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It is not uncommon for infants and toddlers to experience fluid in the middle ear or ear infections at some point during their early years. The immature structure of a baby or toddler’s ear can make it more difficult for fluid to drain from the middle ear. This fluid does not always become the source of an actual infection, so the fluid can remain in the middle ear without causing the typical symptoms of an infection. Children first learn to speak by hearing, and the first three years of life are crucial to their language development skills. Ear infections in childhood are often more easily recognized and therefore more quickly treated, reducing long-term consequences on hearing and speech development. The first step is to have your child’s hearing tested and ears examined if you suspect fluid in the ear or another cause of hearing loss might be the cause of your child’s speech delays. Once the hearing issues have been diagnosed, work with your pediatrician to see what kinds of speech therapies can be helpful for your child. The runny nose started about a week ago and there was a little bit of fever, including one day that I did take off work to let him rest from preschool. An ear infection is caused by fluid build up, usually as a result of a recent cold or upper respiratory infection.
Kids have shorter eustachian tubes that are more prone to blockage, plus larger adenoids and tonsils that help aid in the blockage. If the parents had ear infections as kids, it is likely the child will suffer from them as well.
While the cold that caused the ear infection is easily passed, the ear infection is not contagious.
Kids will often rub or pull on their ears because it hurts or they can't hear as well as usual. Ear infections can really hurt, so if your toddler seems overly cranky for no reason, it might be time to get her ears looked at by a doctor. Laying down puts pressure on the ears and it's painful, so your toddler may fight sleep or say "owww!" when she lays down. Chewing and swallowing can put a lot of pressure on the ears, so you may notice a refusal of foods. Some kiddos show zero symptoms of ear infections, so don't feel bad if you don't notice it.
A doctor will look in your toddler's ears to check for inflammation and reaction of the ear drum to sound and air. Talk to your doctor first, but ours suggested that we could alternate Tylenol and Motrin to alleviate the pain in our son's ears. If the infection isn't severe and looks like it may clear up on it's own or that it may be caused by a virus, the doctor may suggest a waiting period of a few days. Use a Facebook account to add a comment, subject to Facebook's Terms of Service and Privacy Policy. May 21, 2012 By ParentSavvy Your child is pulling on his ear, fussy and having trouble sleeping – could it be caused by an ear infection? A normally happy child has suddenly become irritable, moody, or has more tantrums than usual. Painful ear infections are a rite of passage for children—by the age of five, nearly every child has experienced at least one episode. Ear tubes are tiny cylinders placed through the ear drum (tympanic membrane) to allow air into the middle ear. These tubes can be made out of plastic, metal, or Teflon and may have a coating intended to reduce the possibility of infection. Ear tubes are often recommended when a person experiences repeated middle ear infection (acute otitis media) or has hearing loss caused by the persistent presence of middle ear fluid (otitis media with effusion).
Each year, more than half a million ear tube surgeries are performed on children, making it the most common childhood surgery performed with anesthesia. Sometimes the otolaryngologist will recommend removal of the adenoid tissue (lymph tissue located in the upper airway behind the nose) when ear tubes are placed.
After surgery, the patient is monitored in the recovery room and will usually go home within an hour if no complications occur. Hearing loss caused by the presence of middle ear fluid is immediately resolved by surgery. The otolaryngologist will provide specific postoperative instructions, including when to seek immediate attention and to set follow-up appointments. To avoid the possibility of bacteria entering the middle ear through the ventilation tube, physicians may recommend keeping ears dry by using ear plugs or other water-tight devices during bathing, swimming, and water activities. Consultation with an otolaryngologist (ear, nose, and throat specialist) may be warranted if you or your child has experienced repeated or severe ear infections, ear infections that are not resolved with antibiotics, hearing loss due to fluid in the middle ear, barotrauma, or have an anatomic abnormality that inhibits drainage of the middle ear. Myringotomy with insertion of ear tubes is an extremely common and safe procedure with minimal complications.
Perforation—This can happen when a tube comes out or a long-term tube is removed and the hole in the tympanic membrane (ear drum) does not close.


Scarring—Any irritation of the ear drum (recurrent ear infections), including repeated insertion of ear tubes, can cause scarring called tympanosclerosis or myringosclerosis.
Ear tubes come out too early or stay in too long—If an ear tube expels from the ear drum too soon (which is unpredictable), fluid may return and repeat surgery may be needed.
Just as with all other aspects of human biology, there is a broad range of Eustachian tube function in children- some children get lots of ear infections, some get none.
Allergies are common in children, but there is not much evidence to suggest that they are a cause of either ear infections or middle ear fluid. Ear infections are not contagious, but are often associated with upper respiratory tract infections (such as colds). Acute otitis media (middle ear infection) means that the space behind the eardrum - the middle ear - is full of infected fluid (pus). Any time the ear is filled with fluid (infected or clean), there will be a temporary hearing loss.
The poor ventilation of the middle ear by the immature Eustachian tube can cause fluid to accumulate behind the eardrum, as described above.
Ear wax (cerumen) is a normal bodily secretion, which protects the ear canal skin from infections like swimmer's ear.
Ear wax rarely causes hearing loss by itself, especially if it has not been packed in with a cotton tipped applicator. In the past, one approach to recurrent ear infections was prophylactic (preventative) antibiotics. For children who have more than 5 or 6 ear infections in a year, many ENT doctors recommend placement of ear tubes (see below) to reduce the need for antibiotics, and prevent the temporary hearing loss and ear pain that goes along with infections. For children who have persistent middle ear fluid for more than a few months, most ENT doctors will recommend ear tubes (see below).
It is important to remember that the tube does not "fix" the underlying problem (immature Eustachian tube function and poor ear ventilation). Adenoidectomy adds a small amount of time and risk to the surgery, and like all operations, should not be done unless there is a good reason. In this case, though, the ventilation tube serves to drain the infected fluid out of the ear. The most common problem after tube placement is persistent drainage of liquid from the ear. In rare cases, the hole in the eardrum will not close as expected after the tube comes out (persistent perforation).
I see my patients with tubes around 3 weeks after surgery, and then every three months until the tubes fall out and the ears are fully healed and healthy. If a child has a draining ear for more than 3-4 days, I ask that he or she be brought into the office for an examination. Once the tube is out and the hole in the eardrum has closed, the child is once again dependant on his or her own natural ear ventilation to prevent ear infections and the accumulation of fluid.
About 10-15% of children will need a second set of tubes, and a smaller number will need a third set. Children who have ear tubes in place and who swim more than a foot or so under water should wear ear plugs. Deep diving (more than 3-4 feet underwater) should not be done even with ear plugs while pressure equalizing tubes are in place.
However, long-term ear infections or fluid in the middle ear that may go untreated can cause speech delays that may require some form of speech therapy. Sometimes this fluid becomes infected, by either a virus or bacteria, and causes the tell-tale signs of a childhood ear infection: crying, pulling at the ears, general fussiness, fever, and difficulty sleeping. The signs of fluid in the middle ear can be as subtle as a slight loss of balance and changes in eating habits to hearing and speech related symptoms. During these years they are hearing sounds modeled for them, and while they might not be speaking in complete sentences, they are learning how to form the sounds needed for fluent speech. You wouldn’t be the first parent, however, to not recognize the signs of uninfected fluid in the middle ear. Some children with poorly formed or matured ear structures benefit from having tiny tubes placed in their ears to drain the fluid. Some children who miss that critical window of speech development because they had temporary hearing loss benefit tremendously from working with an SLP to get caught up with developmental milestones. But since I’ve never had an ear infection myself, I simply did not know what to look for. I have never had one in my life, so it's not surprising that it took my son 3.5 years to develop an ear infection even though he's in daycare.
If you have concerns over the number of infections, please don't hesitate to ask your doctor about any further measures that can be taken.
Sometimes the only way to tell if a child has an infection is to have the child examined by a physician. Most ear infections either resolve on their own (viral) or are effectively treated by antibiotics (bacterial).


They also may be called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. These conditions most commonly occur in children, but can also be present in teens and adults and can lead to speech and balance problems, hearing loss, or changes in the structure of the ear drum.
Sometimes children can hear so much better that they complain that normal sounds seem too loud. However, recent research suggests that protecting the ear may not be necessary, except when diving or engaging in water activities in unclean water such as lakes and rivers.
The hole can be patched through a minor surgical procedure called a tympanoplasty or myringoplasty.
Ear tubes that remain too long may result in perforation or may require removal by an otolaryngologist. Whether or not your child requires antibiotics to treat the ear infection depends on the source of the infection and your pediatrician’s recommendations. Because fluid in the middle ear that is not infected often causes no pain in children, the condition can go left undiagnosed and untreated for a long period of time, increasing the likelihood of more severe symptoms down the road.
Ear infections and excess fluid in the ears can result in hearing loss, even if it is temporary. Many parents also find it helpful to work with an ENT – a doctor who specializes in the Ear, Nose, and Throat. You can also help your child at home by speaking clearly, using precise language (perhaps single words for specific items), reducing background noise, and remembering that your child might be older now but needs some patience to recover that lost time in speech development. Sniffles and a runny  nose and lingering cough are simply part of daycare in the winter for toddlers. Greg Severson from Methodist Physicians Clinic – HealthWest to help us understand what to look for. Severson for help in understanding what signs to look  for, and he provided his guidelines on when to visit the doctor. Short- term tubes are smaller and typically stay in place for six months to a year before falling out on their own.
Other less common conditions that may warrant the placement of ear tubes are malformation of the ear drum or eustachian tube, Down Syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a reduction of air pressure, usually seen with altitude changes such as flying and scuba diving). This is most often done under a surgical microscope with a small scalpel (tiny knife), but it can also be accomplished with a laser.
A myringotomy is performed and the fluid behind the ear drum (in the middle ear space) is suctioned out. Current research indicates that removing adenoid tissue concurrent with placement of ear tubes can reduce the risk of recurrent ear infection and the need for repeat surgery. Use the Options menu to expand or contract all items, display or hide summaries or sort the table of contents. Some at home treatments include OTC pain relief and warm compresses to alleviate the initial and immediate pain. Imagine you are walking around underwater and the sounds are all distorted – this is what the world might sound like to a child with fluid in her ears, and this problem can be amplified if there is pain associated with it. If I took my son into the doctor every time he seemed to not feel 100%, we’d be broke from copay and bankrupt on sick time. When I asked him which ear, he would just shrug and change his mind that it didn’t hurt. In these cases, insertion of an ear tube by an otolaryngologist (ear, nose, and throat specialist) may be considered. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. When problems exist and hearing loss for any reason occurs, there is an increased risk that a child will have a speech delay.
So we watch his temperature and listen for any production in his cough (aka hacking up gunk from his lungs) and the color of his snot. But I was still suspicious, so we ended up in a Minute Clinic the night before I left for a blogging conference.
Long-term tubes may fall out on their own, but removal by an otolaryngologist is often necessary.
To prevent this, an ear tube is placed in the hole to keep it open and allow air to reach the middle ear space (ventilation). Ear drops may be administered after the ear tube is placed and may be necessary for a few days.



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