Introduction

Problems of the outer, middle, and inner ear are common in children and should always be checked by a doctor as soon as they happen.

Children’s ears are generally smaller and have narrow, horizontal-lying eustachian tubes. 

Eustachian tubes connect the ears to the back of the throat

Fluid and other substances are more likely to build up or get stuck in a child’s ear. This can cause infection and may lead to temporary or permanent hearing loss.

 Signs and symptoms

Symptoms of an ear problem in children can include:

  • tugging, rubbing, or pulling at the ear
  • being irritable
  • having difficulty sleeping
  • fluid coming out of the ear
  • buildup or crust of wax inside and around the ear
  • difficulty hearing
  • loss of balance
  • fever.

See your local doctor or present to the nearest emergency department if your child is experiencing:

  • high fever that will not go down
  • severe pain
  • blood or pus-like discharge coming from the ear.

Diagnosis

Your child's doctor can diagnose an ear problem by looking at the outside and inside of the ear and checking your child's symptoms. The doctor may refer you to a specialist Ear, Nose and Throat (ENT) doctor if the problem is severe or needs scans and testing.

Common ear problems in children include:

  • buildup of excess wax that blocks the ear
  • a small object being inserted and becoming stuck
  • glue ear (a buildup of thick fluid that cannot drain out)
  • infection of the inner and outer ear.

Treatment

Treatment of common ear problems will depend on the type of issue, your child's symptoms and how severe the issue is. 

Some ear problems can be treated with medication at home, while others may need surgery to fix. 

Your child's doctor will recommend the best treatment for their ear problem.

 Management

Glue ear

The lining of the middle ear keeps itself moist by making a watery fluid. Sometimes, this fluid becomes thick and gluggy, like glue. 

Thick fluid may not be able to pass through the eustachian tube properly and will build up in the ear, causing hearing loss and infection. 

This is called Glue ear. 

Glue ear can go away on its own, especially over summer when colds are less common. 

It can take up to one month to get better, and .it may take up to 3 months for hearing to return to normal.

Children are more at risk of glue ear when they:

  • have a severe cold or flu
  • have a nasal allergy-like allergic rhinitis
  • have a condition that affects the shape or the muscles of the eustachian tube, like cleft palate or Down syndrome
  • live with a family member who smokes
  • are Aboriginal or Torres Strait Islander.

Ask your local doctor to check for glue ear if your child has ear infections that keep coming back, or they are having difficulty hearing.

Glue ear that has not gone away by three months may need to be treated with grommets.

Grommets are small tubes that are inserted into the ear to help fluid drain out. 

It is important not to leave glue ear untreated, as it can cause hearing loss and issues with learning and development.

Excess Wax

Ear wax is a soft substance in the ear that is produced by the ear canal glands. It protects the ear from things like:

  • water
  • foreign objects
  • germs that lead to infection.

Ear wax is made constantly. The new wax will push the old wax out of the ear. Chewing and talking can also help work the wax out of the ear. 

Ear wax has a yellow or orange colour and a thick, pasty texture. You can use a wet washcloth during bath time to gently remove excess wax from your child's ear. Do not insert cotton buds into the ear to clean out the wax.

Sometimes, ear wax can build up inside the ear and become hard. When this happens, your child may feel an ache and temporarily lose their hearing. 

If the built-up ear wax cannot be removed with gentle cleaning, your child will need to see their local doctor to have it treated.

Treatment to remove ear wax can include:

  • medicated drops to soften the ear wax
  • flushing of the ear with a syringe
  • using a micro-suction machine to remove the wax.

Objects in the ear

Children can often try to insert small objects into their own or other people's ears. They will do this because they are exploring the world and are interested in how things feel.

Everyday objects that get stuck in ears include:

  • small toys, like Lego bricks
  • beads
  • cotton buds
  • seeds or stones from fruit or other foods
  • rocks
  • batteries
  • anything else they may find on the floor.

Insects can also fly or crawl into the ear and become stuck.

Do not try to get objects out of a child’s ear by inserting fingers, cotton buds, or other items. Doing this will push the object in further and cause severe infection or damage to the ear.

See your local doctor as soon as possible or go to the nearest emergency department to have the object removed. If your doctor cannot remove the object, they will refer you to a specialist for treatment.

You can reduce the risk of objects being inserted into your child's ear by:

  • supervising children while they are eating smaller foods like peas or corn kernels
  • avoiding toys with small pieces or pieces that come apart easily
  • sweeping or vacuuming the floor regularly.

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.


© Sydney Children’s Hospitals Network 2024