Earache is particularly nasty and common in children

Earache in children: a nasty torture; also in adults

Earache: One of the “top topics” in my everyday life as a pediatrician:

Do you know this: your child wakes up at night, cries and complains of earache? Or it is still so small that it can not talk about it, but it is repeated to the ear, is whining and maybe even has a fever? In this case, too, it is very likely that the child has earache.


Ear pain not only belongs to the “top topics” in my pediatrician everyday life, but from my point of view also to the nastiest pain ever. Especially infants are often affected. Why this is so and what you can do about it, you will learn in the following post.

Earache in children:

The reason for the increased frequency in infants is that their immune system is still immature and they are generally more susceptible to infections. Your immune system has yet to learn how to deal with germs (more information on the “susceptibility to infection” in infancy can be found here). On the other hand, the connection between the middle ear and the nasopharyngeal space, the so-called tuba eustachii or the ear trumpet, is still very short and wide, especially in toddlers.

This allows germs from the nasopharynx to ascend faster to the middle ear and lead to inflammation and swelling of the mucous membranes. Due to the mucous membrane swelling in the Eustachian tube, the important passage to the middle ear is narrowed, thus obstructing the “ventilation” of the normally filled with air cavity (= tympanic cavity) in the middle ear. As a result, where there should actually be air, accumulates more liquid and serves as a perfect breeding ground for the multiplication of germs. The result is initially a so-called. Paukenerguss.


The tympanic effusion may be acute in the course of an infection or chronic, e.g. at the so-called Adeno >

Otitis media = otitis media

This is usually an acute otitis media = AOM. However, there are also chronic middle ear infections, but these are much less common. They come, for example as a result of repeated inflammations before or due to a traumatic tympanic membrane rupture (for example after a blow on the ear or an explosion trauma).

Frequency otitis media

More than 80% of children develop middle ear infections during the first years of life. Most even more than once. Most affected are children between 6 months and 6 years.

Causes of otitis media:

  • virus

In most cases, middle ear infections occur during or after infections of the upper respiratory tract = colds. As mentioned in the article “Infections in Children” (see here), most of these infections are caused by viruses. Some viruses can directly cause an AOM, or favor the additional spread of bacteria = superinfection.

The most common pathogens of a bacterial AOM are pneumococci and Haemophilus influenzae. In rare cases, such as In some childhood diseases (measles), the pathogens can also reach the middle ear via the bloodstream and lead to so-called measles otitis.

Factors that favor the occurrence of middle ear infections:

  • enlarged throat almonds (= Adeno >An AOM, as already mentioned, is often preceded by a cold infection (cough, runny nose, etc.). Usually, the AOM begins with a pain-free “pressure or fullness” in the ear. Then it happens (often at night and at intervals):
  • piercing, pulsating pain in the ear
  • if necessary fever (more about “fever in children”: see here)
  • possibly a headache

Especially in babies and toddlers, however, an AOM often runs without the “classic” symptoms!

  • Babies are often whiny, sleep poorly, refuse to eat, or clam up to their ears.
  • Toddlers often project pain into the abdomen, so you do not immediately think of an AOM.

Complications of otitis media:

  • Tympanic rupture, which is more a consequence than a complication. When the inflammation and fluid accumulation causes increased pressure in the middle ear, tears may occasionally occur in the eardrum. In most cases, the pain subsides abruptly (because the painful pressure is eliminated) and there is a discharge of fluid (e.g., pus) from the affected ear and hearing loss. Most of the resulting hole is small and heals usually without consequences. If the defect is larger or if fluid is flowing out of the ear for a long time, a (ENT) doctor should be consulted. The possibility of an eardrum tear in the context of an AOM is, among other things, the reason why in case of earache without previous medical examination NO fluids (drops, “warm oil” (formerly a “home remedy“), etc.) should enter the ear canal!
  • chronic course
  • one-sided hearing impairment
  • Mastoiditis: Dreaded complication of otitis media, as a result of which the infection spreads to the mucous membrane of the mastoid process (mastoid process). Signs may include: aggravating earache, hearing loss, renewed fever, poor general condition, re-outflow from the ear, pain on pressure on the mastoid, protruding ear (due to swelling of the mastoid). The consequences of mastoiditis may u.U. be life-threatening, therefore children with corresponding abnormalities should immediately be presented to a pediatrician!

Diagnosis of otitis media:

The diagnosis is usually made clinically. That is, the doctor examines the ear with a corresponding lamp. He examines not only the eardrum, but also the external auditory canal. In addition, he provides (usually already at the beginning of the investigation) an overview of the general condition of the little patient and whether, in addition to other physical symptoms may also be evidence of any of the possible complications.

Therapy otitis media:

– Preventive measures against earache, tympanic ulcer, middle ear infections:

Healthy defenses, which you can achieve through a well-balanced diet, plenty of fluids, sufficient sleep and enough exercise in the fresh air, are the best way to prevent infections in general. You can find the ingredients for my grandma’s “All-Healing” tea and the effect of the medicinal plants it contains here. The story of my childhood and the special connection to my grandmother you can read here if interested.

Also important are:

  • adequate and complete vaccine protection
  • keep the ears warm / covered on cold and windy days
  • Pay attention to a free and unobstructed nasal breathing (especially at night)
  • may slightly raise the upper body during sleep (reduces the feeling of pressure in the ear)
  • no continuous use of pacifiers
  • no passive smoking
  • in case of suspected polyps (tendency to infection, nocturnal snoring, etc.) or a hearing impairment: presentation to the ENT specialist for further clarification

– good and cheap “home remedy” for earache:

  • Onion bag:

The onion is a true all-round talent and has an anti-inflammatory and antibacterial effect. For a corresponding bag, you can cut an onion and place it in the middle of a kitchen towel. Either you can then tie the ends together and put the bag on the affected ear (the child lies best on the side). You can also put the pieces of onion in a thinner cloth (gauze bandage or similar) and then “fix” it with a headband or scarf on the affected ear and let it work a little longer or overnight. If the child finds heat comfortable, you can warm the onion sack slightly first (for example on a warm heater). The only small disadvantage of the onion bag: the usually very effective essential oils of the onion are still smelling days later. &# 128578;

  • Heat (only if it is perceived as pleasant by the child):

e.g. warmed up grain pillow; with older children possibly also a red light lamp, however only under supervision!

– General measures at beg. Otitis media:

  • important: the child should not be in pain! It is therefore best to give a painkiller early on (for example with the active ingredient ibuprofen)
  • with simultaneous cold: decongestant nose drops over a limited period of time
  • in case of fever: antipyretic drugs with the active ingredient ibuprofen or paracetamol, further measures: see also article about “fever in children” here
  • if necessary after consultation with the pediatrician: VoWen-T-Tabletten® or Otovowen-Tropfen®: herbal remedy taken orally (via the mouth). More information can be found here

Most of the symptoms are already improved by these measures. On antibiotic therapy can often be dispensed with; especially since the triggering germs are often viruses (against which antibiotics are ineffective).

Special therapy for bacterial otitis media:

  • In the case of bacterial otitis media or very young children, the pediatrician will probably prescribe an antibiotic. If this is necessary, it is important to adhere to the dosing recommendations and observe the instructions on the package leaflet. It is also important to follow the recommended duration of therapy.
  • Many parents, afraid of possible side effects, tend to stop the antibiotic as soon as the first symptoms have improved. This is harmful in that even pathogens remain in the body and can lead to a renewed outbreak of the disease. In addition, the pathogens in the long term against certain antibiotics resistant, that is insensitive. This is an increasing problem in medicine today.
  • In case of otitis media with complications, especially mastoiditis, a rapid and special treatment (stationary) is essential.

For all: a lot of love and attention (best medicine ever)!

Do you and your children have to deal with ear pain now and then? What are your favorite home remedies? I look forward to your feedback in the comments.

Note: All medical contributions that I write on health topics on my blog are for informational purposes only. They in no way replace the doctor’s visit for health problems.

Stay healthy and well and get through the winter infectious time,

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Christina Cherry
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