Glue ear is one of the most common childhood conditions. It is often linked with ear infections and is usually temporary, but long-term glue ear can affect children's hearing, speech development, and cause them to fall behind at school. Here we explain what glue ear is and how it can be treated.
- What is glue ear?
- Why does my child have glue ear?
- How does glue ear affect children?
- What should I do if I think my child has glue ear?
- How is glue ear tested?
- What treatment is available?
- How can I make hearing easier for my child?
- What can my child's school do to help?
- Can my child fly with glue ear?
- Glue ear resources and further reading
What is glue ear?
Click image to enlarge.
For ears to work properly the middle ear needs to be kept full of air. The air travels through the eustachian tube which runs from the middle ear to the back of the throat. In children this tube is not as vertical and wide as it will be when they get older and as a result doesn’t work as well. If the eustachian tube becomes blocked, air cannot enter the middle ear. When this happens, the cells lining the middle ear begin to produce fluid. This is a runny liquid which can get thicker as it fills the middle ear.
With fluid blocking the middle ear, it becomes harder for sound to pass through to the inner ear, making quieter sounds difficult to hear.
Why does my child have glue ear?
Many things can contribute to glue ear, such as colds and flu, allergies and passive smoking. Children with cleft palate, or with genetic conditions such as Down's syndrome, may be more likely to get glue ear as they often have smaller eustachian tubes that do not function well.
How does glue ear affect children?
Changes in behaviour, becoming tired and frustrated, lack of concentration, preferring to play alone and not responding when called may indicate glue ear. These signs can often be mistaken for stubbornness, rudeness and being naughty.
A prolonged period of time with reduced hearing can affect children’s speech development. For example, parts of words may not be pronounced clearly. Children with glue ear may also fall behind at school if they do not have extra support.
What should I do if I think my child has glue ear?
Arrange an appointment with your family doctor (GP). Often glue ear is associated with a heavy cold and will clear up when the congestion from the cold has gone.
Your GP will examine your child’s ears and should be able to tell if glue ear is present. If there is any pain or sign of infection your GP may prescribe a course of antibiotics. Your GP may want to wait to see if the glue ear clears up by itself before referring your child on to the hospital.
If the symptoms continue ask your GP to refer you to the ear, nose and throat (ENT) department at your local hospital.
How is glue ear tested?
A specialist doctor will examine your child’s ears and a further assessment will be carried out. This will include a tympanometry test, which measures how well the eardrum can move. If there is fluid in the middle ear the eardrum will not work properly. A graph (called a tympanogram) will show the results straight away. A hearing test should also be done to check if the glue ear is affecting your child’s hearing and by how much.
The specialist doctor should explain the results of all the tests used and discuss the best way to treat your child. It is a good idea to monitor the glue ear with repeated tests at least three months apart. For most children, the glue ear will clear up in this time. If it has not, you may be offered grommets or temporary hearing aids.
See our resource Understanding your Child's Hearing Tests for further information.
What treatment is available?
Grommets are tiny plastic tubes that are put in the eardrum. They allow air to circulate in the middle ear and stop more fluid from building up. This is done during a short operation in hospital under general anaesthetic. The grommets are inserted after the fluid in the middle ear has been drained away.
A discharge (occasionally blood-stained) may occur for a couple of days immediately after the operation. This is usually because the surgeon has placed antibiotic drops in the ear at the time of the operation. After this time there should not be any discharge. If there is, you should see your GP for advice and antibiotic drops. Any prolonged discharge from the ear should be assessed by your Ear, Nose and Throat (ENT) doctor.
usually stay in until the eardrum has healed and pushed them out.
Sometimes the fluid comes back and another grommet operation may be
Children’s hearing can be affected for long periods of time while waiting to see if the glue ear clears up naturally or while on the waiting list to have the grommet operation. It is important to make sure your child’s speech and education does not suffer during this time. You may want to consider hearing aids or asking for extra support at school.
Our tips about preparing your child for surgery may be helpful if your child is having a grommet operation.
Swimming and bathing with grommets
Some surgeons prefer a child not to swim while they have grommets. This is because the grommets allow direct access of water into the middle ear and a small percentage of children with grommets may develop ear infections. Other surgeons allow swimming with some precautions, such as:
- Try to avoid your child diving or jumping into the water as this increases the outside pressure and forces water through the grommet into the middle ear.
- Try to get your child to wear a swimming cap.
- Don't take your child swimming for at least three weeks after grommet surgery to allow for the operation site to settle down.
- Avoid your child swimming in lakes or non-chlorinated pools. The water in these places usually has a high bacteria count and infection is more likely to occur.
- Soapy water allows water to slip through the
grommet into the middle ear. If the water is dirty it will infect the
middle ear. With your child sitting upright in the bath wash their hair
first before body washing. Tilt their head back and rinse the hair off
with clean water, then apply a shower cap. This way the child can play
in the bath without getting dirty, soapy water in the ear.
Autoinflation may be helpful for some older children during the watchful waiting period or while waiting for grommet surgery.
Autoinflation is a method of encouraging the eustachian tube (the tube that runs from the middle ear to the back of the throat) to open. This can help drain the ear naturally through the eustachian tube, by forcing air from the back of the throat to the middle ear.
The Otovent is suitable for children from three years, and is a device made up of a balloon and a nosepiece. This treatment involves fitting the balloon to the nosepiece, putting the nosepiece against one nostril and keeping the other nostril and mouth closed. By blowing through the nostril, the balloon is inflated until it is about the size of a grapefruit. The nosepiece is removed and the procedure repeated with the other nostril.
Otovents are now available on prescription. Ask your GP about whether they think it will be suitable for your child.
Hearing aids can be useful for children with any level of deafness. There are different types of hearing aid that are suitable for children with glue ear. Most hearing aids work by amplifying (making louder) sounds going into the ear. Good quality, digital hearing aids are available free of charge for all children on the NHS.
How can I make hearing easier for my child?
Basic communication tips can help make listening easier for your child – have a look at the deaf awareness section of our website. If your child is getting very tired from the extra effort involved in listening and lipreading, have a look at our concentration fatigue webpage.
What can my child's school do to help?
Support at school for children with glue ear
Children’s hearing can be affected for long periods of time while waiting to see if the glue ear clears up naturally or while on the waiting list to have the grommet operation or hearing aids. Some children will have glue ear for long periods that may persist through secondary school, so it’s important that your child’s speech and education doesn’t suffer.
If the glue ear persists and leads to children experiencing mild hearing loss, research shows that it can have a major impact on their development, but fortunately, there are lots of things that schools can do to support children with mild hearing loss.
As a starting point, talk to your child’s teacher or the person who has been designated by the school to identify children with special or additional educational needs to ask for extra support at school. In England, this person is known as a Special Educational Needs Coordinator (SENCO). You could also talk to a Teacher of the Deaf (ToD) from the local authority specialist education service for deaf children.
The school aren’t taking my child’s glue ear seriously
Many parents of children with glue ear have told us that their child’s school doesn’t understand the impact glue ear can have on their child’s academic and speech and language development. They don’t always do enough to support children with glue ear.
The law (Children and Families Act 2014) requires that schools in England take steps to support children with medical conditions. Glue ear can be regarded as a ‘medical condition’. Schools must also follow government guidance called Supporting pupils with medical conditions at school. This guidance requires schools to make sure that:
- children with medical conditions are supported so that they have full access to education, including to physical education and school trips
- staff receive appropriate training
- there is someone in charge of how the school supports children with medical conditions they have a policy that sets out how they will support children with medical conditions (this should be readily available).
If you’re concerned about the support that your child is receiving, make sure that the school is clear that your child has a medical condition. Ask them how they’ll make sure they are meeting the requirements of the government guidance.
The Welsh Government has produced guidance for schools on children with medical conditions.
If you live in Scotland, your child may be regarded as having ‘additional support needs’. Schools in Scotland are required to provide support for these children, even if this support is only needed for a short while. The Enquire website has more information on additional support for learning and on your rights in this area.
If your child’s glue ear is lasting for a long time and impacting on their education, they may be regarded as having special or additional educational needs. Schools and other education providers should provide special or additional educational support. Find out more about getting additional support at school.
If your child’s glue ear is likely to, or has, lasted for at least 12 months, without clearing up, then your child may be regarded as having a disability. This means that schools and other education providers in England, Scotland and Wales must ensure they take steps to prevent discrimination and also proactively provide support to counter any disadvantage that your child may experience. Go to The Equality Act and Your Child’s Education for more information.
Northern Ireland has its own anti-discrimination legislation:
- The Special Educational Needs and Disability (Northern Ireland) Order 2005 (SENDO)
- The Disability Discrimination (Northern Ireland) Order 2006.
To find out more information on disability legislation in Northern Ireland call the Equality Commission for Northern Ireland on 028 90 890 890 or visit www.equalityni.org.
What you can do
- Explain to your child’s teacher and/or SENCO that although glue ear is usually temporary, your child is deaf and needs extra help. Show them your child’s most recent audiogram so the school understands what your child can and can’t hear.
- Seek advice from the local authority specialist education service for deaf children, who employ teams of Teachers of the Deaf (ToDs). Not all services provide direct support to children with temporary or mild hearing loss but they should provide the school with guidance and information. If your child has a hearing aid, they should have a ToD.
- Tell them about us! The National Deaf Children’s Society supports children with all types of hearing loss, including glue ear, and has lots of information for professionals who work with deaf children.
- Share our resources with your child’s teacher (and anyone else who works closely with your child) to help them understand how glue ear or mild hearing loss affects children in the classroom and what steps they can do to help make listening and learning easier.
- Encourage your child’s teacher to share our deaf awareness tips and resources with the other children so that they know how to communicate with, and include, your child.
- Explain the benefits of reducing background noise in the classroom as much as possible.
- Ensure that staff and pupils know how to communicate clearly and effectively with your child.
- Check that there has been a specialist assessment of your child’s needs.
- Create a personal passport or profile that summarises all the most important information about your child so that school can support your child in the best way possible.
- Your child might need special educational needs (SEN) support.
If you’re still concerned that your child’s school isn’t doing enough or that your child is falling behind at school, contact our Freephone Helpline for support and guidance on what to do next.
Can my child fly with glue ear?
Generally children with glue ear don’t experience problems flying, although sometimes doctors don’t recommend it depending on the current condition of the ears.
The build-up of fluid in the middle ear can expand during take-off and, more commonly, landing due to changes in cabin pressure, causing discomfort. The risk is the fluid expands so much the eardrum perforates; if this happens a doctor should prescribe antibiotics but there is normally no long term damage.
Before flying, we strongly recommend seeing your GP who may prescribe some decongestant medication.
Eating and drinking during take-off and landing will help open your child’s eustachian tubes and prevent discomfort. Ear plugs known as ‘EarPlanes’ (available from pharmacies) can help to reduce discomfort from changes in air pressure.
Glue ear resources and further reading
- Glue ear poster
Download: Glue ear poster
- Treatments for glue ear factsheet
Information about alternative treatments for glue ear, other than using grommets.
Download: Treatments for glue ear
- How glue ear affects speech
I CAN, a children's communication charity, provides a number of factsheets written by speech and language therapists about the impact of glue ear, speech and language development and communication.
- Harvey gets grommets comic
A short comic book story about a young boy who gets grommets. Aimed at children under 10.
- Glue ear videos
For some further information about glue ear and to watch an animation of how glue ear affects the ear visit the NHS Choices website.
A family tell us about their son's grommet operation and ongoing hearing problems.