Glue ear itself is usually painless, which is why it can go unnoticed. This is what distinguishes it from an acute ear infection (acute otitis media), which typically causes significant pain, a high temperature, and a very unsettled baby. If your child has pain alongside the hearing symptoms, see your GP as the fluid may have become infected.

Grommets are tiny plastic ventilation tubes inserted through a small cut in the eardrum under general anaesthetic. They allow air into the middle ear, which prevents the fluid from building up. Grommets usually fall out on their own after 6 to 12 months as the eardrum grows. They are usually only considered after at least 3 months of significant hearing loss that has not resolved.

What is the difference between glue ear and an ear infection?

An acute ear infection (acute otitis media) typically causes significant pain, high temperature, and a very unsettled baby, and may resolve with or without antibiotics over several days. Glue ear (otitis media with effusion) is the fluid that sometimes remains in the middle ear after an infection, or builds up without any obvious infection. It does not cause pain or fever but can reduce hearing.

Glue ear in babies and toddlers: signs and what happens next

Q: How do I know if my baby has glue ear?

The signs in babies are subtle because glue ear usually does not cause pain. Watch for not responding consistently to sounds, delayed babbling or words compared to typical milestones, seeming to need the TV louder, not turning toward voices, or repeatedly pulling and tugging at one or both ears without obvious distress. If you are concerned, ask your GP to check the ears and refer for a hearing test.

Q: Will glue ear affect my baby's speech?

Persistent glue ear during the first few years, when children are learning language most rapidly, can affect speech and language development because the child is not hearing speech sounds clearly. This is one of the main reasons that glue ear causing significant hearing loss over more than 3 months is taken seriously and assessed by an audiologist and speech therapist.

Q: Should I ask for a hearing test?

Yes. If you have any concern about your baby or toddler's hearing at any age, you are entitled to ask your GP for a referral to audiology. You do not need to wait for the routine newborn hearing screen to flag something. A hearing test cannot hurt and early identification of hearing loss leads to much better outcomes.

Q: How long does glue ear last?

Most cases of glue ear in young children resolve on their own within 3 months, which is why watchful waiting is the first approach. Around half of cases that have not resolved at 3 months will clear within a further 3 months. Persistent glue ear lasting beyond 6 months with associated hearing loss is more likely to need active treatment such as grommets or hearing aids.

6 months to 4 years · Health · Updated July 2026 · All articles

Glue ear is the most common cause of hearing loss in young children, yet it often goes unnoticed for months because it causes no pain and few obvious symptoms. If you have noticed your baby or toddler seeming to miss sounds, not responding to their name, or their speech developing more slowly than expected, glue ear is worth knowing about. The reassuring news: most cases clear on their own.

What glue ear is

The medical name is otitis media with effusion (OME). It means that a thick, sticky fluid has accumulated in the middle ear, behind the eardrum. This fluid dampens the vibration of the tiny bones in the middle ear that normally carry sound, reducing hearing.

The middle ear is connected to the back of the throat via the Eustachian tube, which ventilates the ear and allows fluid to drain. In young children this tube is shorter, more horizontal, and floppier than in adults, making it less efficient. When a child has a cold or an ear infection, the Eustachian tube can become blocked and the fluid that builds up cannot drain away properly. Sometimes fluid accumulates without any obvious preceding infection.

Glue ear is very common in children under 5. Around 80% of children will have at least one episode by the time they start school, according to NICE guidelines.

Glue ear versus an acute ear infection

It helps to understand the difference between glue ear and an acute ear infection, because parents often confuse them.

An acute ear infection (acute otitis media) usually comes on quickly. Your baby will typically be in obvious pain, pulling or batting at one ear, have a high temperature, and be very unsettled. The eardrum is inflamed and the infection may resolve over a few days with or without antibiotics.

Glue ear is what can remain after the infection, or develop without any obvious infection at all. The eardrum is not inflamed. There is no fever and no pain. The fluid sits quietly in the middle ear, reducing hearing, often for weeks or months at a time. Because it is painless, it can easily be missed.

How to recognise it in babies and toddlers

The signs of glue ear in young children are subtle, and parents are often the first to notice them:

Not consistently responding to their name or to sounds behind them.
Appearing to ignore you unless you are face to face with them.
Delayed babbling in babies, or fewer words than expected for their age in toddlers.
Frequently asking you to repeat things, or saying "what?" a lot in older toddlers.
Wanting the television noticeably louder than usual.
Pulling or tugging repeatedly at one or both ears, without fever or obvious pain.
Occasional balance problems or clumsiness, because the fluid can also affect the vestibular system slightly.

None of these signs on their own is definitive, but if you notice a pattern, especially one that has been going on for more than a few weeks, it is worth speaking to your GP.

How glue ear is diagnosed

Your GP will look in your child's ears with an otoscope. They may see a dull, cloudy eardrum rather than the normal pearl-grey translucent appearance. If glue ear is suspected, the next step is a referral to audiology for a hearing test and a tympanometry test. Tympanometry measures how well the eardrum moves in response to small changes in air pressure. In glue ear it produces a flat trace rather than the normal peak, which confirms that fluid is present in the middle ear.

If you are concerned about your baby or toddler's hearing at any age, you can ask your GP directly for an audiology referral. You do not need to wait for a review appointment or a screening programme to flag it.

Why watchful waiting is the first step

NICE guidelines recommend a period of watchful waiting of up to 3 months as the first approach for most children with glue ear, because the majority of cases resolve on their own during this time. Antibiotics, antihistamines, nasal decongestants, and steroids have not been shown to speed up resolution of glue ear and are not recommended by the NHS or NICE for this purpose.

During the waiting period, there are practical things that help your child hear better at home. Get down to their level before speaking, minimise background noise (turn off the TV when talking to them), use clear face-to-face speech, and let their nursery or childminder know so they can seat them near the teacher or carer.

When treatment is considered

If glue ear has been present for more than 3 months and is causing a significant hearing loss, or if a child is showing signs of delayed speech and language development, NICE recommends referral to an ENT (ear, nose and throat) specialist.

Two main treatment options are considered:

Grommets (ventilation tubes) are tiny plastic tubes inserted through a small cut in the eardrum under a brief general anaesthetic. They ventilate the middle ear, preventing fluid from building up, and typically improve hearing immediately. Grommets usually fall out on their own after 6 to 12 months. The procedure is generally well tolerated and children usually go home the same day. NICE recommends grommets when there has been at least 3 months of persistent bilateral hearing loss, or when the impact on speech and language development or quality of life is significant.

Hearing aids are an alternative to surgery for children where grommets are not appropriate, or where parents prefer a non-surgical route. They amplify sound without requiring any procedure and can be very effective during the period when glue ear is present. Some families choose hearing aids as a first option while waiting to see if the glue ear resolves.

The speech and language connection

The first few years of life are the most critical period for speech and language development. Persistent hearing loss during this window, even a mild reduction, can affect how a child learns to hear and reproduce speech sounds. This is why glue ear that lasts beyond 3 months with associated hearing loss is taken seriously, even though the condition itself is benign.

If your child is showing speech or language delays alongside signs of hearing difficulty, ask your GP for both an audiology referral and a referral to a speech and language therapist. These two things work well in parallel.

Frequently asked questions

How do I know if my baby has glue ear?

Watch for not consistently responding to sounds or their name, delayed babbling or words, turning the TV up, or repeatedly pulling at their ears without fever or distress. If you have any concern about your baby's hearing, ask your GP for a check and an audiology referral.

Does glue ear hurt?

No. Glue ear is usually painless. This is what distinguishes it from an acute ear infection, which causes pain, fever, and an unsettled baby. If your child has pain alongside hearing symptoms, see your GP as the fluid may have become infected.

Will glue ear affect my baby's speech?

Persistent glue ear during the key language-learning years can affect speech development because the child is not hearing sounds clearly. This is why significant hearing loss lasting more than 3 months is assessed by an audiologist and, if needed, a speech and language therapist.

What are grommets?

Grommets are tiny plastic ventilation tubes inserted into the eardrum under a brief general anaesthetic. They let air into the middle ear and prevent fluid building up. They usually fall out on their own after 6 to 12 months and most children go home the same day.

Should I ask for a hearing test?

Yes, if you have any concern at all. You do not need to wait for a scheduled check. Ask your GP for an audiology referral. A hearing test has no downside, and early identification of hearing loss leads to much better outcomes.

How long does glue ear last?

Most cases resolve within 3 months. Around half of those that have not cleared at 3 months will clear within a further 3 months. Persistent glue ear beyond 6 months with associated hearing loss is more likely to need active treatment.

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