• Earache is common, but does not always occur.
• Dulled hearing may develop for a few days.
• Fever (high temperature) is common.
• Children may feel sick or vomit, and can be generally unwell.
• Young babies cannot point to their pain. One of the causes of a hot, irritable, crying baby is an ear infection.
• Sometimes the eardrum perforates (bursts). This lets out infected mucus and the ear becomes runny for a few days. As the pain of earache is due to a tense eardrum, a burst eardrum often relieves the pain. A perforated eardrum usually heals quickly after the infection clears.

A note about earache

Earache is a common symptom of ear infection. However, not all earaches are caused by an ear infection. If a child has earache but is otherwise well, an ear infection is unlikely. A common cause of mild earache is a build up mucus in the middle ear after a cold. This usually clears in a few days. Sometimes pain that you can feel in the ear is due to 'referred pain' from other causes such as teeth problems.

What is the treatment for an ear infection?

Most bouts of ear infection will clear on their own without treatment within 2-3 days. The immune system can usually clear bacteria or viruses that cause ear infections. However, treatments that may be advised include the following.

Painkillers

If the ear infection is causing pain then give painkillers to children regularly until the pain eases. For example, paracetamol (Calpol, Disprol, etc) or ibuprofen. These drugs will also lower a raised temperature which can make a child feel better. If antibiotics are prescribed (see below), you should still give the painkiller as well until the pain eases.

Antibiotics - are prescribed in some cases only?

Antibiotics are not advised in most cases. This is because in most cases the infection clears within 2-3 days on it's own. Also, it is best not to take antibiotics unless needed as side-effects such as diarrhoea can sometimes be a problem. Antibiotics are more likely to be prescribed if:

• The child is under two years old (as the risk of complications is greater in babies).
• The infection is severe.
• The infection is not settling within 2-3 days.
• Complications develop.

When an ear infection first develops it is common for a doctor to advise a 'wait and see' approach for 2-3 days. This means just using painkillers to ease the pain, and to see if the infection clears. In most cases, the infection clears. However, if it does not then antibiotics may then be used.

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