RHCG - Earache

Earache

Earaches are common in children. They are often associated with a high temperature. Click here to see how to check your child’s 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. Other people in the household may also be unwell (because viral infections spread easily).

Viral infections tend to get better on their own. They 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 I get help?

Use the traffic light table to know what to do if your child is unwell.

If your child has any of the following:

Has blue lips
Has pauses in their breathing (apnoeas) or has an irregular breathing pattern
Is too breathless to talk / eat or drink
Is pale, mottled (blotchy rash) and feels cold to touch
Has a fit or seizure
Is very distressed (crying inconsolably despite distraction), confused or very hard to wake
Has a rash that does not go away when you press on it (the ‘Glass Test’)
Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (fever is common in babies up to 2 days after they have their vaccinations)

You need help now.

Go to the nearest Hospital Emergency Department or phone 999

If your child has any of the following:

Has pus coming out of their ear
Has swelling (a lump) behind the ear, causing the ear to push forwards, or increasing pain or redness behind their ear
Is dizzy or is losing their balance
Is becoming very sleepy or irritable (you are unable to settle them with toys, TV, food or by picking up) – especially if they are still drowsy or irritable after their fever has come down
Has a severe headache that does not go away and neck stiffness or pain, or discomfort with bright lights (photophobia)
Is have breathing problems, such as fast breathing, shortness of breath or working hard to breathe (pulling in below the lower ribs when they breathe in)
Seems dehydrated (has sunken eyes, difficult to wake them up or has not had a wee for 12 hours)
Has extreme shivering or complains of muscle pain
Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless within 48 hours of having their vaccinations)
Has a fever of 38.0°C or above for 5 or more days
Is getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 24 - 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, then consider taking them to your nearest ED.

If your child has none of the red or amber features

Self care

You can keep looking after your child at home. If you are still concerned about your child, call NHS 24 – dial 111

What should I 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.
If your child is having hearing problems or fluid is coming out of their ear, they should see a GP.
Encourage the whole family to wash their hands regularly to stop the virus spreading.

How long will my child’s symptoms last?

The chart 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 diagrams are taken from www.whenshouldiworry.com}

Where should I get help?

If it is non urgent, speak to your local pharmacist or health visitor.
If your child has any of the above red or amber 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 emergency department in critical or life threatening situations.

Self Care

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 needed. Use any medicines recommended by your doctor or pharmacist. Make sure your child gets plenty of rest. 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.

More information on common childhood illnesses.

Local Pharmacist

Pharmacists are experts in many aspects of healthcare. They are the first port of call for minor ailments and can provide advice and medication (if needed) for a wide range of long term conditions and common ailments including coughs and colds.

Pharmacy First is a free service. You do not need an appointment and many pharmacies have a private consultation area.

Your pharmacist will let you know 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.

Health Visitor

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyle and preventing illness through the Universal Health Visiting Pathway. They work with you through your pregnancy up until your child is ready to start school.

Your health visitor may be able to refer you on to other health professionals, for example if there are hearing or vision concerns.

Contact them by phoning your local health visiting team.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

Breastfeeding, weaning and healthy eating
Exercise, hygiene and safety
Your child’s growth and development
Emotional health and wellbeing, including postnatal depression
Safety in the home
Stopping smoking
Contraception and sexual health
Sleep and behaviour management (including temper tantrums!)
Toilet training
Minor illnesses

For more information watch the video: What does a health visitor do?

GP (General Practitioner)

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/GPs can treat many illnesses that do not warrant a visit to the Emergency Department.
For minor injuries such as cuts that need stitches, broken bones, sprains and minor burns in children aged 5 or over, go to one of our Minor Injury Units (MIU).

NHS 24

If you’re not sure which NHS service you need, call 111. 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 24 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

Emergency Department

Emergency departments 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 the Emergency Department 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 the Emergency Department or riding in an ambulance

Content adapted with permission from the what0-18.nhs.uk resource produced by the Healthier Together initiative

Editorial Information

Last reviewed: 22 September 2022

Next review: 22 September 2025

Reviewer Name(s): Dr Morag Wilson; Dr Geetika Kumar