Ear problems in children

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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Ear problems, like earaches and glue ear, are common in children.  Ear problems may affect the outer ear, middle ear or inner ear.

Excess wax

The skin of the outer ear (the ear canal) produces wax that helps protect the ear. This wax usually comes out by itself and only your child’s outside ear should be cleaned. It can be cleaned with a damp washer. Do not use cotton buds - they can damage the ear and push the wax in further. Occasionally, excess wax collects in the outer ear and may need to be removed. Check with your family doctor who can prescribe drops.

Infection

Sometimes infection in the outer ear occurs, it may occur after swimming. There is usually tenderness, itch or discharge from the ear. This needs to be treated by your family doctor who will examine the ear canal and prescribe ear drops. If the infection does not respond to treatment, referral to an Ear, Nose and Throat specialist would be needed.

Objects

Your child may poke something into the ear, such as a bead. Do not try to remove this yourself. Your family doctor may be able to remove it or may suggest referral to an Ear, Nose and Throat specialist.

Middle ear problems

The middle ear is the small space behind the eardrum. It is filled with air and contains three tiny bones. The middle ear drains into the back of the nose by the eustachian tube. This tube opens briefly when we swallow or yawn and air is then let into the middle ear.

Middle ear infection

This usually occurs when your child has a cold. If the eustachian tube opening is blocked, organisms (germs) can build up in the middle ear as they cannot drain out of the middle ear. As well air cannot reach the middle ear.  Your child gets an earache, fever and reduced hearing. Your child should be taken to the family doctor who will recommend pain relievers and consider prescribing antibiotics.

Some children are at a higher risk of middle ear infections, particularly those who have an allergic nose (allergic rhinitis / hay fever / “sinus”), those with smokers at home, those with a cleft palate or those with Downs syndrome.

Glue ear

When middle ear inflammation occurs, the lining of the middle ear secretes more fluid.  This may be thin or thick, like ‘glue’. If the fluid does not go away within 3 months this is called ‘glue ear’.  Your child hears poorly through this fluid and may seem deaf (and need the TV up louder or seem to ignore you), be irritable or occasionally even can be off-balance.  Your child needs to see your family doctor.

However, if your child continues to have good hearing and speech, your family doctor may check your child over many weeks to see that the fluid disappears naturally.  If the middle ear fluid does not disappear by 3 months or if your child has hearing loss or speech problems, they may be referred to an Ear Nose and Throat Surgeon. Your child may need grommets (tiny tubes) put in the eardrum to let air into the middle ear and clear the fluid. The grommets will gradually fall out of the drum after 6- 12 months.  Most children will recover full (normal) hearing. The fluid may come back in some children (particularly if very young or with an allergic nose) and further treatment will be needed. Some children need grommets again.

Children should not be left for long periods with untreated glue ear. Many studies have shown that the hearing loss does not affect your child's speech development, understanding of language, reading or spelling. It is advisable that your child has a hearing test after the glue ear is better.

How to keep ears dry

While grommets are in position in the ears, it may be advisable to keep water out of the ears. (particularly bath water, swimming pool, and river water )

To keep water out of the ears use ear plugs, Blu-Tac or cotton wool coated with Vaseline. An extra layer of protection, such as a swimming cap or Ear Wrap to cover the ear plugs may be helpful.

Inner ear hearing loss

Deafness can also be caused by problems of the inner ear.  In patients with inner ear deafness (nerve deafness), the outer and middle ear are usually normal.  Soon after a baby is born all families need to ask, 'Does the baby hear?'  In NSW, since 2004, all new born babies have their hearing tested by an automated hearing screening test (the ‘SWISH” test).

If this test does not give a “pass’ result further testing will be arranged in the Audiology Department of a specialist Children’s Hospital. If deafness is shown in one or both ear(s) then your baby will be referred to a baby hearing clinic at one of the three specialist children’s hospitals in NSW.

You need to watch your baby's responses to sound in the early months of life.

If you think your child at any age is not hearing or listening seek medical advice. Parents are good observers and are often very accurate when they suspect hearing loss in their babies or young children.

Children’s hearing can be tested at any age. This may be arranged at Australian Hearing Services, in selected community health centres, in some hospitals, in children's audiology units, and in some ear, nose and throat specialists' offices. Your child's hearing can only be properly tested in a soundproof room.  Ask for a referral, or refer yourself to:

Australian Hearing 131797 have staff who will advise you as to where is the hearing centre closest to your home.

Remember

  • Don't poke things in ears.
  • Middle ear infection requires prompt assessment by your doctor.
  • Watch for hearing loss with or without glue ear. Don't let it continue for long and check that hearing returns to normal after glue ear has gone.

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Kids Health (CHW)
The Children's Hospital at Westmead
Tel: (02) 9845 0000
Fax: (02) 9845 3562
www.chw.edu.au
Sydney Children's Hospital, Randwick
Sydney Children's Hospital, Randwick
Tel: (02) 9382 1688
Fax: (02) 9382 1451
www.sch.edu.au
Kaleidoscope, Hunter Children's Health Network
Kaleidoscope Children Young People and Families Network
Tel: (02) 4921 3670
Fax: (02) 4921 3599
www.kaleidoscope.org.au