Learn what a typical Ear infection with fluid prognosis is at Consumer Reports Health.

Ear infection with fluid

What will happen to my child?

If your child has fluid in the ear, there is a good chance that he or she will get better without any treatment.

About 4 in 10 children with fluid in the ear get better without treatment within three months.

Source:
Lous J, Burton MJ, Felding JU, et al.
Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children (Cochrane review).
In: The Cochrane Library. Wiley, Chichester, UK.

But in some children, especially younger ones, fluid stays in the ear for much longer. About 1 in 20 children who have fluid in the ear when they are younger than school age have it for a year or more.

Source:
American Academy of Pediatrics.
Clinical practice guideline. Otitis media with effusion.
Pediatrics. 2004; 113: 1412-1429.

Even if fluid in the ear does clear up, it may come back. Between 3 in 10 and 4 in 10 children who get fluid in the ear once keep getting it again.

Source:
American Academy of Pediatrics.
Clinical practice guideline. Otitis media with effusion.
Pediatrics. 2004; 113: 1412-1429.

And the younger your child is the first time he or she has an ear infection, the more likely he or she is to have more ear infections followed by fluid in the ear.

Source:
Bluestone CD, Klein JO.
Otitis media in infants and children.
2nd edition. WB Saunders, Philadelphia, U.S.A.; 1995.

Researchers don't know why children who have ear problems early in life are more likely to have these troubles come back. It may be that these children are having problems with their eustachian tubes (the tubes leading from the middle ears to the back of the nose). Or it may be that they have a problem with their

immune system
The immune system is made up of the parts of the body that are devoted to fighting infection. The body is constantly being threatened by infections from things like bacteria, viruses and parasites. The immune system fights these infections in different ways. At the microscopic level, the immune system uses antibodies and white blood cells, which travel in the blood and target infectious agents, such as bacteria. These microscopic parts of the immune system either kill the infectious agent directly, or take it to other parts of the body, like the spleen, where it can be dealt with. The lymph nodes are another important part of the immune system. Within them, white blood cells filter through the foreign material that has entered the blood, to see if there are any infections. When you have a swollen gland during a cold, this is actually a lymph node that is reacting to the infection. Unfortunately, it is possible for the immune system to become confused and to use its destructive powers to target healthy parts of the body. Diseases that result from this type of situation are called autoimmune diseases.

immune system (the parts of the body that fight infection).

Source:
Bluestone CD, Klein JO.
Otitis media in infants and children.
2nd edition. WB Saunders, Philadelphia, U.S.A.; 1995.

How will fluid in the ear affect my child?

It's hard to say how your child will be affected by fluid in the ear in the long term. If the fluid clears up after a few weeks or months, your child's hearing will go back to normal, and he or she will probably not be affected at all.

But if the fluid stays for a long time or comes back often, it may affect how your child develops. Having fluid in the ear during the first few years of life could affect:

How soon your child talks
How well he or she uses language
How he or she behaves
How well he or she does in school.

This is because a child with fluid in the ear may not be able to hear properly. The fluid stops the eardrum and the small bones in the middle ear from moving freely, so they can't carry sounds to the inner ear properly. Your child's hearing loss will probably be worse if both of his or her ears are affected.

To learn to talk and use language, your child needs to hear people speaking. If your child can't hear properly at an age when he or she is learning to talk, it could slow the development of his or her speech and language.

¹ One large study of children aged 10 and under found that fluid in the ear was linked to delays in learning how to use language.

Source:
Bennett KE, Haggard MP.
Behaviour and cognitive outcomes in middle ear disease.
Archives of Disease in Childhood. 1999; 80: 28-35.

⁴

There may be other problems, too. If your child can't hear the teacher, it may affect how well he or she does in preschool or school. And if your child can't hear properly at school or at home, he or she will feel frustrated and may start to misbehave.

But doctors and researchers are still unsure about all of this. For a start, they don't know just how long a child has to have fluid in the ear, or how much hearing loss it has to cause, for speech and language to be affected.

Source:
University of York. Centre for Reviews and Dissemination.
The treatment of persistent glue ear in children.
Effective Health Care. 1992; 1: 4.

⁵

And the amount of hearing loss caused by fluid in the ear varies. Usually, the hearing loss is mild.

Source:
American Academy of Pediatrics.
Clinical practice guideline. Otitis media with effusion.
Pediatrics. 2004; 113: 1412-1429.

² But your child's hearing may change from day to day.

Also, it's not clear how fluid in the ear affects a child's use of language. Some studies have found that children who have repeated bouts of fluid in the ear get lower scores in language tests. But in other studies, having fluid in the ear for a long time didn't make any difference to how well children used language.

Source:
American Academy of Pediatrics.
Clinical practice guideline. Otitis media with effusion.
Pediatrics. 2004; 113: 1412-1429.

² So it may be that some children have more problems from fluid in the ear than others do.

Source:
Klein JO.
The burden of otitis media.
Vaccine. 2000; 19 (supplement 1): S2-S8.

⁶

What your doctor may do

Doctors usually recommend a period of watchful waiting to see if the fluid in the ear clears up on its own. (Watchful waiting is when your doctor regularly checks on your child rather than using a treatment.) If the fluid doesn't clear up and your child has a loss of hearing in both ears, then your doctor may recommend treatment. For more information, see What treatments work for fluid in the ear?.

If your child has fluid in the ear, it's wise to keep an eye on him or her to make sure that the condition clears up quickly. If you think the fluid isn't clearing up, or if it keeps coming back, take your child to the doctor. It's also a good idea to ask your child's teacher to keep an eye on your child.

Source:
Bennett KE, Haggard MP.
Behaviour and cognitive outcomes in middle ear disease.
Archives of Disease in Childhood. 1999; 80: 28-35.

⁴

If your child has Down's syndrome,

cleft palate
Babies who are born with a cleft palate have a hole in the roof of their mouth. Surgeons usually correct the problem during the first year of a child's life.

cleft palate or another disability, then even a short period of hearing loss from fluid in the ear can be a serious problem. Your doctor should make sure that your child is treated right away.

Once fluid in the ear clears up, your child's ears and hearing should return to normal. But in a very few children, this condition can cause further problems. For more information, see Complications of fluid in the ear.

There are several steps you can take to help keep your child's ears free of fluid and infection. For more information, see How to keep your child's ears healthy.

As children get older, fluid in the ear normally goes away completely. Problems with fluid in the ear don't normally continue after age 6.

Source:
Klein JO.
The burden of otitis media.
Vaccine. 2000; 19 (supplement 1): S2-S8.

⁶

Sources for the information on this page:

Lous J, Burton MJ, Felding JU, et al.Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children (Cochrane review).In: The Cochrane Library. Wiley, Chichester, UK.

American Academy of Pediatrics.Clinical practice guideline. Otitis media with effusion.Pediatrics. 2004; 113: 1412-1429.

Bluestone CD, Klein JO.Otitis media in infants and children.2nd edition. WB Saunders, Philadelphia, U.S.A.; 1995.

Bennett KE, Haggard MP.Behaviour and cognitive outcomes in middle ear disease.Archives of Disease in Childhood. 1999; 80: 28-35.

University of York. Centre for Reviews and Dissemination.The treatment of persistent glue ear in children.Effective Health Care. 1992; 1: 4.

Klein JO.The burden of otitis media.Vaccine. 2000; 19 (supplement 1): S2-S8.

This information was last updated on May 11, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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