Ear fluid, also called otitis media with effusion (OME), is a build-up of mucus or liquid behind the ear drum without symptoms of infection.
Fluid often goes away on its own, so your doctor will often recommend watchful waiting for the first three months. Be sure to follow-up with your doctor to make sure the fluid goes away completely.
The fluid is most likely to go away quickly if it has been there less than three months or has a known start time, such as after a cold or ear infection. Fluid is much more likely to persist when it has been there for at least three months or when it is found during a regular check-up visit and the start date is unknown.
The most common symptoms of ear fluid are mild discomfort, fullness in the ear, and mild hearing problems. Some children also have disturbed sleep, emotional distress, delayed speech, irritability, clumsiness, balance problems, or trouble learning in school.
Keep your child away from second-hand smoke, especially in closed spaces like the car or in the house. If your child is more than 12-months-old and still uses a pacifier, stopping the pacifier in the daytime may help the fluid go away.
Medical treatment does not work well, so you should not give your child antibiotics, antihistamines, decongestants, steroids (by mouth or in the nose), or drugs to reduce acid reflux. No benefits have ever been shown for chiropractic, special diets, herbal remedies, complementary medicine, or alternative (natural) therapies.
Yes, because the fluid may still be there and could later cause problems. Fluid that lasts a long time can damage the ear and require surgery. Also, young children often do not express themselves well, even when struggling with hearing problems or other issues related to the fluid. The best way to prevent problems is to see the doctor every three to six months until the fluid goes away.
The fluid can make it harder for your child to hear, especially in a group setting or with background noise, but the effect is usually small and goes away when the fluid clears up.
Stand or sit close to your child when you speak and be sure to let them see your face. Speak very clearly, and if your child does not understand something, repeat it. Hearing difficulties can be frustrating for your child, so be patient and understanding. See Table 11 in the full guideline for specific strategies.
The fluid cannot directly turn into an ear infection, but during a cold it increases your child’s risk of getting an ear infection because the fluid makes it easier for germs to grow and spread.
If the ear is completely full of fluid there is usually no problem, but when the fluid is partial or mixed with air it can hurt when the plane is coming down. Your doctor can measure the amount of fluid with a tympanogram, which gives a flat reading when the ear is full. It may help to keep your child awake when the plane is landing and encourage him or her to swallow to even out the pressure.
Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline (update): otitis media with effusion. Otolaryngol Head Neck Surg. 2016;154(1 Suppl):215-225.