Earache in children: wax, infection, swimmer’s ear, or something else?
If your child has an earache, it’s usually caused by a minor infection or irritation and will often improve in a few days. But it can be painful, and it’s hard to know what to do next.
This guide helps you:
- ease pain safely at home
- spot red flags early
- work out the likely cause (earwax vs infection vs swimmer’s ear vs referred pain)
- know when to call NHS 111 or see a GP
Quick answer: what to do now
- Give pain relief suitable for your child’s age (follow the label or a clinician’s advice).
- Use a warm flannel against the ear for short periods if it soothes them.
- Keep the ear dry (avoid swimming; try to keep shampoo/water out during baths).
If your child seems very unwell, has severe symptoms, or you’re worried, seek urgent medical advice.
When to worry about an earache in a child (red flags)
Get urgent help (call NHS 111 or seek urgent GP advice) if your child has earache and:
- a very high temperature, or they’re hot and shivery
- swelling around the ear, or redness/pain behind the ear
- fluid, pus or blood coming from the ear
- new hearing loss, or a noticeable change in hearing
- they’re becoming generally unwell, very sleepy, dizzy, or hard to settle
- there’s something stuck in the ear
- the pain is severe or rapidly getting worse
Extra caution:
- If your child is under 2 and has earache in both ears, get medical advice the same day.
- If you need advice for a child under 5, NHS 111 is a good first step.
Earache in a child with no fever: what it can mean
It’s common to assume “no fever means no infection”, but that’s not always true.
A child can still have:
- a middle ear infection (otitis media)
- an outer ear infection (swimmer’s ear)
- earwax-related blockage
- pain that feels like it’s from the ear but is actually from the throat, teeth, or jaw
If your child is otherwise well, focus on pain relief and monitoring. If it isn’t starting to improve within 48–72 hours, or they’re getting worse at any point, get them assessed.
Wax, infection, swimmer’s ear, or something else? (simple decision table)
| Likely cause |
Common clues |
What to do |
When to get checked |
| Earwax build-up |
Blocked/muffled hearing, fullness/pressure, discomfort; sometimes worse after pushing wax in with cotton buds |
Don’t put anything in the ear. Keep it dry. Get advice before using drops if your child has discharge or ear problems. |
If pain is significant, there’s hearing loss, symptoms persist, or you’re unsure what’s going on |
| Middle ear infection (otitis media) |
Ear pain, irritability, poor sleep, reduced appetite; may follow a cold; fever may or may not be present |
Pain relief, fluids, rest. Monitor closely over 2–3 days. |
If worsening, not improving after 2–3 days, discharge, swelling, or your child is very unwell |
| Swimmer’s ear (otitis externa) |
Itchy ear canal, pain/tenderness (especially when touching the outer ear), after swimming; sometimes discharge |
Keep ear dry. Don’t insert objects. Seek advice about suitable treatments. |
If severe pain, discharge, swelling, fever, or symptoms don’t improve |
| Referred pain (not “from the ear”) |
Sore throat, tonsillitis symptoms, teething, tooth pain, jaw joint pain; ear looks/feels “fine” otherwise |
Treat the likely cause and use pain relief. Watch for new ear symptoms. |
If unsure, symptoms are severe, or not improving as expected |
What helps at home (and what to avoid)
What can help:
- pain relief appropriate for your child’s age
- a warm flannel (if it helps your child)
- encouraging fluids and rest
- keeping the ear dry
What to avoid:
- cotton buds or putting anything in the ear (this often makes wax and irritation worse)
- trying to remove earwax yourself
- getting water/shampoo into the affected ear
- using eardrops or oils unless you’ve been advised they’re suitable (especially if there’s discharge or you suspect a perforated eardrum)
Ear infection in children: what to expect (and do they need antibiotics?)
Ear infections in children are common. Many improve on their own within a few days.
Antibiotics are sometimes needed, but not always. In many cases, the most important early treatment is good pain control and monitoring.
Seek advice if:
- your child is getting worse
- they’re not starting to improve within about 2–3 days
- they have discharge, swelling around the ear, or hearing changes
Swimmer’s ear in children (outer ear infection)
Swimmer’s ear often causes pain and itchiness in the ear canal, and can come on after swimming or after the ear canal has been irritated (for example, by scratching or cotton buds).
Key steps:
- keep the ear dry
- avoid swimming until it’s improving
- don’t insert anything into the ear
- seek advice if pain is severe, there’s discharge, or it’s not improving
Earwax in children: safest next steps
Earwax is normal and protective. Problems happen when wax builds up and blocks the ear.
What not to do:
- don’t use cotton buds or try to dig wax out
What to do instead:
- if you suspect wax (blocked hearing/fullness), get advice on the safest approach for your child
If you think it’s earwax (or you want it checked), Monkspath can help you decide what to do next. If suitable, you can book our ear wax removal service (private), subject to clinical assessment and suitability.
Still unsure? A pharmacist can help you decide what to do next
If your child’s earache isn’t urgent but you want reassurance, a pharmacist assessment can help.
What we’ll usually ask:
- age, symptoms, and how long it’s been going on
- fever, discharge, swelling, or hearing changes
- whether they’ve been swimming recently
- what you’ve already tried for pain relief
What we can do:
- give clear, evidence-based self-care advice
- help you judge whether it looks like wax, infection, or something else
- signpost you to the right next step (self-care, NHS 111, GP, urgent care)
