Glue Ear (Fluid Behind the Eardrum) and Your Child's Hearing
Glue ear is a build-up of fluid in the middle ear, behind the eardrum. It is common in young children and can make sounds seem muffled, so a child may seem not to listen, turn the television up or be slow with speech. It often gets better on its own, but it can last or come back, so hearing should be checked and followed up.
Glue ear is usually not painful, which is why it can go unnoticed. If you suspect it, a doctor can look at the ears, and a pediatric hearing test can show how much it is affecting your child's hearing.
What is glue ear?
The middle ear is a small air-filled space behind the eardrum. Normally, a narrow tube connecting the middle ear to the back of the nose lets air in and fluid drain away. In young children this tube is smaller and works less efficiently, especially during colds. When it does not drain properly, fluid can collect behind the eardrum and become thick, like glue. The medical name is otitis media with effusion.
Because the fluid stops the eardrum and the tiny middle-ear bones from moving freely, sound does not pass through as well, causing a temporary, conductive type of hearing loss in one or both ears.
Signs of glue ear
Signs can be subtle and may come and go:
- seeming not to hear well, or not responding when called;
- turning up the volume of the television or tablet;
- asking for things to be repeated or misunderstanding;
- speaking loudly, or speech that is unclear or slower to develop;
- seeming tired, frustrated or less attentive, especially at nursery or school;
- balance problems;
- occasional earache or a feeling of fullness in the ear.
Our guide to signs a child may not be hearing well, by age lists more signs to watch for at different stages.
Who is more likely to get glue ear?
Glue ear is most common in young children. It often follows colds or ear infections, so children who get these frequently may be more prone to it. Children with certain conditions, such as a cleft palate or Down's syndrome, are more likely to have glue ear that does not clear by itself. Exposure to cigarette smoke is linked with more ear infections in young children, which is another reason to keep children away from smoke. Many children have glue ear at some point without any lasting effect.
How is glue ear checked?
A doctor can examine the ears with an otoscope. A hearing assessment adds important information:
- Tympanometry gently measures how well the eardrum moves. A flat result can suggest fluid behind the eardrum.
- An age-appropriate hearing test shows how much the fluid is affecting hearing at that time.
Because glue ear can change over time, checks are often repeated to see whether it is clearing. Our article on hearing tests explained describes these tests.
How is glue ear managed?
Glue ear often clears up by itself, so doctors commonly suggest a period of monitoring with follow-up hearing checks. If it lasts, keeps returning or is affecting hearing, speech or learning, an ear, nose and throat (ENT) doctor may discuss options. These may include a simple technique to help air into the middle ear (autoinflation), small ventilation tubes in the eardrum (grommets), or temporary hearing aids for some children. The right choice depends on the individual child and is a medical decision.
There is generally no medicine that clears glue ear itself; antibiotics are only considered if an ear infection develops. Always follow your doctor's advice rather than starting medicines on your own.
Does glue ear affect speech?
It can. When hearing is muffled for a long time, especially in the early years when language is developing, some children are slower to talk or have less clear speech. Most catch up once hearing improves, but it is sensible to keep an eye on speech and language, and to read signs of speech delay in children if you are concerned.
How to help your child while glue ear is present
- Get close and face your child when talking, and get their attention first.
- Reduce background noise, such as turning off the television during conversations.
- Speak clearly at a normal level rather than shouting.
- Let nursery or school know, so your child can sit near the teacher.
- Keep your child away from cigarette smoke.
For a broader overview of how hearing is checked as children grow, see our guide to children's hearing.
When to see a specialist
Arrange a pediatric hearing test if your child seems to hear less after colds, has repeated ear infections, turns up the volume, or has speech that seems behind. A follow-up hearing check is also useful after glue ear has been diagnosed, to see whether hearing has returned.
See a doctor promptly if your child has ear pain with fever, discharge from the ear, swelling behind the ear, or seems very unwell. You can book an appointment online, and no referral is needed for a hearing assessment.
Frequently asked questions
Is glue ear the same as an ear infection?
No, although they are related. An ear infection usually starts suddenly with pain and sometimes fever, while glue ear is fluid that stays behind the eardrum, often without pain. Glue ear can follow an infection or a cold.
Does glue ear affect speech?
It can, especially if hearing is muffled for a long time while a child is learning to talk. Some children are slower to speak or less clear. Most catch up once hearing improves, but speech and language should be watched and assessed if there are concerns.
Who treats glue ear?
Glue ear is a medical condition, so it is managed by your child's doctor and, when needed, an ear, nose and throat (ENT) specialist. An audiologist checks how much it is affecting hearing and can repeat tests over time to help guide those decisions.
Related reading
- Children's Hearing: From Newborn Screening to School Age
- Signs a Child May Not Be Hearing Well, by Age
- Hearing Tests Explained: The Main Types and What Each One Shows
Sources
This article is general information and does not replace advice from a qualified professional.