Toddler Ear Pain No Fever – When babies complain about ear pain, parents worry. They often want to know the cause and how to relieve any suffering. Ear pain is one of the most common causes of children’s hospital visits. There are different causes of ear pain such as a sore throat, teething, blocked Eustachian tubes or an ear infection. To pinpoint the cause of a toddler’s ear pain, knowledge of some common causes can be helpful.

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What Causes Ear Pain in ChildrenWhat Causes Ear Pain In Children?

Scientists are working hard to learn more about illnesses that affect the ears as they can impact language development. Studies have found that Native American and Hispanic children have more infections than other ethnic groups [1].
It is common for young children to experience different types of ear problems with pain ranging from mild to severe. Parents may want to consider the following:

Acute otitis media

This ear infection involves the Eustachian tube. The Eustachian tube connects the middle ear to the back of the nose. With a middle ear infection, this tube gets blocked with fluids pooling in the middle ear space. Bacteria or viruses may grow in the stagnant pool of liquid, triggering an infection and subsequent pain.

Acute otitis media is an infection that frequently appears during or after a viral upper respiratory infection. Pus may form behind the eardrum, increasing the pain and pressure. Pain and fever are common symptoms of this infection. Young children that cannot yet verbalize pain may rub their ears.

Otitis media with effusion

This can occur once an ear infection has already run its course, but fluid remains behind the eardrum. Children with this condition may not show signs or symptoms of this infection, but a doctor can easily see the fluid pooling using a special instrument.

Chronic otitis media

Compared to acute otitis media, chronic otitis media is milder [2]. This ear infection occurs when the eustachian tube is not draining correctly and causes inflammation. Fluid tends to build up behind the eardrum. This kind of ear infection is treated with antibiotics. However, scientists are finding more of these infections resistant to antibiotics [3].

Sometimes the infection is alleviated, but the fluid is still present in the middle ear. Temporary hearing loss may occur while the fluid remains in the middle ear. It is rare, but when acute otitis media is not treated, hearing loss may become permanent.

Otitis externa

This type of ear infection occurs when there is an inflammation or infection in the ear canal which is located between the outer ear and the eardrum. Another term for this is “swimmer’s ear.” This can occur when there is an overzealous cleaning of the ear or exposure to dirty water. Ear drops that contain steroids and antibiotics may be recommended especially when the cause is a bacterial infection.

Serous otitis media

Also referred to as “glue ear”, children between six months to two years are more at risk of this ear infection. This condition can develop after the occurrence of a middle ear infection where there is a build up of pus and fluid in the middle ear.

Temporomandibular joint disorders (TMJ)

Ear pain may also be caused by joint disorders. These problems typically occur in the hinge that connects the jaw to the skull. Symptoms of TMJ that children may exhibit include headache, facial pain, jaw pain, pain when opening the mouth or when chewing. It is most common in children over ten. This condition does not cause a fever [4].
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Signs and Symptoms of Ear Infection
Signs And Symptoms Of Ear Infection

An ear infection in children is often caused by bacteria and usually begins with a cold, sore throat or upper respiratory infection. Sometimes, a virus or bacterial infection may spread to the middle ear. The earache that begins in the middle ear acts as a secondary infection.
There are certain symptoms which can help determine whether a toddler is suffering from an ear infection. Older children may be able to help by describing the pain. This aids the pediatrician in assessing the problem. These symptoms may appear:

  • Constant crying and fussiness
  • Fluid draining from the ear
  • Pulling or tugging at the ear or ears
  • Difficulty sleeping
  • Cannot respond quickly or slow to respond with quiet sounds
  • Difficulty balancing when walking or clumsiness
  • Fever in infants and young children
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Toddler Ear Pain No Fever
Treatments For Toddler Ear Pain No Fever

If an earache pain is mild and there is no fever present, monitor the affected child for two days. Meanwhile, these treatments may help ease the earache:

Elevate the head

Keep a child’s head slightly elevated when lying down as this will encourage drainage and may reduce the earache.

Use pain relievers

Check with a doctor before giving child ibuprofen or any other pain reliever so the correct type and dosage are used.

Try a warm compress

Another treatment that can help alleviate the symptoms of earaches and lessen the discomfort is a warm compress applied to the affected ear for about 20 minutes. Make sure that the compress is warm and not hot. Too much heat can worsen the inflammation in the ear canal.
Visit a pediatrician. If the earache is present for more than a week, schedule an appointment with the doctor to discuss possible treatments.

Tips on how to prevent toddler ear pain

Around 90% of children experience ear pain or otitis media before they enter school age with around 30% to 40% of them having recurrent ear infections [5]. Aside from the treatments mentioned above, there are some steps to help prevent the onset of ear infections.


Babies who were breastfed were less likely to develop ear infections compared to those who were formula-fed [6]. This was because the babies were feeding at an angle. A baby’s head should be at a 45-degree upright angle when feeding. This prevents milk from going back up the throat which can infect the underdeveloped eustachian tube.

Boost immunity

Proper nutrition is required for a baby’s immune system to function correctly. This includes good quality fats, protein, veggies, plenty of vitamins and minerals. Feeding children can be quite a challenge. Many are picky eaters or prefer sugary foods with empty calories. Ensure that a child’s diet is packed with nutrients.

Treat the cold

Since bacterial and viral infections can contribute to the development of ear pain, treat any colds as soon as the symptoms appear. If there is nose congestion, ask a doctor about using saline nose drops to clear the nasal passages. This helps to prevent the buildup of fluid behind the eardrum. Bolster a child’s immunity by providing supplements as long as a pediatrician agrees.

Skip the dairy and juice

Wean a child away from dairy and juice as these create a higher risk of ear infections. Dairy and juice can cause more mucus to develop in the upper respiratory system. The sugar that is present in these drinks may affect a child’s immune function. This can cause congestion in the ears and chest which can lead to ear problems.

Avoid exposure to smoke

Another way to prevent ear pain in toddlers is to minimize their exposure to tobacco and wood smoke. Even smoke residue clinging on clothes can put a child at risk for ear infections since the immune system is still underdeveloped. Wood smoke, when inhaled, can also trigger upper respiratory infections in young children [7].

Parents and pediatricians can work together to find the best treatment. The effects of recurrent ear infections cannot be underestimated as they impact a child’s speech and development.

Scientists are evaluating drugs that are currently used to treat ear infections and trying to develop more effective medications and easier ways to administer medications. In fact, one team is working on how to administer a possible vaccine without a needle [8].

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Toddler Ear Pain No Fever Resources

[1]   The National Institute on Deafness and Other Communication Disorders; Ear Infections in Children, May 12, 2017.
[2]   WebMD Medical Reference; Understanding Ear Infection Symptoms, Brennan Dan, March 23, 2019.
[3]   National Institute of Deafness and Other Communications Disorders; Ear Infections in Children, May 12, 2017.
[4]   National Institute of Deafness and Other Communications Disorders; Ear Infections in Children, May 12, 2017.
[5]   Seattle Children’s Hospital Research Foundation; Earache, Schmitt Pediatric Guidelines LLC, March 14th,2019.
[6]   US National Library of Medicine; Ear infections, Paediatr Child Health, September 14, 2009.
[7]   WebMD Medical Reference; Understanding Ear Infection — Symptoms,  Dan Brennan, MD, March 23, 2019.
[8]  National Institute of Deafness and Other Communications Disorders; Ear Infections in Children, May 12, 2017.

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