Earaches and Earwax

Types of earaches in children

There are 3 things that typically account for ear pain in children.

  1. “Swimmer’s Ear” or Outer Ear Infection
  • An skin infection of the outer ear canal
  • This occurs when water gets into the outer ear canal and causes irritation and inflammation of the canal.
  • Usually occurs in the Summer from swimming, but can happen year round.
  • The ear itself is usually painful to touch or is painful when pulled.
  • This is usually treated with ear drops prescribed by the doctor.
  • If your child has frequent swimmer’s ear, there are some prophylactic things to try. 1) Well fitting ear plugs to help keep the ear dry. 2) After swimming, try draining the water out of the ear put a few drops of over-the-counter “swimmer’s ear drops” or a few drops of 1/2 vinegar and 1/2 alcohol in the ear canal. Although these are not treatments, they may help prevent swimmer’s ear.
  1. Middle Ear Infection
  • An infection behind the ear drum.
  • Can be viral or bacterial.
  • Is usually associated with a cold, runny nose and congestion.
  • There does not have to be a fever.
  • The only way to know if antibiotics are needed is for a medical provider to look in the ears.
  • We do not prescribe antibiotics for ear pain without seeing your child first. Antibiotics given when there is not a bacterial infection increase antibiotic resistance and can cause unwanted side effects.
  • Although not always necessary, we will sometimes ask that your child return for re-evaluation after treating with an antibiotic. Ask your provider if there is any value in having the ears rechecked after antibiotics are done.
  • While fluid or infection are present behind the ear drum, the child’s hearing can be slightly dulled in that ear. Hearing usually returns to normal when the fluid is gone.
  • The evaluation and treatment of ear infections are designed to avoid hearing loss (and possible speech problems in younger children), which can develop if the infection and/or fluid continues for several months.
  • A child is generally referred for ear tube evaluation if she has had 6 infections in 6 months or never clears fluid from behind the ear drum for 3 straight months.
  1. Teething
  • A child can also have ear pain that is referred pain from teething.
  • Please click on the above “Teething” link for more information.


  • Most parents worry about excessive earwax.
  • Earwax is normal and is produced in the outer canal to trap dirt and small particles.
  • Earwax provides insulation for sound waves to bounce back to the ear drum more effectively
  • Earwax raises the pH of the outer ear canal, which makes it harder for bacteria to grow and cause swimmer’s ear.
  • Earwax gradually works its way out of the canal and can easily be wiped away with a washcloth.
  • Probing inside the canal with a Q-tip is unnecessary and should be avoided because it usually results in pushing the wax farther in, causing a large block of impacted wax.
  • When evaluating the child for an ear infection, your doctor or nurse practitioner may need to remove some of the wax to get a good view of the eardrum. We may use a curette to scoop out the wax or wash it out with warm peroxide or water.
  • At home you may try over-the-counter earwax dissolving solutions, such as Debrox or Murine, to break down and thin out the wax.