It is possibly one of the harder things for parents to identify especially in children who are too young to speak. It is also very painful and will give children and adults alike sleeplessness if it is not diagnosed and treated. The most common sign of an ear infection in children are:

· Ear pain
· Fever
· Fussiness
· Increased crying
· Irritability

Many children will have temporary and minor hearing loss during, and right after, an ear infection. Permanent hearing loss is rare, but the risk increases with the number of infections. As I said if a child is too young to say what is wrong, look out for a reddened ear or the baby continually putting a hand to its ear.

Ear pain in children can often be caused by a buildup of fluid and pressure behind the eardrum, in the area called the middle ear. The middle ear is connected to the nasal passages by a short narrow tube, the Eustachian tube. The Eustachian tube allows normal fluids to drain out of the middle ear, and helps keep the pressure in your ear equalised.

A cold or allergy can block the Eustachian tube due to inflammation and the buildup of secretions. This is especially likely in small children, because their Eustachian tube is shorter and more horizontal. Closing of the Eustachian tube prevents the normal flow of fluid from the middle ear. The fluid begins to build up, which can cause stuffiness, pain, hearing loss, and an ear infection.

Ear pain in adults is less likely to be from an ear infection. What you feel as ear pain may actually be coming from another location, such as your temperamental joint, your teeth, throat, or other location. This is called "referred" pain.

Ear pain in a child or infant is not always from infection, however. Other causes might include ear canal irritation from cotton-tipped swabs, soap or shampoo staying in the ear or water from bathing
At home the following steps may help an earache:
A cold pack or cold wet wash cloth applied to the outer ear for 20 minutes may reduce pain.
For children old enough to safely chew gum, chewing may help relieve the pain and pressure of an ear infection.
If a child is uncomfortable lying down, resting in an upright position can help reduce pressure in the middle ear.
Olive oil or over-the-counter ear drops are gentle and effective, as long as the eardrum has not ruptured. Prescription drops, such as Auralgan, are also effective for pain relief.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can provide relief for children and adults with an earache. (Remember thought, do NOT give aspirin to children.)

These are some of the causes of earache:

Arthritis of the jaw
Ear infection
Middle ear infection - acute (short and severe episode)
Middle ear infection - chronic (does not go away or recurs)
Outer ear (canal) infection - acute
Outer ear (canal) infection - chronic
Outer ear (canal) infection - malignant
Ear injury from pressure changes (from high altitudes and other causes)
Object stuck in the ear or severely impacted ear wax
Ruptured or perforated eardrum
Sinus infection
Sore throat with referred pain to the ears
Temporomandibular joint syndrome (TMJ)
Tooth infection

Unless you know for sure though, do not assume that you know what the ear ache is caused by, see the Doctor for a proper diagnosis.

If the ear pain is because you are flaying, you can relieve ear pain caused by rapidly descending from high altitudes by swallowing or chewing gum. Allowing infants to suck on a bottle while the plane is descending can help.

If your child has any of the following you should not delay in calling your doctor!

Your child has a high fever or severe pain or seems sicker than is usual for an ear infection
Any new symptoms appear, especially:
Dizziness
Severe headache
Swelling around the ear
Weakness of the face muscles
Severe pain suddenly stops; this may be a sign of a ruptured eardrum
Symptoms (pain, fever, or irritability) get worse or do not improve within 24 - 48 hours