Recurrent Ear Infections in Children: When Are Grommets or ENT Review Needed?

Ear infections are very common in children. Many children have the occasional painful ear during or after a cold and recover fully. Recurrent ear infections are different. They can cause repeated pain, sleepless nights, antibiotics, time off school or nursery and anxiety for parents.

Some children also develop hearing loss between infections because of glue ear. Others have persistent discharge from the ear, especially if there is a perforation or grommet-related otorrhoea.

At Hampshire ENT Clinics, Miss Eleanor Sproson assesses children with recurrent ear infections, glue ear, hearing concerns and persistent ear discharge. The aim is to identify why infections keep happening and whether monitoring, medical treatment or surgery may help.

Quick answer: when should a child with ear infections see ENT?

ENT assessment is useful if ear infections are frequent, severe, associated with hearing loss, causing persistent discharge, linked to speech or school concerns, or continuing despite appropriate treatment. Urgent review may be needed if there is foul-smelling discharge, dizziness, facial weakness, swelling behind the ear or concern about cholesteatoma.

What is acute otitis media?

Acute otitis media is infection or inflammation of the middle ear. It often follows a cold, when the Eustachian tube becomes blocked and fluid or infection builds up behind the eardrum.

Symptoms may include earache, fever, irritability, poor feeding, poor sleep, temporary hearing loss or ear discharge if the eardrum perforates. Many infections settle without complications, but repeated episodes can be disruptive.

Why do some children get repeated ear infections?

Children are more prone to ear infections because their Eustachian tubes are shorter, narrower and less efficient than in adults. Viral infections, nursery exposure, enlarged adenoids, glue ear, allergic rhinitis and family tendency can all contribute.

Some children move from one cold to the next, particularly during winter. Others have a pattern of recurrent infections with persistent fluid behind the eardrum between episodes.

Recurrent ear infections versus glue ear

Recurrent acute otitis media means repeated episodes of painful ear infection. Glue ear means persistent fluid behind the eardrum without acute infection. The two conditions can overlap.

A child with glue ear may have muffled hearing between infections. A child with recurrent infections may hear normally between episodes. Hearing tests and examination help distinguish the patterns.

What does persistent ear discharge mean?

Ear discharge can occur when an acute infection causes a temporary eardrum perforation, when a child has grommets and develops otorrhoea, or when there is chronic ear disease.

Persistent, recurrent, foul-smelling or blood-stained discharge should be assessed. Rarely, it can be a sign of cholesteatoma, a skin cyst in the middle ear that can damage surrounding structures if untreated.

How does ENT assess recurrent ear infections?

Assessment includes a careful history of the number of infections, severity, antibiotic use, ear discharge, hearing, speech, balance symptoms, nasal obstruction, snoring and adenoid symptoms. The ear canals and eardrums are examined, often with a microscope or otoscope.

Hearing tests and tympanometry may be arranged if hearing loss or glue ear is suspected.

When are grommets considered?

Grommets may be considered for selected children with recurrent acute otitis media or persistent glue ear causing hearing problems. They ventilate the middle ear and can reduce fluid build-up. In children with recurrent infections, grommets can also allow some infections to be treated with ear drops rather than repeated oral antibiotics.

Grommets are not right for every child, and the decision depends on the pattern of infections, hearing levels, age, development and risks.

What about adenoidectomy?

Adenoidectomy may be considered if enlarged or chronically inflamed adenoids are contributing to recurrent ear problems, glue ear, nasal blockage or snoring. It may be combined with grommet insertion in selected cases.

When to book an appointment

Parents should consider private paediatric ENT assessment if a child has repeated painful ear infections, repeated antibiotics, persistent ear discharge, hearing concerns, speech delay or ear problems affecting school or sleep.

Hampshire ENT Clinics provides consultant-led paediatric ENT care across Hampshire and the South Coast.

Frequently asked questions

How many ear infections are too many?

There is no single number that applies to every child. Frequency, severity, recovery, hearing, school impact and complications all matter.

Do children grow out of recurrent ear infections?

Many do as the Eustachian tube matures and immune exposure changes. Persistent or severe cases should be assessed.

Can recurrent infections cause hearing loss?

Yes. Hearing may be temporarily reduced during infection or persistently reduced if glue ear is present between infections.

What are grommets?

Grommets are small ventilation tubes placed in the eardrum during a short operation under general anaesthetic.

Do grommets stop all ear infections?

No. They may reduce infections in selected children and can make some infections easier to treat with drops, but they are not a guarantee.

What does ear discharge through grommets mean?

It can happen with infection. It is often treated with ear drops, but persistent or recurrent discharge should be reviewed.

Is ear discharge ever serious?

Yes. Persistent, foul-smelling or recurrent discharge needs assessment to exclude chronic ear disease or cholesteatoma.

Can enlarged adenoids affect the ears?

Yes. Adenoids can contribute to Eustachian tube dysfunction, glue ear and recurrent ear infections.

Will my child need a hearing test?

A hearing test is often helpful, especially if there are concerns about speech, school progress or persistent fluid behind the eardrum.

Who sees children with recurrent ear infections at Hampshire ENT Clinics?

Miss Eleanor Sproson assesses children with recurrent ear infections, glue ear, grommets and related paediatric ENT problems.