Mild, short-lived and child otherwise well.
Use age-appropriate pain relief if suitable, offer fluids and monitor. Many childhood ear infections improve within about three days.
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Ear pain in children · GP care
Ease the pain. Know when the ear needs looking at.
Ear pain commonly follows a cold and many infections improve within a few days. Age, fever, discharge, hearing change and swelling around the ear help determine whether the child needs an examination.
An otoscope examination is often needed to identify the cause. Antibiotics are not automatic and do not help every ear infection.
Choose a suitable route
Choose the right starting point.
Short-lived mild pain may be supported at home, while persistent pain, discharge or hearing change usually needs the ear examined.
Not improving or needs examination.
Arrange review if pain is not starting to improve after three days, keeps recurring, comes with discharge or hearing change, or you are concerned.
Explore in-person GP careSwelling, severe illness or young baby.
Use NHS 111 for swelling around the ear, fluid discharge, very high temperature, significant illness, hearing loss or a young baby with symptoms.
Contact NHS 111Do not put oil, ear drops or cotton buds into a child's ear unless a clinician advises it.
Notice the pattern
What changes the next step.
Ear pain may come from the middle ear, ear canal, throat, teeth or pressure changes.
After a cold
Middle-ear infection often follows a cold and may cause fever, irritability, poor sleep or pulling at the ear.
Outer-ear pain
Pain after swimming, itch or tenderness when the outer ear is touched can suggest an ear-canal problem.
Discharge
Fluid, pus or blood from the ear needs assessment and changes which treatments are safe.
Hearing change
Temporary muffled hearing can follow infection; persistent or sudden hearing change needs review.
Babies may show ear pain through crying, feeding difficulty, poor sleep or irritability rather than pointing to the ear.
A focused GP assessment
Look in the ear before deciding on treatment.
A GP can examine the ear canal and eardrum, assess the throat and general health, and explain whether observation or treatment is appropriate.
Explore in-person GP care01
Review the illness.
Discuss duration, cold symptoms, fever, pain severity, discharge, swimming, injury, hearing and previous infections.
02
Examine both ears.
An otoscope helps distinguish middle-ear infection, outer-ear infection, wax, perforation and other causes.
03
Plan follow-up.
The child's age, examination and general condition guide pain relief, observation, antibiotics or referral.
A proportionate plan
Prioritise comfort and the examination findings.
Many uncomplicated middle-ear infections improve without antibiotics, but pain control and safety-netting remain important.
01
Pain relief
Use age-appropriate paracetamol or ibuprofen if suitable and follow the product instructions. Check with a pharmacist if unsure.
02
Observation when safe
If the child is otherwise well, the clinician may recommend monitoring because many infections improve within a few days.
03
Targeted treatment
Antibiotics or ear drops are used only for selected causes and ages. Discharge or a possible perforation affects which drops are safe.
Do not give paracetamol and ibuprofen at the same time unless advised, and do not insert cotton buds or objects into the ear.
Prepare for a useful review
Note pain, fever, discharge and hearing.
Record when pain began, which ear, highest temperature, cold symptoms, discharge, hearing change, swimming or injury and whether the child is feeding and sleeping.
Bring details of medicine already given, allergies, previous infections, grommets or ear surgery. An in-person appointment is usually most useful.
Explore GP appointments ↗Good to know
Questions about ear pain in children.
Practical answers to help you choose a sensible next step without trying to diagnose the concern yourself.
Do all childhood ear infections need antibiotics?
No. Many improve by themselves within a few days. Age, examination findings, severity and the child's general health guide whether antibiotics are appropriate.
When should the ear be examined?
Arrange review when pain is not starting to improve after three days, there is discharge or hearing change, infections recur, or the child is very young or unwell.
Can I put olive oil or drops in the ear?
Do not put oil, drops or cotton buds in a child's ear unless a clinician advises it, especially when discharge or a perforated eardrum is possible.
What does swelling behind the ear mean?
Swelling, redness or tenderness around or behind the ear needs urgent GP or NHS 111 assessment.
Clinical information: NHS children's ear infectionsNHS earacheNHS ear infections. This information is general and does not replace individual medical advice.