Tubes for ear infections
It used to be the norm for toddlers to get tubes in their ears when they suffered frequent ear infections. Tubes, also called tympanostomy tubes, allow fluid that had built up behind the ear drum to drain, relieving pain and allowing a child to hear better. However, research has found that tubes may not be needed as often as previously thought. Not only that, but the overuse of tubes could do more harm than good.
Ear infections are often treated with antibiotics, though even that isn’t always necessary. Sometimes numbing drops and an OTC pain reliever may be enough to manage discomfort until the infection clears up on its own. This should always be discussed with your doctor, who will know if antibiotics are truly needed or not.
For children with frequent ear infections, parents may feel frantic to resolve the problem so their little one feels better. Tubes seem like a simple solution. The surgery is done under a general anesthesia and children can usually go home a few hours after the surgery. However, tubes are not without possible complications. Aside from the expense, ear tubes have the potential to cause scarring and may also leave the child with a perforated eardrum, which can cause hearing loss, speech delays, and other issues. Consider, too, that some children have tubes put in more than once.
The surgery is done under a general anesthesia and children can usually go home a few hours after the surgery.
In a study published in the New England Journal of Medicine, researchers found that, in children with fluid behind their eardrums for at least three months who also had mild to moderate hearing loss, there was no difference in the development outcomes of children who received ear tubes and those who did not.
Other studies found that, on average, children who get tubes in their ears have greater damage and more hearing loss than children who do not. And children who experience developmental delays when very young tend to outgrow them and catch up developmentally, even without treatment with tubes.
Of course, the result of this research does not indicate that tubes should never be used. In fact, the American Academy of Pediatrics recommends that tubes may be indicated in children who have three episodes in six months or four episodes in a year.
For some children, it may be better to wait for your child to outgrow ear infections, which typically clear up by the time a child is 3 or 4 years old. Some doctors recommend watching the child and rechecking every 3-6 months to see if the problem gets worse before jumping into surgical treatment. In most cases, the problem will go away on its own if the child is otherwise healthy. In other cases, such as in children with Down Syndrome or a cleft palate, tubes may be needed sooner.
In any case, instead of insisting on tubes that may not really be needed, discuss your options with your doctor and an ear, nose and throat specialist to decide if surgery is really the best option for your child.
Reviewed by Dr. Sara Connolly, January 2019
Takeaways
- Tubes for treating ear infections are not as common as they used to be.
- Research shows that tubes can sometimes cause problems and do not necessarily improve a child’s development.
- Children usually outgrow ear infections by the time they are 3 or 4 years old, so tubes may not be needed.
- You should not insist on tubes if your doctor does not feel they are necessary.
My son got tubes at 16 months. I was devastated when our pediatrician sent us to an ENT for a second opinion about tubes. I prefer a more natural, holistic approach to most healthcare decisions. I was stuck between a rock and a hard place when my son was put on 5 different antibiotics within a 3 month period, trying to clear 2 persistent ear infections. These infections were painful for my son and we spent many nights up with an uncomfortable little boy. My son had none of the risk factors for chronic ear infections, and I felt very defeated as a parent because there was nothing I could do. My pediatrician and ENT said that sometimes bone structure can cause reoccurring ear infections, but I felt like there should be something I could do. Finally, when I was faced with trying yet another any abiotic or tubes, and after trying all of the homeopathic remedies that my pediatrician ok’d, we decided tubes may be the best option. The procedure went well, and he was home and back to normal in no time. My son is now 25 months old, and his tubes just came out. Thankfully, we have not had any more trouble with ear infections! While I absolutely recommend exhausting other options, tubes were the best solution for us.