All Ears

One of the more common childhood complaints we get in clinic has to do with ear pain. In fact, when I was little and dreamed about being a pediatrician, I always pictured myself treating children’s ear infections! That dream worked out pretty well for me!

Nicole Keller, D.O.

Nicole Keller, D.O.


At some point of your child’s life, there’s a good chance they too will complain of ear pain (medically known as “otalgia”). While middle/inner ear infections (otherwise known as “otitis media”) are the most commonly thought of problem causing ear pain, there are a lot of other things that could also be the culprit. Here’s some common ear ailments other than your typical ear infection that present to us and how you might be able to spot them…everyone, “all ears?”


  • Babies starting at age 4 to 6 months up until around 2 years old are getting their first set of teeth. Many times, the pressure and swelling from incoming teeth can be referred to the ears. You baby may be tugging on their ears a lot but not necessarily have a lot of other symptoms. This ear tugging may be solely from teething!


  • When we get a cold, or upper respiratory infection, congestion is one of the more common symptoms. Since our ears, nose, mouth and throat are all essentially connected, congestion in one area can lead to congestion in another. So if your child is fighting off a cold and feels pressure in their ears, it may be from congestion. This is similar to the pain/pressure you might feel when flying on an airplane. Incidentally, ear infections are also a common secondary infection during or after the tail end of a cold. So if that ear pressure or pain changes, gets worse, or is associated with fever, having your child seen to diagnose a possible secondary ear infection would be smart.

Swimmer’s earears

  • Swimmer’s ear is the common name for what we call “otitis externa” – an outer ear infection located in the ear canal. This type of ear pain tends to be seen after a child has been swimming a lot or has been exposed to water more than usual. Usually water that gets in the outer ear canal (when showering or bathing for example) dries on its own and doesn’t cause much problem. When there is excess water in the outer ear canal, that extra dampness sticks around and makes a great environment for bacteria to grow. This can create an outer ear infection. This type of infection usually presents with pain when moving the external ear (the pinna), sleeping on the ear or other movement that involves the outer ear canal. This infection does usually require an antibiotic ear drop and should be evaluated and treated by your child’s doctor. There is an over the counter product that helps dry out the outer ear canal and can be used in children doing a lot of swimming. Make sure to check with your doctor to make sure it is alright to use – it should not be used if your child has had ear tubes placed, for example.

Foreign body

  • Believe it or not, I’ve found some odd things in ears…beads and Barbie shoes are a couple of my funniest finds. If your child is complaining of ear pain without any other symptoms, a foreign body is a possibility. You want to make sure to have your child seen by their doctor right away if you suspect an object might have been placed in the ear. Removal of that object is necessary to prevent further trauma.

Excess ear wax

  • Occasionally ear pain or pressure can be caused by excess ear wax (medically known as “cerumen”) occluding the ear canal. Many times this is accompanied by a complaint of hearing changes as well. While it might seem smart to try and clean the ear canal yourself, it is never smart to use cotton swabs (or “q-tips”) in the inner ear. All this does is push ear wax further in the canal making it more likely to get clogged and increasing your chances of traumatizing the ear canal or ear drum. This complaint should be evaluated by a medical team for possible ear flushing to dislodge excess ear wax. You can also use an over the counter product called “Debrox” to help soften the ear wax and help it come out easier on its own or during a flushing.

Lastly, a word on ear cleaning. Many parents will ask how often or how to clean their child’s ear. I usually tell people that the ear is like a self-cleaning oven – there really isn’t a lot you need to do.  Have your child wipe clean the outer ear with cotton balls or washcloths on a regular basis during baths/showers. The ear canal itself doesn’t need regular cleaning and should be dried with a washcloth, externally only, after bathing. Ear wax is produced as a protective coating for the ear and should typically be left alone – the old saying, “you should never stick anything smaller than your elbow in your ear” is pretty true! The more you try to take out ear wax, the more the body produces which can lead to a cycle of excess ear wax production and further problems. Let water run in and out of the ear during baths to flush out lose/dislodged particles and leave the rest to your body to push out when it is ready.

As always, if you aren’t sure what your child’s ear tugging, pain or pressure is caused by, give your doctor’s office a call. We’ll always be happy to take a look in the ears and answer any questions you might have. Thanks for reading!


The Scoop on Poop

Before you became a parent, you probably never thought that you would fixate on the quality of another individual’s poop. Yet, here you are: My child’s poop is blue. My baby has loose, like diarrhea, poops. My toddler is passing poop that looks like balls. Is this ok? A newborn’s poop is called “meconium”: it […]

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Vrinda Kumar, M.D.

Vrinda Kumar, M.D.

Teething: Can you handle the tooth?

The teething process generally begins between four to eight months of age.  Some babies will start earlier, and some babies won’t get their first tooth until after a year old. Usually (but not always), the two bottom middle teeth come first, then the two upper middle teeth, then the teeth to the side of those, and then finally the teeth in the back. By the age of two, most kids will have all 20 of their baby teeth!

It is normal for the teeth to not come in straight, and it is normal for those first few teeth to have wide gaps in between them.  Don’t worry!  They usually straighten themselves out as the other teeth start coming in.

Symptoms of teething:

  • drooling
  • gum swelling/redness
  • fussiness
  • difficulty sleeping
  • solid food aversion
  • biting and chewing everything in sight!

Some babies may also have:

  • low grade fevers (<101 degrees F)
  • loose stools (they can be green and slimy from all that extra drool making its way through the gut)
  • diaper rash (from all those loose stools)
  • ear pain (it is normal for teething babies to pull on their ears because in babies, tooth pain is felt in the ears)

If your child has high fevers >101 F, signs of dehydration (not a lot of wet diapers, not a lot of drooling, no tears when crying), or other symptoms that are persistent, you should call your doctor.

Things you can try to help your teething baby deal with the pain:

  • give your child something clean and safe to chew on (firm teething toys or a cold clean washcloth, for example)
  • try giving your baby cold foods if he/she is eating solidsteething
  • Orajel naturals (The active ingredient Benzocaine in regular Orajel has some rare but serious side effects: the benzocaine, if swallowed, can numb a child’s airway cause them to potentially choke on their saliva, and it can also affect the hemoglobin in your child’s red blood cells, a condition called methemoglobinemia)
  • teething tablets and teething gels are available, and are generally safe if used as directed
  • for those nights where nothing else seems to help, an occasional dose of Tylenol

Teething necklaces with amber beads are available as alternative to medication. Even though some parents say they work, it makes me very nervous to have a choking hazard hanging around a child’s neck, and I do not generally recommend it.

I hope this helps. And remember your child won’t teethe forever, so hang in there!

Dispelling Vaccine Myths

As pediatricians, one of the common topics of discussion we face is in regards to vaccinations. As a group, Dr. Ababio, Dr. Kumar, Dr. Alessia, Dr. Granoff and I whole-heartedly believe in the necessity, safety and effectiveness of vaccines. We want you as parents to have reliable, scientific, unbiased and ACCURATE information about how to […]

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