Earache

  • Lots of children get earache and often this is with a temperature. It is usually due to a viral infection and so your child may also have a runny nose, cough or sore throat. Other people in your house may have similar symptoms viral infections spread very quickly.
  • If a number of people are unwell in the same household, this also suggests a viral infection (because viral infections are easily spread)
  • Viruses don’t need antibiotics as they get better on their own.

  • Antibiotics may cause side effects such as rash and diarrhoea antibiotic resistance. The more antibiotics we use, the more chance of antibiotic resistance

 

When should you worry?

If your child has any of the following:

  • Droopping of face on one side
  • Breathing very fast or breathing that stops or pauses
  • Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
  • Becomes pale, blue, mottled and/or unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched, continuous cry or extremely agitated
  • Has a fit (seizure)
  • A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months
  • Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Has pus coming out of their ear
  • Develops swelling, pain, redness behind the ear
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips, tongue or looking pale
  • Not had a wee or wet nappy in last 12 hours
  • Sleepy or not responding normally
  • Crying and unsettled
  • Poor feeding (babies) or not drinking (children)
  • A temperature 39oC or above in babies 3-6 months
  • Temperature of 38oC or above for more than 5 days or shivering with fever(rigors)
  • Getting worse or you are worried about them
  • Temperature over 38oC for more than 5 days or shivering with fever (rigors)

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that during the current COVID-19 crisis, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest Emergency Department

If your child has none of the above:

 

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.

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Treatment
  • Most children with earache do not require treatment with antibiotics. Antibiotics rarely speed up recovery and often cause side effects such as rash and diarrhoea. They will also promote the development of antibiotic resistant bacteria in your child.

Antibiotics are usually only considered if your child:

  • Is under 6 months of age and has otitis media (a middle ear infection)
  • Is between 6 months and 2 years of age with infection in both ears, or significant systemic features, fever and overwhelming misery
  • Has pus draining from their ear
  • Has a serious health condition that makes them more vulnerable to serious infection
  • Complications of a bacterial infection such as spread to another part of the body

If your child has any features of severe infection (amber or red features above), they will need to be urgently assessed by a healthcare professional

You can help relieve symptoms by:

  • Giving your child paracetamol or ibuprofen to help relieve pain (always follow the instructions for the correct dosage)
  • Encouraging your child to drink plenty of fluids

How long will your child’s symptoms last?

  • The chart below shows how long earaches take to get better in children. The faces represent 10 children who have seen their GP with an earache. Green faces are those children whose earache has got better within that time period
  • After a week, more than three-quarters of those with earache will be better whether they take antibiotics or not. Most (14 out of 15) who take antibiotics will get better just as quickly as if they hadn’t taken them

The diagrams above are taken from www.whenshouldiworry.com

 

Prevention

It is not possible to prevent ear infections; however, you can do things that may reduce your child’s chances of developing the condition.

  • Avoid cleaning your child’s ears with cotton buds – this may damage and irritate the ear canal and pushes wax further into the ear. Wax is designed to come out by itself
  • Try not to let soap or shampoo get into your child’s ear canal
  • Try to keep your child’s ears dry; if water gets in, tip it out as soon as possible. However, this can be extremely challenging in young children!
  • Ensure your child is up-to-date with their immunisations
  • Avoid exposing your child to smoky environments (passive smoking)

Where should you seek help?

  • If it is non-urgent, speak to your local pharmacist or health visitor.
  • Follow the advice in the red, amber and green boxes above

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Click below to find information on your local health visiting team: 

North Cumbria

Northumberland

North Tyneside

Newcastle

Gateshead

South Tyneside

Sunderland

County Durham

Darlington

Hartlepool

Stockton

Middlesbrough

Redcar and Cleveland

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

What the school nursing service deliver may vary depending on your local area offer. Click the link below to find information on your local school nursing team: 

North Cumbria

Northumberland

North Tyneside

Newcastle

Gateshead

South Tyneside

Sunderland

County Durham

Darlington

Hartlepool

Stockton

Middlesbrough

Redcar and Cleveland

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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