When a bean sprout accidentally got into the ear of a thirteen-year-old Gitartha Agasti while playing, little did he know that this would lead to severe ear pain a month later. Neither did his mother, Malabika Kakati Barman, a homemaker from Assam. “The doctor prescribed an eardrop for three days which dislodged the bean sprout. After a follow-up with the doctor, my son recovered within a few days,” recalls Malabika.
Ear pain in children could be due to various reasons.
Causes of ear infection
Dr Gopal Wasgaonkar, a consultant pediatrician at Aster Aadhar Hospital, Kolhapur, on a call with Happiest Health, mentions the common factors that cause ear pain in children:
- Ear wax which might get blocked
- Foreign body insertion that causes trauma in the eardrum (tympanic membrane) resulting in its inflammation
- Viral upper respiratory tract infection: pathogens reach the ear and increase pressure in the eardrum leading to its inflammation
- Acute otitis media: inflammation of the middle ear caused by viral or bacterial pathogens
Dr Rao describes how viral infections cause acute otitis media. “The nose and the ears are connected through the eustachian tube. All the secretions from the ear will flow into the nose through this tube. But whenever there is an infection, the pathogens can enter this tube and infect the middle ear resulting in inflammation.”
He goes on to explain why inflammation of the middle ear causes pain. “In case of inflammation, the tissues tend to produce a lot of liquids (pus) behind the tympanic membrane or eardrum. The pus accumulation behind the eardrum tightens it. The bulging of the tympanic membrane or eardrum causes the pain,” he says.
Signs of ear infection
Dr Sameera S Rao, consultant pediatrician and neonatologist, Motherhood Hospitals, Bengaluru, says that the typical symptoms that characterise ear pain in children are:
- High-grade fever
- Not responding to oral paracetamol
- Pus formation in the ears
Signs in infants and toddlers
Dr Wasgaonkar says that it is difficult for infants and toddlers to articulate if they feel pain. “A clinical examination is recommended if your child has a fever or is unusually cranky. Both the ears are checked through the otoscope (an instrument used for checking the ear) to know if there is any pain or inflammatory signs in the ears,” he says.
Dr Rao adds, “One of the signs includes the associated symptoms which can be cough and cold with high-grade fever. This usually presents itself in very irritable babies who keep on touching or stretching their ears and crying loudly. The feed intake will decrease. Some kids can present with episodes of vomiting, inactivity and sleeplessness, which can appear in severe infections.”
Fluid in the ear
“Whenever there is fluid, pus accumulation or abscess anywhere in the body, it causes pain. When an ear infection is left untreated, it might lead to pus accumulation which causes the eardrums to tighten. This tightness is reduced when pus is discharged which relieves the pain. Visiting a pediatrician is important to detect such infections earlier and avoid pus formation,” says Dr Wasgaonkar.
Dr Rao reaffirms, “A child with an active discharge of pus from the ears is unlikely to have ear pain as pus discharge relieves that pain. Once the stretching of the eardrums comes down, the pain reduces.”
How foreign objects cause ear pain
Dr Rao explains, “There are three parts [of the ear] – the external ear (before the tympanic membrane or eardrum which can be seen with the naked eye), the middle ear (after the tympanic membrane) and the inner ear (controls the balance of the body). The skin of the passage or the drainage between the external ear and the tympanic membrane is very tight. It is stretched over the bones. So, if a kid inserts a foreign object, it causes local injury to the skin. This can cause pus formation and thus ear pain, as it’s a very narrow cavity.”
Dr Wasgaonkar says that analgesic eardrops are usually given to relieve the pain and reduce inflammation in mild cases where there is some local injury or aberration. “In cases where the ear pain is due to bacterial infections, antibiotics are also prescribed,” he says.
Takeaway: beware of ear drop usage
Dr Wasgaonkar stresses the importance of visiting a pediatrician in case of ear pain in children to avoid complications which might occur if left untreated. He further adds, “Unless and until the tympanic membrane is intact, it is important to not put any antibiotic eardrops. If eardrops are put locally when there is any perforation in the membrane, the eardrops can reach the middle ear and cause infection.”