“HUH?” Does Your Child Have Fluid In Their Ears?


When my twin boys were two years old, they used to plop down in the family room and watch cartoons, just like any kid their age. One would sit up on the couch with my wife and me, and the other would sit on the floor. I didn’t think much of it at all, until I noticed that the one on the floor would slowly migrate toward the TV, until he was right in front of it. We would, of course, scold him and tell him he would “go blind if he stayed that close” and he would dutifully move back from the screen. Then, the whole process would begin again as he would inch back toward the TV!

Eventually, I got wise and decided to check his ears and his hearing. Sure enough – he had fluid in both ears. Ear problems in kids come in two main varieties. The first is recurrent ear infection; these are easy to spot, because kids end up with painful ears and fevers and are just miserable. The other problem type involves fluid accumulation behind the eardrum. This is what my son had, and it’s much harder to spot – the only real symptom is hearing difficulty. It doesn’t cause pain and antibiotics don’t help, because the cause is not bacteria. Instead, it’s due to poor function of the Eustachian tube, which has the primary job of ventilating the middle ear space and normalizing pressure. With the ear full of fluid, air can’t circulate through the middle ear like it should and the fluid does not let sound pass through very well.

The only time a parent may see symptoms of this is when the kid gets on an airplane. The resulting pressure changes are not able to be equalized and that leads to severe pain. When a child gets on an airplane happy, but within minutes of takeoff starts screaming, that’s not an infection that set in within minutes. That’s a pressure problem in the middle ear.

Antibiotics won’t help at all, but decongestants and “popping” the ears may. Most kids, though, have this problem chronically, and if it goes on for several months, the best option is to drain the accumulated fluid with tube insertion, so that hearing can be normalized. If fluid is left for too long, it will start to affect the clarity of the child’s speech and eventually, they will end up in speech therapy before the therapist (wisely) raises the suspicion of a hearing problem.

Nowadays, we are much better about screening for hearing loss. This was not always the case. My sons graduated from the new Powers High School facility. The building is a magnificent reminder of an older era of architecture, and large letters carved in stone at the top are a reminder of its original purpose: Michigan School for the Deaf. More than a hundred years ago, before antibiotics and universal hearing screening, many kids suffered consequences of ear infections that they would not today. A simple bacterial infection that now responds to a prescription for seven days of the “pink stuff” (antibiotic) could, back in the day, lead to permanent hearing loss if the bacteria grew uncontrolled in the sensitive middle and inner ears.

Thank goodness for Sir Alexander Fleming – the Scottish physician who discovered that the fungus growing on his orange actually killed bacteria … and was later called Penicillin!


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