Ear Problems and Injuries, Age 11 and Younger

Ear pain in children may be a sign of an infection in the space behind the eardrum (Reference middle ear Opens New Window Reference Opens New Window). Ear infections (Reference otitis media Opens New Window) most commonly occur when cold symptoms, such as a runny or stuffy nose and a cough, have been present for a few days.

An ear infection may occur when the Reference eustachian tube Opens New Window swells and closes and fluid accumulates in the middle ear. The combination of fluid and germs (from bacteria or viruses) creates a perfect environment for an infection. Swelling from the infection can cause pain from increased pressure on the eardrum. The pressure can cause the Reference eardrum to rupture Opens New Window (perforate). A single eardrum rupture is not serious and does not cause hearing loss. Repeated ruptures may lead to hearing loss.

Middle ear infections are more common in children than in adults. Young children have short, soft, more horizontal Reference eustachian tubes Opens New Window Reference Opens New Window that are more easily blocked than those of older children and adults.

Ear infection is the most commonly diagnosed Reference bacterial infection Opens New Window in children younger than age 7. Almost all children will have at least one ear infection by the time they are 7 years old. Most ear infections occur in babies between the ages of 6 months to 3 years. After age 7, ear problems may be related to inflammation, infection, or fluid buildup in the middle or external ear. Ear infections are more common in boys than in girls, and they most often occur in children who:

• Spend time in day care settings.
• Are bottle-fed.
• Use a pacifier.
• Live in households where parents or caregivers smoke.
• Have had a previous ear infection.
• Have problems present since birth (congenital abnormalities), such as Reference cleft lip Opens New Window, Reference cleft palate Opens New Window, or Reference Down syndrome Opens New Window.
• Have allergies.

Fluid often remains in the middle ear (Reference serous otitis Opens New Window, or middle ear effusion) after an ear infection. This may cause no symptoms, or it may cause a muffling of sound, decreased hearing, and mild discomfort. The body usually reabsorbs fluid behind the eardrum within 3 months, and hearing returns to normal. Reference Recurrent ear infections and persistent effusion may occur in some children.

Even though ear infections are a common cause of ear pain, not all ear pain means an infection. Other common causes of apparent ear pain in young children include:

• Teething.
• A sore throat.
• An accumulation of Reference earwax Opens New Window.
• An object in the ear.
• Air pressure changes, such as flying in an airplane.
• Fluid buildup without infection (serous otitis).

When evaluating ear pain in a child, remember that ear infections commonly occur after symptoms of a cold have been present for a few days. When other symptoms, such as Reference fever, are present, ear pain or drainage may be less important than the other symptoms.

Reference Check your child's symptoms to decide if and when your child should see a doctor.

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