Ear infections, earache and glue ear - HE1414

What are ear infections, earache and glue ear?

Ear infections, earache and glue ear are common problems in young children. For most children, they are short-lived problems. But in some cases ear infections and glue ear can cause hearing loss, which can lead to learning or behaviour problems.

Ear infections and earache

• Ear infections are when a cold or infection spreads up the small tubes (Eustachian tubes) that connect the ear to the back of the nose and throat.
• The tubes get blocked with infected fluid (pus), which spreads into the middle ear and puts pressure on the eardrum.
• The eardrum bulges out and causes a painful earache.

Ear infections can cause reduced hearing and in rare cases may lead to infection of the bone around the ear.

A normal ear

An infected ear

How can I tell if my baby or child has an ear infection or an earache?

Sometimes, the only sign of an ear infection is a fever. If the ear infection causes an earache, your baby or child may:

• cry or grizzle
• keep touching an ear again and again
• get a ‘runny’ ear.

Older children will tell you if their ear hurts, and they may not be able to hear properly. 

If you think your baby or child has an ear infection or an earache, call your doctor or nurse right away. You can also call Healthline on 0800 611 116.

What is a ‘runny’ ear?

With an ear infection, the pus in the middle ear puts pressure on the eardrum, which can be very painful.

Sometimes, the pressure can cause the eardrum to burst, and the pus leaks out of the ear – this is a runny ear. Because there is no more pressure on the eardrum, the pain goes away, and your baby or child seems to be much better. But the ear infection is still there.

Your baby or child will need to see a doctor to have the infection treated and to make sure the eardrum heals properly. 

Treating ear infections and earaches

Medicine for the pain

An earache is painful. Your doctor or nurse will tell you which medicine is best to help with the pain. Paracetamol is often recommended. Always follow the directions carefully.

Giving antibiotics

Not all ear infections need antibiotics. In most cases, pain relief such as paracetamol is all that is needed. Your doctor will tell you which treatment is best.

Ears usually stop hurting before the infection is properly better, so if your doctor has prescribed a course of antibiotics:

• give the antibiotics exactly as the doctor or pharmacist told you
• keep giving your baby or child the antibiotics until they are finished.

When all the antibiotics are finished take your baby or child back to the doctor or a mobile hearing clinic nurse for a check. Only a doctor or nurse can tell if the infection has gone.

Glue ear

Glue ear is a condition where the middle ear, which normally contains air, is filled with a glue-like fluid. The small tubes (Eustachian tubes) that connect the ear to the back of the nose and throat get blocked, and fluid builds up. A blocked nose, a cold, swollen adenoids, allergies or tobacco smoke that irritates the nasal cavity may cause the tubes to get blocked and so cause glue ear. Glue ear usually gets better without treatment but sometimes can cause mild to moderate hearing loss.

Glue ear

How can I tell if my baby or child has glue ear?

Glue ear is usually painless, so you may not know there’s a problem.

In babies, the signs might be:

• not showing interest in sounds
• crying, fretting, not sleeping
• unusual or unsettled behaviour.

In toddlers and young children, the signs might be:

• not listening
• difficult behaviour
• often having an earache
• snoring and breathing through the mouth.

If you think your baby or child has glue ear, or you are worried about their hearing, take them your doctor, practice nurse or mobile hearing clinic.

Treating glue ear

For most children, glue ear doesn’t last long, and it usually doesn’t cause significant hearing loss or learning and behaviour problems.

However, grommets may be recommended if your child gets glue ear often, it lasts for a long time, and their hearing is affected. Grommets are small plastic tubes that are put into the eardrum to let air back into the middle ear. This is done in hospital.

Once the air can get back into the middle ear, hearing usually returns to normal.

An ear with grommets

Grommets

Children with grommets can bath and shower as usual. When swimming, they need to keep their head out of the water so that the water doesn’t go into the middle ear.

Grommets aren’t a permanent cure for glue ear. Over time, they will come out of the eardrum, and the hole they were keeping open will heal. Hopefully, the child’s Eustachian tubes will have grown larger by then so that they don’t get blocked easily and can naturally let air into the middle ear.

There are no medicines which effectively treat or prevent glue ear, but vaccination with the pneumococcal vaccine can help prevent ear infections and glue ear.

How can I help my child with glue ear?

• Look at your child when you speak, and speak slowly, clearly and slightly louder than normal.
• If your child’s behaviour changes, it may be caused by the hearing problem.
• If your child goes to school or preschool, tell the teacher about their glue ear and hearing problems. The teacher can help by seating your child at the front of the class.

Preventing ear infections and glue ear

It is not easy to prevent ear infections, but the following may help reduce the risk:

• keeping your child smoke-free
  
• breastfeeding your baby for at least 3 to six months is protective against the early development of ear infections - this is because breastfeeding boosts the infection-fighting system (immune system)
• be smokefree
• keep rooms warm and dry
• always see your doctor, nurse or mobile hearing clinic if your baby or child has sore ears
• make sure your child gets the B4 School Check and has their hearing tested
• get your child vaccinated, and keep them up-to-date with all vaccinations.

Hearing loss

Hearing loss can affect how your baby or child talks, behaves and learns.

Make sure your baby or child can hear

• Does your baby respond to sounds?
• Is your baby or toddler learning to talk?
• Does your toddler listen to stories or music?
• Does your toddler or child understand what you say?
• Is your child learning at preschool or school

If you answered ‘No’ to any of these questions or if you are worried, talk to your, doctor, practice nurse or mobile hearing clinic nurse.

More information

For more advice or information:

• talk to your doctor, practice nurse or mobile hearing clinic nurse
• call Healthline on 0800 611 116.