Have you ever seen your child crying and tugging at his ears? Or a trail of yellow coloured, dried discharge outside his ear canal with eczematous skin?

Hearing is vital for speech and language development in children, and severe ear infections can cause permanent damage to the ears if not treated.

child with ear pain

Symptom #1: Blocked ears or hearing loss

Ear wax

The most common cause of blocked ears is accumulation of ear wax. This is aggravated by the practice of using cotton buds and other instruments in a futile attempt to remove the ear wax. It is not advisable to insert any instrument into the ear canals as one can either cause abrasions and infection of the ear. For ear wax removal, you should bring your child to see your family doctor or ENT specialist. ENT specialist clinics have a microscope and special micro instruments to remove wax under direct vision safely.

Middle Ear Infection

An infection of the middle ear is also known as otitis media. It is often by infections of the upper respiratory system or allergies. In the acute phase, the symptoms of otitis media include fever and ear pain. In the chronic phase, which is painless, the only symptom may be that of ear block or muffled hearing, due to fluid accumulation behind the ear drum. If your child is very young, he may be unable to express the loss of hearing, but you may notice that he isn’t as responsive to conversations.

Your family doctor or ENT specialist will have to examine your child’s ears to make a diagnosis of middle ear infection. Hearing screening may also need to be done to confirm the diagnosis and plan treatment.

Treatment generally involves a course of antibiotics. Should the fluid in the middle ear persist despite treatment, the ENT specialist may have to insert a tiny tube (grommet tube) into the ear drum to allow the fluid to drain out, so that your child can hear and speak better.

Symptom #2: Ear pain and discharge

External ear infection

The most common cause of acute ear pain and discharge is an infection of the external ear, commonly known as swimmer’s ear. It can be caused by water that remains in the ear after swimming, creating a moist environment that encourages bacterial growth. Ear picking with fingers, cotton buds and other instruments can also lead to infections.
Treatment involves suctioning of the debris and bacteria from the ear canal with the aid of a microscope, as well as a course of oral or topical antibiotics. Severe infections may require several weeks before resolution.

There are symptoms not be localized to the ear that may also indicate ear infections in children, especially in babies or toddlers.

  • Symptoms of a cold or the flu: ear infections are frequently associated with respiratory infections.
  • Fussiness during the day or night
  • Waking at night
  • Fever: usually low grade

Dr Valerie Tay’s tips for healthy ears and hearing:

a. Avoid using cotton buds or other instruments to clear ear wax. Ear wax migrates out from the ear canal naturally. Using cotton buds interrupts this natural migration process, and may cause impaction of the wax and infection.

b. Keep your ears dry. Special ear plugs can be used when swimming. Dry your ears thoroughly after exposure to moisture from swimming or bathing. You can dry your child’s ears with a hair dryer on the lowest setting and hold it about 20cm away from the ear.

c. After an ear infection or surgery, check with your doctor before your child resumes swimming again.

d. Avoid exposure to loud music. Concerts and musicals can cause damage to children’s hearing, so if it is necessary for your child to attend these events, consider covering your child’s ears with an ear plug. If your child is older and often uses a portable music player with earphones, counsel him about adjusting the maximum volume. Researchers at the Boston Children’s Hospital determined that listening to a portable music player with headphones at 60 percent of their potential volume for one hour a day is relatively safe.

Dr Valerie Tay is an Ear Nose & Throat Specialist of SMG ENT Centre, a subsidiary of Singapore Medical Group who believes that health is a way of life.