What causes earaches in children?

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
The reason why kids tend to get a lot of earaches has nothing to do with how loudly they're watching those goofy Wiggles, but with their aural anatomy. In the first year of life, a child's ear canal (the tubes that connect the nasal passages to the middle ear) are narrow and almost horizontal, without much of a downward slope. So? Well, that means that fluid behind the eardrum has less of a chance of having gravity drain it out. Add that to the fact that babies tend to spend a lot of time lying down, and you've got a situation where fluid that accumulates in the canal can stagnate and serve as a breeding ground for bacteria. It's also the reason why children who bottle-feed lying down are more susceptible to ear infections. Kids who have colds or who are cutting teeth are also prone to ear infections. When babies' teeth emerge, they break through tiny capillaries in the gums. Bacteria at the site of tooth eruption can sneak into the bloodstream, find that nice yummy fluid behind the eardrum, and set up camp.
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Earaches can be caused by:
  • Infection -- Under normal circumstances, a short narrow tube (the Eustachian tube) drains the middle ear into the nasal passages. Often, during a cold or with an allergy, the mucous membranes lining the Eustachian tube will swell, closing off the tube. If the tube closes, the fluid cannot flow through as it should. If the fluid accumulates in the middle ear and becomes stagnant, there is a good chance that bacteria will grow, causing an infection in the middle ear. This can happen in one or both ears. Ear infections are more likely to occur in children and infants because their tubes are so much smaller than those of adults are. If a child is irritable, has a fever, and is pulling on the ear, suspect an ear infection. Ear infections need to be treated with antibiotics to kill the bacteria inside the middle ear.
  • Earwax Blockage -- Earwax is the body's way of keeping the ear canal clean. Sometimes, however, the earwax can build up and harden, causing temporary hearing loss, pain, and pressure in the ear. It is not a good idea to poke at this buildup of earwax with swabs or fingers. A professional should remove the hardened earwax.
  • Water in the Ear -- If water enters the ear due to swimming, bathing, or showering, it can cause an earache. This can generally be resolved by drying out the ear.
  • Altitude Change -- Ear pain and stuffiness can occur when changing altitudes (most commonly in an airplane). The cause of the pain or stuffiness is a clog in the Eustachian tube.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.