There are many causes of ear pain in the middle of the night in children, and prompt emergency medical attention is usually recommended. However, if the pain is mild and there are no other uncomfortable symptoms, you may not need to go to the emergency room immediately. Common causes of ear pain in children include acute inflammation of the external ear canal, middle ear, or eardrum, or neuropathic ear pain caused by parents or children using cotton swabs or ear scoops to damage the external ear canal or eardrum, as well as tonsillitis, pharyngitis, or auricular herpes zoster. If the symptoms are mild and there is no other obvious discomfort, or if the skin of the ear is only red and swollen, there is no need to worry too much and the child does not need to seek immediate emergency medical attention, but can be seen in a pediatric clinic after resting. Children may put small food or toys in their ears while playing, or small insects may get into their ears, which can also cause earache. If the foreign body is difficult to remove on its own, it may also require emergency medical attention.