About Us
Our Services
New Patients
Forms & Policies
Medical Resources
   Medical Conditions
      Abdominal Pain, Recurrent
      Acute Ear Infections and Your Child
      Acute Lymphoblastic Leukemia
      Acute Otitis Media
      Acute Strep Throat
      ADHD and Your School-aged Child
      Allergies in Children
      Anemia and Your Young Child
      Anesthesia and Your Child
      Ankle Sprain Treatment (Care of the Young Athlete)
      Antibiotics and Your Child
      Asthma and Exercise (Care of the Young Athlete)
      Asthma and Your Child
      Asthma Triggers
      Atopic Dermatitis (Eczema)
      Attention-Deficit Hyperactivity Disorder
      Attention-Deficit Hyperactivity Disorder (ADHD)
      Breast Enlargement, Premature
      Breath-Holding Spells
      Bronchiolitis and Your Young Child
      Care of the Premature Infant
      Celiac Disease
      Chickenpox Immunization
      Chickenpox Vaccine, The
      Coarctation of the Aorta
      Common Childhood Infections
      Congenital Hip Dysplasia
      Constipation and Your Child
      Coxsackie A16
      Croup and Your Young Child
      Croup: When Your Child Needs Hospital Care
      Crying and Your Baby: How to Calm a Fussy or Colicky Baby
      Cyclic Vomiting Syndrome (CVS)
      Developmental Dysplasia of the Hip
      Diabetic Mother, Infant of
      Diaper Rash
      Diarrhea and Dehydration
      Diarrhea, Vomiting, and Water Loss (Dehydration)
      Ear Infection
      Ear Infections
      Eating Disorders
      Eating Disorders: Anorexia and Bulimia
      Eczema (Atopic Dermatitis)
      Enlarged Lymph Nodes
      Erythema Multiforme
      Eye Problems Related to Headache
      Febrile Seizure
      Febrile Seizures
      Fetal Alcohol Syndrome
      Fever and Your Child
      Fifth Disease
      Fifth Disease (Erythema Infectiosum)
      Flu, The
      Food Allergies and Your Child
      Food Born Illnesses
      Fragile X Syndrome
      Gastroenteritis, Viral
      Gastroesophageal Reflux
      Guide to Children's Dental Health, A
      Hand Foot and Mouth
      Hand-Foot-and-Mouth Disease
      Head Lice
      Headache Related to Eye Problems
      Hepatitis A
      Hepatitis A Immunization
      Hepatitis B
      Hepatitis B Immunization
      Hepatitis C
      Hib Immunization
      High Blood Pressure
      Hip Dysplasia (Developmental Dysplasia of the Hip)
      How to Take Your Child's Temperature?
      Imaging Tests: A Look Inside Your Child's Body
      Infant of a Diabetic Mother
      Infectious Mononucleosis
      Influenza Immunization
      Inhaled and Intranasal Corticosteroids and Your Child
      Kawasaki Syndrome
      Language Development in Young Children
      Lead Poisoning
      Learning Disabilities: What Parents Need to Know
      Lung Hypoplasia
      Lyme Disease
      Mental Health
      Middle Ear Fluid and Your Child
      MMR Immunization
      Molluscum Contagiosum
      Obesity in Childhood
      Osgood-Schlatter Disease
      Otitis Media, Acute
      Pneumococcal Conjugate Immunization
      Pneumonia and Your Child
      Polio Immunization
      Premature Thelarche
      Prematurity, Retinopathy of
      Pulmonary Hypertension
      Pulmonary Hypertension (PPH & SPH)
      Retinopathy of Prematurity
      Rheumatic Fever, Acute
      Ringworm (Tinea)
      Rubella (German Measles)
      Safety of Blood Transfusions
      Seasonal Influenza (Flu) 2014–2015
      Separation Anxiety
      Sinusitis and Your Child
      Sleep Apnea and Your Child
      Speech Development in Young Children
      Stevens-Johnson Syndrome
      Strep Throat
      Strep Throat-Acute
      Strep Throat-Recurrent
      Stuttering and the Young Child
      Swine Flu
      Swine Flu (H1N1) FAQ
      Swine Flu (H1N1) Vaccine
      Swollen Glands
      Tear Duct, Blocked
      Tetralogy of Fallot
      Thyroid Problems
      Tinea (ringworm infection)
      Tonsils and the Adenoid
      Toxic Shock Syndrome
      Turner Syndrome
      Type 2 Diabetes: Tips for Healthy Living
      Underdeveloped Lungs
      Urinary Tract Infection
      Urinary Tract Infections in Young Children
      Varicella or Chickenpox
      Varivax Immunization
      Vesicoureteral Reflux
      What Is ADHD?
      What is Clean Intermittent Catheterization?
      Whooping Cough (Pertussis)
      Wilson Disease
   What's Going Around?
Contact Us

Practice News

Anywhere Family Practice is thrilled to announce the addition of Dr. Julie Johnson to our team.
We will be transitioning to a new patient portal in April. Watch for new updates on this website!

Is Your Child Sick?TM


Are You Sick?

Middle Ear Fluid and Your Child

Print, Share, or View Spanish version of this article

The middle ear is the space behind the eardrum that is usually filled with air. When a child has middle ear fluid (otitis media with effusion), it means that a watery or mucus-like fluid has collected in the middle ear. Otitis media means middle ear inflammation, and effusion means fluid.

Middle ear fluid is not the same as an ear infection. An ear infection occurs when middle ear fluid is infected with viruses, bacteria, or both, often during a cold. Children with middle ear fluid have no signs or symptoms of infection. Most children don't have fever or severe pain, but may have mild discomfort or trouble hearing. About 90% of children get middle ear fluid at some time before age 5.

The following is information from the American Academy of Pediatrics about the causes, symptoms, risk reduction, testing, and treatments for middle ear fluid, as well as how middle ear fluid may affect your child's learning.

What causes middle ear fluid?

There is no one cause for middle ear fluid. Often your child's doctor may not know the cause. Middle ear fluid could be caused by

  • A past ear infection

  • A cold or flu

  • Blockage of the eustachian tube (a narrow channel that connects the middle ear to the back of the nose)

What are the symptoms of middle ear fluid?

Many healthy children with middle ear fluid have little or no problems. They usually get better on their own. Often middle ear fluid is found at a regular checkup. Ear discomfort, if present, is usually mild. Your child may be irritable, rub his ears, or have trouble sleeping. Other symptoms include hearing loss, irritability, sleep problems, clumsiness, speech or language problems, and poor school performance. You may notice your child sitting closer to the TV or turning the sound up louder than usual. Sometimes it may seem like your child isn't paying attention to you, especially when at the playground or in a noisy environment.

Talk with your child's doctor if you are concerned about your child's hearing. Keep a record of your child's ear problems. Write down your child's name, child's doctor's name and number, date and type of ear problem or infection, treatment, and results. This may help your child's doctor find the cause of the middle ear fluid.

Can middle ear fluid affect my child's learning?

Some children with middle ear fluid are at risk for delays in speaking or may have problems with learning or schoolwork, especially children with

  • Permanent hearing loss not caused by middle ear fluid

  • Speech and language delays or disorders

  • Developmental delay of social and communication skills disorders (for example, autism spectrum disorders)

  • Syndromes that affect cognitive, speech, and language delays (for example, Down syndrome)

  • Craniofacial disorders that affect cognitive, speech, and language delays (for example, cleft palate)

  • Blindness or visual loss that can't be corrected

If your child is at risk and has ongoing middle ear fluid, her hearing, speech, and language should be checked.

How can I reduce the risk of middle ear fluid?

Children who live with smokers, attend group child care, or use pacifiers have more ear infections. Because some children who have middle ear infections later get middle ear fluid, you may want to

  • Keep your child away from tobacco smoke.

  • Keep your child away from children who are sick.

  • Throw away pacifiers or limit to daytime use, if your child is older than 1 year.

Are there special tests to check for middle ear fluid?

Two tests that can check for middle ear fluid are pneumatic otoscopy and tympanometry. A pneumatic otoscope is the recommended test for middle ear fluid. With this tool, the doctor looks at the eardrum and uses air to see how well the eardrum moves. Tympanometry is another test for middle ear fluid that uses sound to see how well the eardrum moves. An eardrum with fluid behind it doesn't move as well as a normal eardrum. Your child must sit still for both tests; the tests are painless.

Because these tests don't check hearing level, a hearing test may be given, if needed. Hearing tests measure how well your child hears. Although hearing tests don't test for middle ear fluid, they can measure if the fluid is affecting your child's hearing level. The type of hearing test given depends on your child's age and ability to participate.

How can middle ear fluid be treated?

Middle ear fluid can be treated in several ways. Treatment options include observation and tube surgery or adenoid surgery. Because a treatment that works for one child may not work for another, your child's doctor can help you decide which treatment is best for your child and when you should see an ear, nose, and throat (ENT) specialist. If one treatment doesn't work, another treatment can be tried. Ask your child's doctor or ENT specialist about the costs, advantages, and disadvantages of each treatment.

When should middle ear fluid be treated?

Your child is more likely to need treatment for middle ear fluid if she has any of the following:

  • Conditions placing her at risk for developmental delays (see "Can middle ear fluid affect my child's learning?")

  • Fluid in both ears, especially if present more than 3 months

  • Hearing loss or other significant symptoms (see "What are the symptoms of middle ear fluid?")

What treatments are not recommended?

A number of treatments are not recommended for young children with middle ear fluid.

  • Medicines not recommended include antibiotics, decongestants, antihistamines, and steroids (by mouth or in nasal sprays). All of these have side effects and do not cure middle ear fluid.

  • Surgical treatments not recommended include myringotomy (draining of fluid without placing a tube) and tonsillectomy (removal of the tonsils). If your child's doctor or ENT specialist suggests one of these surgeries, it may be for another medical reason. Ask your doctor why your child needs the surgery.

What about other treatment options?

There is no evidence that complementary and alternative medicine treatments or that treatment for allergies works to decrease middle ear fluid. Some of these treatments may be harmful and many are expensive.

Copyright © 2010