Ear drainage in toddlers

Ear - Discharge

Is this your child's symptom?

Drainage of substance or liquid from the ear canal
Drainage through an ear tube is included

Types of Ear Discharge

Pus or Cloudy Fluid. This is the most common type of ear discharge. The main cause is an ear infection. The drainage is from a torn eardrum. The eardrum ruptures in about 10&percnt; of bacterial ear infections.
Ear Tube Fluid Release. Children with frequent ear infections may get ventilation tubes put in. These help the middle ear drain its fluids and become dry. Sometimes, the ear tube gets plugged up. Normal fluids build up in the middle ear until the ear tube opens up again. This can cause some clear fluid drainage from the ear canal for a day.
Earwax. Earwax is light brown, dark brown, or orange brown in color. If it gets wet, it can look like a discharge.
Blood. This follows an injury to the ear. Usually, it's just a minor scratch of the lining of the ear canal.
Water. Bath water or tears can get in the ear canal. Seeing a clear "discharge" that happens once is likely this.
Ear Drops. The person who sees the discharge may not know someone else put in drops.
Swimmer's Ear Discharge. Early symptoms are an itchy ear canal. Later symptoms include a whitish, watery discharge. Mainly occurs in swimmers and in the summer time.
Ear Canal Foreign Object. Young children may put small objects in their ear canal. It can cause a low grade infection and pus colored discharge. If the object was sharp, the discharge may have streaks of blood.

When to Call for Ear - Discharge

Call Doctor or Seek Care Now

Pink or red swelling behind the ear
Clear or bloody fluid after a head injury
Bleeding from the ear canal. Exception: few drops and after an ear exam.
Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
Fever over 104° F (40° C)
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Age less than 6 months old
Ear pain or crying like in pain
Discharge is yellow or green, cloudy white or smells bad
Clear drainage (not from a head injury) lasts more than 24 hours
You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

You have other questions or concerns

Self Care at Home

Normal earwax or other harmless discharge

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Bellevue
Everett
Federal Way
Seattle

Care Advice for Ear Discharge

Earwax:
- Ear wax protects the lining of the ear canal and has germ-killing properties.
- If the earwax is removed, the ear canals become itchy.
- Do not use cotton swabs (Q-tips) in your child's ear.
- Call Your Doctor If: begins to look like pus (yellow or green discharge).
Clear Discharge (without head injury):
- Most likely, this is from tears or water that entered the ear canal. This can happen during a bath, shower, swimming or water fight.
- Don't overlook eardrops your child or someone else used without telling you.
- In children with ventilation tubes, some clear or slightly cloudy fluid can occur. This happens when a tube blockage opens up and drains.
- Call Your Doctor If: clear drainage lasts for more than 24 hours.
Blood After Ear Exam:
- Sometimes, ear wax needs to be removed by your doctor to see the eardrum. If ear wax was removed, it can cause a small scratch inside the ear canal. This happens about 10&percnt; of the time. The scratch oozes 1 or 2 drops of blood and then clots.
- This should heal up in a few days.
- It shouldn't affect the hearing.
- Don't put anything in the ear canal. This may start the bleeding again.
- Call Your Doctor If: bleeding starts again.
Cloudy Discharge - Ear Infection:
- Cloudy fluid or pus draining from the ear canal usually means there's an ear infection.
- The pus drains because there's a small tear in the eardrum.
- To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed.
- See Earache care guide for more advice.
Call Your Doctor If: Your child becomes worse.

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 12/30/2022

Last Revised: 12/30/2022

Ear infections and glue ear

Ear infections are very common in small children. Most infections get better quickly and are not usually serious. The two types of ear infections often seen in children are middle ear infections (otitis media) and outer ear infections (otitis externa). Most ear infections involve the middle ear.

Every time a middle ear infection happens, fluid collects behind the ear drum. This fluid usually slowly clears by itself, but children who get frequent infections may have fluid stay behind the eardrum for longer. This is called glue ear. Glue ear may last for many weeks or months, making it harder for your child to hear. Occasionally, glue ear can temporarily affect language development.

What causes ear infections?

Babies and young children get more middle ear infections than older children because they have smaller tubes (called the Eustachian tubes) that connect the middle ear to the throat. When your child has a cold, germs from the throat can travel up to the middle ear and cause an infection. Infections develop more easily in smaller tubes and it's not uncommon for small children to have lots of ear infections in one year, sometimes as often as once every month.

Outer ear infections are usually due to excess moisture in the canal, for example after swimming. They can also be caused by damage to the canal (e.g. from scratching or cleaning with earbuds).

Signs and symptoms of ear infections

Babies and children may have ear pain with both middle and outer ear infections. This pain can cause irritability. Your child may also have symptoms of a cold (e.g. runny nose, sore throat).

Middle ear infections (otitis media)

As fluid collects behind the eardrum, it causes the drum to bulge, resulting in intense pain. Occasionally, the eardrum will bulge so much that it tears (this is called a burst eardrum), and you will see a thick yellow discharge come from the ear. When this happens, children often suddenly feel better, as the bulging has stopped. A burst eardrum normally heals without treatment.
Children with middle ear infections often have a fever – sometimes a fever will be the only symptom of a middle ear infection.

Outer ear infections (otitis externa)

There can be discharge from the ear, or your child might complain of a feeling of fullness in their ear.
The ear may be red and swollen. The redness may spread beyond the ear.
The ear may be painful to touch and move.
Your child may have a fever.

Glue ear

Glue ear is not an infection, but usually follows one or more middle ear infections. Signs and symptoms of glue ear can include:

problems hearing – children may want to have things repeated, talk loudly or have the television up loud. Parents or teachers may notice this, especially in noisy places such as classrooms. In smaller children, hearing difficulties may delay or stall their language development.
some pressure or pain in the ear
irritability or problems sleeping
problems with balance.

When to see a doctor

If you think your child may have an ear infection, take them to see the GP.

A middle ear infection may spread to the firm, bony area behind the ear. You should visit your GP or local emergency department if there is redness, swelling or pain in this area.

If your child has frequent ear infections or their hearing appears to be affected by glue ear, they should have their hearing tested by a hearing specialist (an audiologist). Your GP may also refer them to see a paediatrician or an ear, nose and throat (ENT) specialist.

Treatment

Antibiotics are not often used to treat middle ear infections, as they are often caused by a virus. Antibiotics do not treat viruses. In very young or very unwell children, the GP may prescribe a short course of antibiotics if there's risk of bacterial infection.
Outer ear infections always need treatment with antibiotic drops.

Glue ear

If your child is not bothered by the glue ear, no treatment is needed. It usually goes away by itself over time.
Sometimes antibiotics are prescribed to kill any germs left in the middle ear, and this may help the fluid to clear.
If the glue ear still persists and is affecting your child's hearing over many months, your doctor or ENT specialist may suggest surgery. This is a quick operation during which small tubes (called grommets) are put into your child's ear. These tubes help fluid drain from the middle ear.

Care at home

If your child is in pain, you can give them pain relief, such as paracetamol or ibuprofen. See our fact sheet Pain relief for children.
If your child’s doctor prescribes ear drops, have your child lie down with the affected ear facing the ceiling. Put the drops in and keep your child in the same position for a few minutes, to allow the drops to be absorbed (or place a cotton wool ball in the ear to keep the drops in the canal).
Children with an outer ear infection should avoid swimming for one week to allow the infection to heal.
If your child has hearing troubles that don't improve in the weeks following a middle ear infection, or continues to be irritable, go back to the GP as your child may have glue ear.
Your child may sleep better at night if they are propped up on two or more pillows (only do this if your child is old enough to use pillows).
Don’t allow anyone to smoke in the home or around your child. Cigarette smoke has been shown to stop fluids from being able to drain from the eardrum.
Most children outgrow middle ear problems (including glue ear), and have perfect and undamaged ears with normal hearing when they get older.

Key points to remember

It's common for small children to have several ear infections in one year, as often as once every month.
Antibiotics are not often needed for middle ear infections, but outer ear infections are treated with antibiotic ear drops.
Glue ear is caused by fluid that collects behind the eardrum, in the middle ear. It usually clears on its own with no treatment, but sometimes requires surgery to insert grommets for drainage.
Hearing and speech development can be affected if glue ear is persistent.

For more information

Kids Health Info fact sheet: Fever in children
Kids Health Info fact sheet: Pain relief for children
Kids Health Info fact sheet: Tonsillitis
Better Health Channel: Ear infections

Common questions our doctors are asked

Can my child go swimming during an ear infection?

If your child has an outer ear infection, wait until one week after treatment to give the ear time to heal before letting your child swim. For middle ear infections and glue ear, swimming is OK but should be avoided if the ear drum is perforated. Discuss this with your GP or specialist.

If my child has speech problems caused by glue ear, will surgery help their speech improve?

If language delay is caused by difficulty hearing from glue ear, then correcting the glue ear often results in rapid improvements in language. Most children catch up quickly with their peers and the delay is completely corrected.

My child is in a lot of pain with his ear infection. Can I give Painstop?

Painstop is usually not required, and is now only available by prescription. It contains codeine, which may cause nausea or constipation in children. Paracetamol and ibuprofen can be used safely.

Will my child grow out of their ear infections?

As children grow, the tubes in their ears (called the Eustachian tubes) also grow. This is usually associated with fewer - and less severe - ear infections as the child grows. As they get older, children tend to have fewer colds, and this means they will also have fewer ear infections.

Should I clean my child’s ears to prevent a build-up of wax?

No. There is no need to remove the wax in a child’s ears. The body is able to do this by itself. Large clumps of wax that are visible at the opening of the ear canal can be removed, but earbuds should not be used in children.

Developed by The Royal Children's Hospital General Medicine, Emergency and Otolaryngology departments. We acknowledge the input of RCH consumers and carers.

Reviewed March 2018.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.

Discharge from the ear in a child

Article rating

4.13 (Votes: 16)

Contents

Causes
What can tell the color of discharge from the ear?
Treatment

Ear discharge is a substance that comes out of the external auditory canal due to natural or pathological causes. It can be of different consistency, color, origin and indicates the development of diseases of the auditory system. It is impossible to understand the cause of its appearance and prescribe a course of effective treatment. With discharge from the ear of a child, you need to contact a pediatric otolaryngologist, since this process is fraught with serious complications. Especially you should not hesitate if you have the following symptoms:

fever;
pinna pain;
redness of the pinna;
headache;
swelling of the face, neck;
hearing loss;
stuffy ear;
burning, itching in the ear;
dizziness;
nausea.

Causes

Fluid from the ears in children does not always indicate the course of a pathological process. It can appear under the influence of natural factors:

water ingress;
strong fluctuations in pressure, air temperature;
increased physical activity;
age-related hormonal changes;
improper care of the external auditory canal.

Such secretions stop when the factor that caused them is eliminated. However, it is not always possible to understand whether the fluid from the ear is natural or not, so a consultation with a doctor will not be superfluous. In addition, his explanations of how to avoid such situations in the future will be useful. nine0007

Pathological discharge may appear due to:

Mechanical trauma to the ear canal. Often this happens when cleaning the ears with cotton swabs or putting foreign objects in there.
Otitis. This disease is an inflammatory process in the ear, accompanied by high fever, pain, tinnitus.
Furuncle. When it is opened on its own, pus is released from the ears. The child also feels pain when moving his jaws: while eating, talking, yawning. nine0004
Otomycosis. This disease is characterized by the reproduction of fungal flora in the ear. The discharge is accompanied by itching and pain.
Cholesteatoma. This is a benign neoplasm that increases the secretion of the glands in the ears. Among the accompanying symptoms: congestion, burning, itching.
Injuries of the skull, brain. This condition is life-threatening and requires immediate medical attention. The fluid from the ears is usually bloody or clear with a pink tint. nine0004

What can the color of ear discharge say?

Doctors analyze their color to determine the cause. Here is how the color of the liquid and the factor that caused it are related:

Yellow indicates an inflammatory process: if there is no pain, then this may mean that the infection has entered the ear canals due to diseases of other ENT organs; if there is pain, most likely, this is an indicator of otitis media.
Bloody may appear after an ear injury, rupture of the eardrum and malignant tumors of the organ of hearing. nine0004
Brown indicates a cerumen plug or bacterial infection.
Watery appear with allergic otitis, with trauma to the skull.
White is often a sign of seborrheic dermatitis.
Grey, black or white discharge of a cheesy consistency with black patches most often indicates the presence of a fungal process.

Treatment

To confirm the diagnosis, the ENT doctor will conduct a thorough examination, analyze the color, consistency and other characteristics of the discharge. Additional research may be required:

bacterial culture and blood tests to detect the pathogen;
audiometry, otoscopy, computed tomography to establish a more accurate clinical picture.

If the discharge from the child's ear was caused by natural causes, the doctor will advise the correction of the patient's lifestyle, teach the proper care of the hearing organs.

In pathological discharges, the root cause is treated, since in themselves they are only a symptom. Antifungal and antibacterial drugs, instillation, washing, warming up the diseased ear can be prescribed. nine0007

The Ear, Nose and Throat Clinic is ready to host small patients with any pathological manifestations of the ENT organs. The professionalism and extensive experience of our pediatric otolaryngologists allow us to make an accurate diagnosis and prescribe the best treatment program. Contact us at the contact phone number.

Seeing a doctor early can help keep you healthy.
Don't delay treatment, call now. We work around the clock in Moscow. nine0007

tel.: 8 (499) 501-15-53 (24 hours)

Ear inflammation in a child: how to prevent complications

Otitis is one of the most common diseases in childhood. According to international statistics, 98% of children suffer from ear inflammation at least once, 60% experience the disease twice. What is effective prevention and how otitis is treated, said the otorhinolaryngologist of the Morozov Children's Hospital, Candidate of Medical Sciences, holder of the status of "Moscow Doctor" Alexander Mikhailovich Ivanenko. nine0007

Why does otitis occur?

Depending on the location of the inflammatory process, otitis media can be external, middle or internal. Otitis externa is caused by microbes and fungi, most often manifested by damage to the skin of the ear canal and boils in the auricle.

Acute otitis media is an acute inflammation of the mucous membrane of the middle ear cavity. It develops against the background of respiratory infections. Ear infection occurs through the auditory tube, when mucus from the nasopharynx enters the middle ear and viruses, bacteria, fungal flora freely penetrate from the nasopharynx through the mouth of the auditory tube into the tympanic cavity. nine0007

Due to anatomical features, the smaller the child, the shorter and wider the auditory tube connecting the ear cavity with the nasopharynx. Therefore, in an infant who spends most of his time lying down, and in a younger child who does not know how to clean his nose, mucus can flow at any time. In adolescent children, the auditory tube is a tortuous narrow tube, so the infection from the nasopharynx to the middle ear is less likely to pass.

Adenoid vegetations also contribute to the development of ear inflammation. This is an overgrowth of the nasopharyngeal tonsil, which is the main focus of bacterial infection in the nasopharynx. nine0007

How does the disease manifest itself?

The main symptom of otitis media is pain in the ear. Children under one year old, as a rule, refuse to eat, because sucking movements cause pain. Babies often touch their ears, rub them, and cry. You can suspect otitis media by pressing on the tragus of the child's auricle.

The key method for diagnosing otitis media is otoscopy - an examination by a doctor of the external auditory canal and eardrum using a special instrument.

How to treat otitis?

If the inflammatory process is at the initial stage, outpatient treatment is carried out. The therapy is selected by a pediatrician or an otorhinolaryngologist depending on the child's condition. Be sure to use vasoconstrictor drops in the nose.

If timely medical care is not provided, the inflammatory process turns into acute catarrhal otitis media, and then into acute purulent otitis media, characterized by the appearance of purulent discharge from the ear.