Springdale Mason Pediatrics

Ear Fluid (Middle Ear Effusion)

Definition

  • The buildup of fluid in the middle ear (the space behind the eardrum)
  • The space is normally filled with air. The presence of fluid dampens the hearing.

Call or Return If

  • Your child develops an earache
  • Your child's speech development is delayed
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • A feeling of fullness, congestion or pressure in the ear. Popping noise may also be felt.
  • Mildly reduced hearing (short-term)
  • There is no earache or fever.

Diagnosis

  • A doctor can diagnose middle ear effusion by looking at the eardrum. It will have fluid behind it, but not be red or bulging. Because of the fluid, the eardrum doesn't move when the doctor applies air pressure.

Cause

  • The middle ear is the space behind the eardrum. Fluid is normally made here in small amounts.
  • Usually, the fluid drains out of the ear through a tube. This tube is called the eustachian tube. It allows the fluid to drain into the back of the throat.
  • After a cold or ear infection, the eustachian tube may become swollen. The swelling causes it to be blocked for a short time. Fluid can build up instead of draining out normally. This can follow bacterial or viral ear infections. The fluid is not infected.
  • Nasal allergies can also interfere with drainage of the middle ear fluid.

After Care Advice

Help Your Child With Short-term Hearing Loss:
  • Most children with middle ear fluid have a mild hearing loss (20 to 30 dB). If hearing loss occurs before age 2, it may affect normal speech development. The fluid will probably clear in 1 to 2 months. Most children's speech will catch up after a short-term hearing loss. In the meantime, help your child deal with the limited hearing. When you talk with your child:
  • Get close to your child, get eye contact, and get his full attention. At times, check that he understands what you have said.
  • Speak in a louder voice than you normally use. A common mistake is to assume your child is ignoring you. In reality, he doesn't hear you.
  • Reduce any background noise from radio or television while talking with your child.
  • If your child goes to school, be sure he sits in front. Have him sit near the teacher. Middle ear fluid interferes with the ability to hear in a crowd or classroom.
No Restrictions:
  • Your child doesn't have any restrictions because of ear fluid. Your child can go outside and does not need to cover the ears.
  • Swimming is allowed unless there is a tear or hole in the eardrum. Also, if your child has ear tubes or ear drainage, he should not swim.
  • Air travel or a trip to the mountains is safe. Have your child swallow fluids or suck on a pacifier during descent. Children over age 6 can also chew gum during this time.
Allergy Medicines:
  • Nose allergies can cause ear stuffiness.
  • If your child has hay fever or other allergies, give an allergy medicine. An example is Benadryl.
Antibiotics Not Needed:
  • Antibiotics do not help to clear middle ear fluid.
  • Your child doesn't need an antibiotic unless he develops a bacterial ear infection.
  • Your child's doctor decides this based upon an ear exam.
What to Expect:
  • The middle ear fluid clears up by itself in 90% of children. Therefore, no treatment is needed for most children. The fluid will slowly go away.
  • By 1 month, 50% of children will still have fluid.
  • By 2 months, 20% of children will still have fluid.
  • By 3 months, only 10% of children will still have fluid.
  • Ear fluid that is still present after 3 to 4 months may need other treatment. Some children need ear tubes placed by an ear surgeon. Reason: The fluid will most likely not clear up by itself.
Ear Recheck:
  • Your child needs to be checked again. Reason: To be sure the ear fluid doesn't last longer than 3 months. The doctor will also want to check your child's speech development.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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