One of the last things parents settling in for bed want to hear is the sound of their child crying from the pain of an earache. Nighttime earaches painful enough to awaken your peacefully sleeping child may not come frequently, but they're often severe when they do. Knowing the facts about nighttime earaches in children can help minimize your stress while maximizing your ability to help your child get through this common but painful experience.

Although causes vary, your child’s painful nighttime earaches most likely stem from a middle ear infection. According to Dr. Evet Benjamin, pediatrician and author of the book “Pediatric Answers,” earache-inducing middle ear infections are the most common infection in U.S. children, particularly infants and toddlers. These infections typically occur when fluid builds up in your child’s middle ear, often as a result of allergies or an illness, such as an upper respiratory infection. Lynn Marotz, a registered nurse and author of the book “Health, Safety, and Nutrition for the Young Child,” states that other possible causes of your child’s nightly earaches include teeth erupting, compacted earwax and foreign objects in the ear.

A child waking up with earaches often demonstrates extreme tearfulness as a result of the pain and discomfort from the pain. Uncontrollable crying--especially when in a reclining position, notes Marotz--and other signs of ear pain, such as irritability, fussiness and tugging or pulling at the ear are common during nighttime bouts with earaches. Other signs you might notice include hearing problems, ear discharge, redness of the external ear and a fever.

Although earache symptoms often seem serious, in most cases you shouldn’t need to rush your child to the emergency room during the middle of the night. Focus on minimizing your child’s pain enough to allow her to sleep restfully. According to Medline Plus Medical Encyclopedia, various home remedies include topical ear drops, such as body-temperature olive oil, lying in a slightly inclined position and over-the-counter pain relievers, such as acetaminophen or ibuprofen.

Dr. Robert H. Pantell, University of California-San Francisco Professor of Pediatrics and co-author of the book “Taking Care of Your Child,” notes that two common childhood immunizations--one protects against hemophilus influenza B and the other against pneumococcus--typically prevent most serious middle ear infections in U.S. children. Consider taking your child to your primary care doctor the day after the nighttime earache bout to verify the cause of the ear pain, especially if your child doesn’t seem to be better. Your child’s doctor will do a thorough physical exam and ask about the duration and severity of the symptoms. In certain cases, the doctor may prescribe antibiotics; make sure your child takes the medication for the required length of time to minimize future nighttime earaches.

If your child wakes up with a severe earache and suddenly stops complaining of pain, then she may have a ruptured eardrum, a potentially serious complication that could lead to loss of hearing. Never insert any liquids into your child’s affected ear if she may have a ruptured eardrum, as doing so could cause infections. Other signs of a perforated eardrum include drastically increasing ear pain, ear drainage and dizziness, notes Medline Plus.