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If you’ve had a child with an earache, you know how awful it is—the crying, ear pulling, fluid drainage and fever. Almost all kids have at least one painful ear infection by age 5, according to the American Academy of Otolaryngology (AAO). Symptoms usually come on rapidly with one or both ears affected.

Typically, an ear infection occurs right after your child’s been sick with a cold, the flu or allergies. These conditions cause the nose, throat and Eustachian tubes (they run from the middle ear to the back of the throat) to get congested and swollen. If the Eustachian tubes are blocked, fluid backs up in the middle ear, which then may become infected and cause inflammation and pain, says the Mayo Clinic.

Most ear infections improve in a few days on their own and clear up within a week or two without treatment, but always call your pediatrician. For some kids, such as babies younger than 6 months or with severe cases, your doctor may prescribe antibiotics right away. On the other hand, don’t be surprised if the doctor suggests a wait-and-see approach for children older than 6 months. Studies show many kids are at the same place 10 days out regardless of treatment, according to the American Academy of Pediatrics.

In the meantime, your child doesn’t have to suffer. Ask your pediatrician about prescription numbing drops or over-the-counter pain medication to help your little one feel better as she heals. Applying warm, damp compresses to the ear may also relieve pain.

WHEN IT’S SOMETHING MORE

Sometimes ear infections are more concerning: Chronic infections or recurrent episodes of fluid in the ear may cause issues with balance, speech, hearing and learning.

For a child who’s always battling an ear infection, has an infection that lasts for months or has hearing loss due to fluid in the middle ear, ear tubes are an option, says the AAO.

During this outpatient surgery, an ENT (ear, nose and throat specialist) places tiny cylinders through the ear drum to allow air into the middle ear. The average age of kids who undergo the procedure is 1 to 3 years old. More than half a million ear tube surgeries are done each year, making it the most common childhood surgery performed with anesthesia, says the AAO.

While ear tubes reduce the risk of ear infections and restore hearing loss caused by middle ear fluid, they don’t prevent all ear infections. Typically, infections that do occur are less frequent and don’t involve hearing loss (because the fluid can drain). If your child suffers from frequent infections, ask your pediatrician to refer you to an ENT.