Earache is a very common complaint that children have.A painful ear can make young children cranky with continuous crying, refusing feed and sleeping fitfully.Parents are at a loss, trying to soothe the child.
All parents must have faced at least one such episode of an earache when the child’s pain has brought tears to your eyes.

1. Why does the ear ache?

The Many Causes

• Wax
• Foreign body
• Otomycosis
• Otitis externa
• Trauma
• Herpes zoster
• Exostosis
• Keratosis obturans
• Acute otitis media
• Acute mastoiditis
• Secretory otitis media
• Traumatic perforation
• Otitis barotrauma
• Haemotympanum
• Chronic suppurative otitis media with intracranial complications.

Commonest causes of Earache:

• Infected wax

  Water entry in the ear causes the wax to swell up .This cause pressure over the tympanic membrane.Child will have blocked ear,decreased hearing and occasionally pain.
  The wet wax may also get infected and cause pain.

Children themselves and parents often try to clean their ears with objects like ear buds(often too big ), hair clips , safety pin ,feathers and other risky objects ..This may cause the ear canal to have abrasions which get infected.

• Furuncle of the ear canal(most commonly occurs following ear cleaning)

Pain due to causes in the ear canal is a very painful condition called otitis externa.If a child is crying due to otitis externa she/he will not allow you to even touch their ear.Forceful cleaning of ear in that case make condition worse.

• Acute otitis media: This starts to occur when children especially preschoolers have repeated prolonged episodes of cough and cold. This causes blockage of the passage between nose and ear(eustachian tube).

Nasal obstruction and the sudden blockage causes the tympanic membrane (ear drum) to become in drawn.This cause excessive secretion in the middle ear which may get infected and form pus.Like pus anywhere it causes pain, pressure over tympanic membrane.Ear discharge with sudden relief of pain may occur following rupture of the infected ear drum.Pain due to this condition may not persist through out the day .It increases often at night.Child will allow examination.Never start ear drops etc without doctors permission as it can cause earache to increase in this condition.

• Trauma 
• Referred pain
  From caries tooth, newly erupting tooth, mumps parotitis.different pathologies in oral cavity and oropharynx and larynx 
• Secretory Otitis media
  Children having allergic Rhinitis may have persistent low-grade blockage of the Eustachian canal. This cases retracted eardrum, secretion inside the middle ear cavity(the part of the ear behind the drum), blocked ear, with occasional pain.

• Otomycosis(fungal infection of the ear)Initially may not be painful, but later if left untreated causes pain.Needs prolonged course of topical antifungal alone or in combination with other drugs depending on condition.

2.What can you do to relieve the pain?

• Hot fomentation (warm compress )over the ear.
• Over the counter pain medications like paracetamol and Ibuprofen often available at home and may be given.
• Antibiotics will have to prescribed in most cases.
• Topical antibiotic eardrop, ointment for furuncle, otitis externa will relieve pain.This needs to be started after consultation with an ENT Surgeon.

Earache is a very painful condition both for children and adults.Though 100%prevention may be difficult you can definitely take some action to prevent most cases.

3.Prevention

• Make your child drink water regularly.Hydration status has a role to play in making wax soft and liquid.The more liquid the wax is less chance it will accumulate and get infected.
• Consult your doctor in case of cold and nasal discharge does not improve within 3 days.Generally, earache starts after the 5th day of continuous cold and nasal congestion.

• Never clean the ear forcibly.It’s better to apply a wax solvent ear drop(4 to 6 drops twice a day for 7 days)  every 2 to 3 weeks to avoid built up.

• If the child complains of an earache no, eardrop, warm oil etc should be applied before consulting an ENT Surgeon.
• If the child suffers from Allergic Rhinitis it should be adequately treated to avoid ear problems.

The ear is one of the 5 important sense organs and it definitely lets us know its importance when it aches.Prevention as always is better.

Do you have an earache?How do you manage?Comment below to let me know.

Updated:August  2018

Disclaimer: This information is meant to spread awareness about health and is not meant as a replacement for Doctors consultation.In the case of  emergency ,visit your nearest emergency room for medical care.