*If you have concerns about your children’s hearing, speech and language development, and/or general health, please consult with your doctor for a trained medical opinion.*
In graduate school I learned that having liquid in the middle ear that doesn’t clear can make it challenging for kids to hear and learn language. It makes sense: ears need to function at their best to help kids learn speech and language.
Ear infections occur when the drainage tube (called the Eustachian tube) that starts in the middle ear and extends down to the sinus cavity gets blocked. The middle ear is not able to drain and whatever material that remains can get infected. However, when the Eustachian tube stops functioning, it doesn’t mean that an ear infection is going to occur. Fluid can sit in the middle ear impeding the child’s ability to hear without an ear infection occurring.
I kind of think of graduate school as the “theory” and being a mom is the “practice” — at least when it comes to Eustachian tube dysfunction! I’ve learned a lot about ear tubes from my boys. My eldest had them put in at 17 months of age and now my second child, 26 months old, will be getting them in a couple weeks.
In case you were wondering, ear tube surgery involves creating a perforation in the ear drum and inserting a plastic grommet that aerates the middle ear cavity. Here are my takeaways:
1) More than one ear infection per year is above average
The average baby has one ear infection by age one and two by age two. My eldest had 8 by 16 months of age. Big red flag for ear tubes. If I had known the average number of ear infections kiddos get, I would have insisted on ear tubes even earlier. The earliest a child can get ear tubes is around seven months of age. When my second son at 24 months of age had three ear infections in four months, it tipped me off that he had a problem. After he couldn’t clear the fluid from his ears five weeks later, the the otolaryngologist (aka the ENT) said he needed tubes.
2) Advocate with your pediatrician
Unfortunately, my normally terrific pediatrician did not refer me to the ENT. I asked that my pediatrician help me get an appointment with an ENT. I think a lot of pediatricians do not want to initiate the process because they don’t like recommending surgery. Your pediatrician can make a referral without saying one way or another that your child needs ear tubes. He or she can leave it to the ENT doctor who knows for sure if surgery is required.
3) Standing or fluctuating liquid in ears
Many kids do get ear infections, but they are able to clear the liquid out of their ears. However, for some kids it can take up to three months. During those months, kids aren’t able to hear to their fullest potential. That means that any language stimulation a kids is receiving may not be enough to overcome any delays. Chronic fluid in the middle ear space can yield a hearing loss in the range of 30 dB.
4) Chronic cold and allergy symptoms
Kids that can’t seem to get over colds or catch cold after cold after cold, may not be hearing adequately. When you see a runny nose, imagine what’s happening inside their ears. It’s hard to know if their Eustachian tubes are working.
5) Tonsil and adenoid dysfunction
My friends with children who have needed ear tubes, sometimes also have their adenoids taken out at the same time. Tonsils can be so enlarged that they take up a lot of space in the mouth (causing speech problems and trouble breathing, just to name a few consequences). Allergies and chronic colds affect the entire system so standing liquid in the middle ear could be part of the picture.
As usual, feel free to email me or comment with your experience and/or thoughts!