infections.”

    Rebecca Metcalf, 27, from West Sussex, mum to Monty, 3, and Blossom, 5 months

    Did you know…

    It’s common for symptoms of an ear infection to be confused with a throat infection, because the ears and throat are so closely linked that an infected throat will often cause pain in the ears.

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