Ear Problems: Should My Child Be Treated for Fluid Buildup in the Middle Ear?

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You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Non-Interactive Decision Point

Ear Problems: Should My Child Be Treated for Fluid Buildup in the Middle Ear?

Get the facts

Your options

  • Treat fluid buildup in your child's middle ear.
  • Don't treat the fluid buildup. Instead, wait and see if the fluid clears up on its own.

Key points to remember

  • Fluid buildup in the middle ear usually clears up within 3 months without treatment.
  • Decongestants, antihistamines, and other over-the-counter cold medicines usually don't help treat or prevent fluid in the middle ear.
  • In rare cases, fluid buildup that lasts 3 months or more may cause hearing problems. But hearing usually returns to normal after the fluid is gone.
  • If a hearing test shows that your child has trouble hearing, treatment with antibiotics or surgery may be recommended. But if your child's hearing is okay, you can wait another 3 months to see if the fluid clears up on its own.
FAQs

What is fluid buildup in the middle ear?

Fluid buildup in the middle ear is called otitis media with effusion. The middle ear is the small part of the ear just inside the eardrum.

Your child may not have any symptoms, or he or she may have some minor discomfort and a feeling of pressure or fullness in the ears. Your child may say that his or her ears feel plugged.

Fluid can build up when a cold, allergy, or some other problem causes the small tube that carries fluid from the middle ear to the throat to swell and close. If this tube, called the eustachian tube , gets blocked, fluid builds up in the middle ear.

For some children, the fluid goes away in a few weeks. But a few children still have fluid buildup 3 months after it starts. If your child still has fluid after an ear infection, he or she is more likely to get another infection.

In rare cases, fluid buildup that lasts 3 months or more may cause hearing problems. But hearing usually returns to normal after the fluid is gone.

How is fluid buildup in the middle ear treated?

In most cases, fluid in the middle ear clears up within 3 months without treatment. But if the fluid is still there after 3 months and your child has trouble hearing, treatment may be advised.

Your doctor may suggest one of the following treatments:

  • Antibiotics are sometimes used. But they don't always work or prevent the fluid from coming back. Most children won't need to take antibiotics.
  • Ear tubes allow fluid to drain out of the middle ear. They can also help keep the fluid from coming back, improve hearing, and prevent repeat ear infections. These tubes stay in place for 6 to 12 months and then fall out on their own. Most children who get ear tubes are helped. But some children may need to have tubes put in their ears again, because the fluid comes back.
  • Surgery to remove the adenoids can help air and fluid move through the nasal passages more easily and prevent future fluid buildup. In rare cases, the tonsils may also be taken out. Adenoids and tonsils are small masses of tissue at the back of the throat. They can swell and cause fluid to get trapped in the middle ear. In most cases, doctors recommend this surgery only when antibiotics or ear tubes haven't worked.

What home treatments can you try?

If your child has an infection and not just fluid buildup, you can treat him or her at home with:

  • A warm washcloth placed over your child's ear.
  • Rest.

Why might your doctor recommend treating fluid buildup in the middle ear?

Your doctor might suggest treatment if:

  • Your child has had fluid in his or her middle ear for 3 months or more.
  • Your child is having a hard time hearing.
  • Your child has repeat ear infections.

Compare your options

Compare

What is usually involved?

















What are the benefits?

















What are the risks and side effects?

















Treat fluid buildup in the middle ear Treat fluid buildup in the middle ear
  • Antibiotics:
    • Your child will take a pill or a liquid for several days until all the medicine is gone.
  • Ear tubes:
    • Your child will be asleep during the procedure.
    • A small hole will be made in each eardrum to create a space for the tubes.
    • Most children recover quickly and have little or no pain.
    • Your child most likely will go home within 1 to 2 hours after the surgery and return to school or day care the next day.
    • The surgery can be done in a surgery clinic.
  • Adenoid surgery:
    • Your child will be asleep during the procedure.
    • The doctor will remove the adenoids from the back of your child's throat through the mouth. In rare cases, the tonsils may also be taken out.
    • The surgery can be done in a surgery clinic or hospital.
  • Antibiotics:
    • May help clear the fluid from the middle ear.
  • Ear tubes:
    • Can clear fluid from the middle ear and improve hearing.
    • Can relieve pressure and pain in the middle ear.
    • Can prevent future fluid buildup and repeat ear infections.
  • Adenoid surgery:
    • Can help air and fluid move through the nasal passages more easily and prevent future fluid buildup in the middle ear.
  • Possible side effects of antibiotics include:
  • Possible risks of ear tube placement include:
    • A blockage in the tube, which can cause fluid to build up again and cause an infection.
    • A thickening of the eardrum over time, which may cause hearing problems.
    • Discharge of pus from the ear.
    • A hole in the eardrum that doesn't close after the tube comes out.
    • Scarring of the eardrum. But this is rare.
    • A buildup of tissue behind the eardrum. But this is rare.
    • One or both tubes slipping out of place. But this is rare.
  • Possible risks of adenoid surgery include:
    • Bleeding.
    • Infection.
    • Pain.
  • Less common risks of ear tube placement and adenoid surgery include more serious bleeding and problems from anesthesia.
Don't treat fluid buildup Don't treat fluid buildup
  • You wait and see if the fluid clears up on its own.
  • If your child has an infection, you can relieve his or her symptoms at home by:
    • Putting a warm washcloth on your child's ear.
    • Encouraging your child to rest.
  • In most children, the fluid clears up within 3 months without treatment.
  • Your child can avoid the side effects of antibiotics and the risks of surgery.
  • You don't have to pay for antibiotics or surgery.
  • If the fluid doesn't clear up on its own, you can decide later to try treatment.
  • Your child may have some mild discomfort and a feeling of pressure or fullness in his or her ears until the fluid clears up on its own.
  • Sometimes the fluid doesn't go away on its own. If it lasts a long time, it can damage the eardrum and may:
    • Increase the chance of repeat ear infections.
    • Cause hearing problems.

Personal stories about treatment for fluid behind the eardrum

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My little boy, Mateo, is 5 years old. He has only had two ear infections, but he still has fluid behind his eardrum since this last infection. The fluid has been behind his eardrum for 3 months now. It doesn't seem to bother him. I'm going to have Mateo's hearing tested and, if it is okay, I'm just going to wait to see if the fluid will go away on its own.

Ramon, age 45

My daughter, Sarah, is almost 3 years old. A few months ago, she had her fourth ear infection, and this time there is still fluid behind her eardrum. I am worried. I don't want Sarah to have trouble with her speech. I have heard about putting tubes in children's ears to help drain fluid. Even though surgery is scary, I'm going to go ahead and talk with Sarah's doctor about having it done. Sarah is tired of taking medicines, and I don't want Sarah to have any hearing loss.

Wilson, age 33

My daughter, Amanda, is 4. She just had her first ear infection 4 months ago and still has fluid behind her eardrum. I had her hearing tested, and there is no problem. The fluid doesn't seem to bother her. Amanda really hates to take medicine, so I'm just going to wait and see if the fluid will go away on its own.

Michelle, age 25

My son, Saul, is 7 years old. Saul has only had a few ear infections, and none of them have caused much trouble. This last infection, though, was worse than any other. It started 5 months ago. The doctor gave Saul antibiotics, and that seemed to help. The problem is that Saul still has fluid behind his left eardrum. It doesn't really bother him, except he says that his ear seems "stuffy." We have tried letting it get better on its own, but it isn't changing. We're going to go ahead and talk with Saul's doctor about trying antibiotics again.

Rachel, age 42

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to treat fluid buildup in your child's middle ear

Reasons not to treat fluid buildup

I want to get rid of the fluid in my child's middle ear now before it causes my child any problems.

I want to wait and see if the fluid clears up on its own.

More important
Equally important
More important

I'm worried that fluid in the ears may cause my child to have problems hearing.

I'm not worried that my child will develop hearing problems.

More important
Equally important
More important

I'm not worried about the risks and side effects of treatment.

I'm worried that my child might not be able to handle the side effects of treatment.

More important
Equally important
More important

I'm not worried about how much treatment costs.

I don't have insurance, and I can't afford to pay for treatment myself.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having my child treated

NOT having my child treated

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Does fluid buildup in the middle ear always need to be treated?
2, Can having a buildup of fluid in the middle ear cause hearing problems?

Decide what's next

1, Do you understand the options available to you?
2, Are you clear about which benefits and side effects matter most to you?
3, Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
2, Check what you need to do before you make this decision.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision  

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts  

Key concepts that you understood

Key concepts that may need review

Getting ready to act  

Patient choices

What matters to you  

Print Summary

Credits and References

Credits
Author Healthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer John Pope, MD - Pediatrics
References
Other Works Consulted
  • Berkman ND, et al. (2013) Otitis Media With Effusion: Comparative Effectiveness of Treatments. Comparative Effectiveness Review No. 101. (AHRQ Publication No. 13-EHC091-EF). Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.effectivehealthcare.ahrq.gov/reports/final.cfm.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Ear Problems: Should My Child Be Treated for Fluid Buildup in the Middle Ear?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Treat fluid buildup in your child's middle ear.
  • Don't treat the fluid buildup. Instead, wait and see if the fluid clears up on its own.

Key points to remember

  • Fluid buildup in the middle ear usually clears up within 3 months without treatment.
  • Decongestants, antihistamines, and other over-the-counter cold medicines usually don't help treat or prevent fluid in the middle ear.
  • In rare cases, fluid buildup that lasts 3 months or more may cause hearing problems. But hearing usually returns to normal after the fluid is gone.
  • If a hearing test shows that your child has trouble hearing, treatment with antibiotics or surgery may be recommended. But if your child's hearing is okay, you can wait another 3 months to see if the fluid clears up on its own.
FAQs

What is fluid buildup in the middle ear?

Fluid buildup in the middle ear is called otitis media with effusion. The middle ear is the small part of the ear just inside the eardrum.

Your child may not have any symptoms, or he or she may have some minor discomfort and a feeling of pressure or fullness in the ears. Your child may say that his or her ears feel plugged.

Fluid can build up when a cold, allergy, or some other problem causes the small tube that carries fluid from the middle ear to the throat to swell and close. If this tube, called the eustachian tube , gets blocked, fluid builds up in the middle ear.

For some children, the fluid goes away in a few weeks. But a few children still have fluid buildup 3 months after it starts. If your child still has fluid after an ear infection, he or she is more likely to get another infection.

In rare cases, fluid buildup that lasts 3 months or more may cause hearing problems. But hearing usually returns to normal after the fluid is gone.

How is fluid buildup in the middle ear treated?

In most cases, fluid in the middle ear clears up within 3 months without treatment. But if the fluid is still there after 3 months and your child has trouble hearing, treatment may be advised.

Your doctor may suggest one of the following treatments:

  • Antibiotics are sometimes used. But they don't always work or prevent the fluid from coming back. Most children won't need to take antibiotics.
  • Ear tubes allow fluid to drain out of the middle ear. They can also help keep the fluid from coming back, improve hearing, and prevent repeat ear infections. These tubes stay in place for 6 to 12 months and then fall out on their own. Most children who get ear tubes are helped. But some children may need to have tubes put in their ears again, because the fluid comes back.
  • Surgery to remove the adenoids can help air and fluid move through the nasal passages more easily and prevent future fluid buildup. In rare cases, the tonsils may also be taken out. Adenoids and tonsils are small masses of tissue at the back of the throat. They can swell and cause fluid to get trapped in the middle ear. In most cases, doctors recommend this surgery only when antibiotics or ear tubes haven't worked.

What home treatments can you try?

If your child has an infection and not just fluid buildup, you can treat him or her at home with:

  • A warm washcloth placed over your child's ear.
  • Rest.

Why might your doctor recommend treating fluid buildup in the middle ear?

Your doctor might suggest treatment if:

  • Your child has had fluid in his or her middle ear for 3 months or more.
  • Your child is having a hard time hearing.
  • Your child has repeat ear infections.

2. Compare your options

  Treat fluid buildup in the middle ear Don't treat fluid buildup
What is usually involved?
  • Antibiotics:
    • Your child will take a pill or a liquid for several days until all the medicine is gone.
  • Ear tubes:
    • Your child will be asleep during the procedure.
    • A small hole will be made in each eardrum to create a space for the tubes.
    • Most children recover quickly and have little or no pain.
    • Your child most likely will go home within 1 to 2 hours after the surgery and return to school or day care the next day.
    • The surgery can be done in a surgery clinic.
  • Adenoid surgery:
    • Your child will be asleep during the procedure.
    • The doctor will remove the adenoids from the back of your child's throat through the mouth. In rare cases, the tonsils may also be taken out.
    • The surgery can be done in a surgery clinic or hospital.
  • You wait and see if the fluid clears up on its own.
  • If your child has an infection, you can relieve his or her symptoms at home by:
    • Putting a warm washcloth on your child's ear.
    • Encouraging your child to rest.
What are the benefits?
  • Antibiotics:
    • May help clear the fluid from the middle ear.
  • Ear tubes:
    • Can clear fluid from the middle ear and improve hearing.
    • Can relieve pressure and pain in the middle ear.
    • Can prevent future fluid buildup and repeat ear infections.
  • Adenoid surgery:
    • Can help air and fluid move through the nasal passages more easily and prevent future fluid buildup in the middle ear.
  • In most children, the fluid clears up within 3 months without treatment.
  • Your child can avoid the side effects of antibiotics and the risks of surgery.
  • You don't have to pay for antibiotics or surgery.
  • If the fluid doesn't clear up on its own, you can decide later to try treatment.
What are the risks and side effects?
  • Possible side effects of antibiotics include:
  • Possible risks of ear tube placement include:
    • A blockage in the tube, which can cause fluid to build up again and cause an infection.
    • A thickening of the eardrum over time, which may cause hearing problems.
    • Discharge of pus from the ear.
    • A hole in the eardrum that doesn't close after the tube comes out.
    • Scarring of the eardrum. But this is rare.
    • A buildup of tissue behind the eardrum. But this is rare.
    • One or both tubes slipping out of place. But this is rare.
  • Possible risks of adenoid surgery include:
    • Bleeding.
    • Infection.
    • Pain.
  • Less common risks of ear tube placement and adenoid surgery include more serious bleeding and problems from anesthesia.
  • Your child may have some mild discomfort and a feeling of pressure or fullness in his or her ears until the fluid clears up on its own.
  • Sometimes the fluid doesn't go away on its own. If it lasts a long time, it can damage the eardrum and may:
    • Increase the chance of repeat ear infections.
    • Cause hearing problems.

Personal stories

Personal stories about treatment for fluid behind the eardrum

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My little boy, Mateo, is 5 years old. He has only had two ear infections, but he still has fluid behind his eardrum since this last infection. The fluid has been behind his eardrum for 3 months now. It doesn't seem to bother him. I'm going to have Mateo's hearing tested and, if it is okay, I'm just going to wait to see if the fluid will go away on its own."

— Ramon, age 45

"My daughter, Sarah, is almost 3 years old. A few months ago, she had her fourth ear infection, and this time there is still fluid behind her eardrum. I am worried. I don't want Sarah to have trouble with her speech. I have heard about putting tubes in children's ears to help drain fluid. Even though surgery is scary, I'm going to go ahead and talk with Sarah's doctor about having it done. Sarah is tired of taking medicines, and I don't want Sarah to have any hearing loss."

— Wilson, age 33

"My daughter, Amanda, is 4. She just had her first ear infection 4 months ago and still has fluid behind her eardrum. I had her hearing tested, and there is no problem. The fluid doesn't seem to bother her. Amanda really hates to take medicine, so I'm just going to wait and see if the fluid will go away on its own."

— Michelle, age 25

"My son, Saul, is 7 years old. Saul has only had a few ear infections, and none of them have caused much trouble. This last infection, though, was worse than any other. It started 5 months ago. The doctor gave Saul antibiotics, and that seemed to help. The problem is that Saul still has fluid behind his left eardrum. It doesn't really bother him, except he says that his ear seems "stuffy." We have tried letting it get better on its own, but it isn't changing. We're going to go ahead and talk with Saul's doctor about trying antibiotics again."

— Rachel, age 42

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to treat fluid buildup in your child's middle ear

Reasons not to treat fluid buildup

I want to get rid of the fluid in my child's middle ear now before it causes my child any problems.

I want to wait and see if the fluid clears up on its own.

             
More important
Equally important
More important

I'm worried that fluid in the ears may cause my child to have problems hearing.

I'm not worried that my child will develop hearing problems.

             
More important
Equally important
More important

I'm not worried about the risks and side effects of treatment.

I'm worried that my child might not be able to handle the side effects of treatment.

             
More important
Equally important
More important

I'm not worried about how much treatment costs.

I don't have insurance, and I can't afford to pay for treatment myself.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having my child treated

NOT having my child treated

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Does fluid buildup in the middle ear always need to be treated?

  • Yes
  • No
  • I'm not sure
That's right. Fluid buildup in the middle ear usually clears up within 3 months without treatment.

2. Can having a buildup of fluid in the middle ear cause hearing problems?

  • Yes
  • No
  • I'm not sure
That's right. In rare cases, fluid buildup that lasts 3 months or more may cause hearing problems. But hearing usually returns to normal after the fluid is gone.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.
 
Credits
By Healthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer John Pope, MD - Pediatrics
References
Other Works Consulted
  • Berkman ND, et al. (2013) Otitis Media With Effusion: Comparative Effectiveness of Treatments. Comparative Effectiveness Review No. 101. (AHRQ Publication No. 13-EHC091-EF). Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.effectivehealthcare.ahrq.gov/reports/final.cfm.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Current as of: May 4, 2017

Author: Healthwise Staff

Medical Review: Susan C. Kim, MD - Pediatrics & Kathleen Romito, MD - Family Medicine & John Pope, MD - Pediatrics