Ear infections and glue ear factsheet

Introduction

Ear infections are common in children and happen when germs and bacteria enter the ear, causing pain and swelling. 

The eustachian tubes, which connect the ears to the back of the throat, are also narrower and more horizontal in children. This makes it difficult for fluid to drain, causing it to build up and develop into infection.

Middle ear infections or otitis media

Infections in the middle ear, located behind the eardrum, usually begin with a cold or illness. This leads to a buildup of fluid containing bacteria and germs, which develops into an infection.

Outer ear infections or otitis externa

Infections in the outer ear canal, between the outside of the ear and the eardrum, happen when fluid gets trapped. When trapped fluid contains bacteria, it can cause an infection. This commonly happens when swimming and is known as "swimmer’s ear."

Glue ear

Glue ear is a condition where the liquid made by the middle ear becomes thick and sticky, like glue. 

When the liquid becomes too thick, it cannot drain through the eustachian tube properly and builds up in the middle ear. This can cause infection and hearing loss. 

Glue ear can be caused by:

  • previous and reoccurring ear infections
  • colds and other upper respiratory infections
  • exposure to cigarette smoke.

 Signs and symptoms

Take your child to the doctor as soon as they show signs of an ear infection or glue ear. Untreated ear infections can be serious and may lead to the infection spreading and hearing loss. 

If your child has redness, swelling, or pain behind their ear, see your local doctor or go to the nearest emergency department immediately.

middle ear infections

Your child may have:

  • ear pain
  • tugging and rubbing of the ears
  • hearing loss
  • headaches
  • irritability
  • fever
  • loss of balance.

outer ear infections

your child may have:

  • tenderness and pain in the outer ear, especially when moving the jaw
  • muffled hearing
  • feeling of pressure or fullness in the ear
  • redness and swelling
  • clear or yellow fluid coming out of the ear
  • a swishing or squelching sensation in the ear when moving.

Glue ear

Glue ear does not always show the same signs as a middle ear infection, so it is important to watch your child for signs of hearing loss, including:

  • rubbing or pulling ears
  • not listening or paying attention
  • changes or a delay to their speech
  • needing the volume to be louder for TV and music
  • trouble with balance.

Diagnosis

Your child’s doctor can diagnose an ear infection by checking their symptoms and looking inside the ear with an otoscope, a magnifying tool that can see the ear drum.

Treatment

Treatment options depend on which type of ear infection your child has and how severe it is.

Middle ear infections

Middle ear infections usually clear up in about a week. Your child’s doctor may suggest pain relief with paracetamol or ibuprofen or prescribe numbing ear drops. Always speak to your doctor before using drops for middle ear infections. 

Antibiotics are not usually given unless your child has severe symptoms. 

Your child may need to be referred to an ear, nose and throat (ENT) specialist to treat severe or reoccurring ear infections.

Outer ear infections

Your child's doctor will prescribe medicated ear drops. You will need to give these drops to your child several times a day, following the doctor's or pharmacist's instructions. 

The doctor may place gauze into the ear canal for more severe infections to help deliver the medicine. 

Your child should avoid swimming and touching the inside of their ear while the infection clears up. 

Symptoms should improve by the third day of treatment, and your child should feel much better by the end of the first week. If symptoms do not improve, follow up with your child’s doctor.

Glue ear

Glue ear will usually get better on its own. Your child’s doctor may recommend grommet treatment if it lasts over three months. 

Grommets are small tubes inserted into the ear to help fluid drain. Early treatment of glue ear is important, as it can lead to hearing loss and issues with learning, communication, and development.

 Management

Risk factors and prevention

Children often get ear infections. However, some factors can make your child more likely to have severe and repeated infections. 

These can include:

  • being born with a condition or syndrome that affects the structure of the ears, nose, and throat, like cleft palate or Down syndrome
  • being Aboriginal or Torres Strait Islander
  • living with people who smoke
  • hay fever, allergies, and other breathing issues and illnesses.

Outer ear infections can be more common in children who swim often, especially in dirty water, such as public pools, lakes, and rivers.

You can lower the risk of ear infections by:

  • not smoking in places where children are, including in the home, backyard, and car
  • having your child seen by their doctor as soon as possible to treat coughs, colds, and runny noses
  • gently cleaning your child’s outer ear with a damp cloth instead of cotton buds.

For babies, you can:

  • breastfeed for as long as possible if you can do so
  • hold their head upright when bottle feeding to avoid fluid getting into the ear tubes
  • avoid putting them to sleep in the cot or bassinet with a bottle.

Ruptured eardrum

The eardrum is a sheet of tissue that separates the middle ear from the outer ear. When children have severe middle ear infections, pressure can build up from trapped fluid, leading to the eardrum rupturing or bursting. 

Your child will feel immediate relief from pain when the eardrum ruptures, and yellow discharge may drain out.

The eardrum will usually heal by itself. Check-in with your local doctor around six weeks after the rupture to make sure it has healed properly. Your child should avoid swimming and getting the ear wet during a bath or shower while they are recovering.

Last updated Monday 17th June 2024

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