Discuss as:

What parents need to know about earaches

Pediatricians often prescribe antibiotics for ear pain but bacterial infections aren't necessarily the culprit. Earaches can also be caused by viruses or allergies. NBC's Dr. Nancy Snyderman reports.

By Kristina Krohn, NBC News

Every parent worries about ear infections, often turning to the first line of defense: antibiotics. But according to new recommendations from the American Academy of Pediatrics (AAP) issued on Monday, doctors now say to hold off on the antibiotics for children older than six months.


"The goal is to improve the diagnosis and make sure that we preserve the healing power of antibiotics by using them judiciously in kids who benefit most. And conversely, giving kids who don't need them the opportunity to improve on their own," said Dr. Richard Rosenfeld a pediatric otolaryngologist at SUNY Downstate Medical Center. 

 

Ear infection symptoms are the main reason doctors prescribe antibiotics to children. While every parent wants their children to feel better as quickly as possible, the AAP stresses antibiotics may not be the answer.

According to the new guidelines, children over six months old with earaches should get antibiotics if:

  • They have a history of frequent ear infections
  • Their fever is higher than 102.2
  • Their pain lasts longer than two days
  • They have a bulging ear drum 

Without these symptoms, an earache is mostly likely caused by a virus, allergies, even teething. In these cases, it is safe to put off seeing the doctor and taking antibiotics.

In these cases, the AAP encourages doctors and families to watch the child closely for improvement for 48 to 72 hours before giving antibiotics. Parents should give a child pain relievers (acetaminophen or ibuprofen based on the child’s age -- never Aspirin). If symptoms gets worse parents should not hesitate to go to their doctor.

Dr. Richard Rosenfeld, a pediatric otolaryngologist at SUNY Downstate Medical Center, says other than the common cold ear infections are the number one reason parents take their children to pediatricians. He also said the bottom line for parents is be sure your doctor is making an accurate diagnosis before they treat an ear infection, and explore the opportunity for observation as well as talking about preventive strategies.

For children with multiple ear infections, tubes implanted in the ear can help drain fluid while also allowing air into the middle ear to ward off future infections. 

But what can parents do to prevent their children from getting ear infections in the first place?

  • Ensure children are up to date on their vaccines and get influenza and pneumococcal vaccines as soon as they are eligible
  • Exclusively breast feed up to six months of age
  • Avoid exposing children to tobacco smoke