Seeing drainage from a child’s ear with tubes can understandably cause concern for parents. While ear tube insertion is a common procedure, drainage might seem alarming but can sometimes be a normal part of healing or the tubes functioning as intended. This article explains why drainage occurs, what different types of discharge indicate, when to seek medical advice, and how to care for your child’s ear.
Understanding Ear Tubes and Drainage
Ear tubes, tiny hollow cylinders often made of plastic or metal, are surgically placed into a child’s eardrum. They ventilate the middle ear and prevent fluid accumulation, often used for recurrent ear infections or persistent fluid buildup affecting hearing and speech development.
These tubes allow air into the middle ear, equalizing pressure and facilitating fluid drainage. While the Eustachian tube normally performs these functions, in children, it’s often narrower and more horizontal, making it prone to blockages and inefficient drainage.
Drainage can occur for a few reasons. Sometimes, it means the tube is effectively allowing previously trapped fluid to exit the ear canal. This fluid could be residual from a prior infection or simply fluid the middle ear is now able to clear. However, drainage can also indicate a middle ear infection, where the tube provides a pathway for infected fluid to escape, preventing it from remaining trapped and causing pressure and pain.
Recognizing Different Types of Drainage
The appearance of ear drainage offers clues about its cause. Drainage varies in consistency (thin, watery, thick, or mucus-like) and color (clear, yellow, white, green, or blood-tinged).
Clear or slightly yellowish drainage, especially in the first few days after tube placement, can be normal. This often represents fluid previously trapped behind the eardrum now draining through the tubes, or it may occur if water enters the ear canal, such as during bathing.
Yellow, white, or cloudy drainage often indicates an ear infection. This discharge can be pus-like and may have a foul smell. Thick, yellow, or green drainage suggests an active bacterial infection.
Bloody drainage can occur for several reasons. A small amount mixed with fluid might be present immediately after surgery due to minor irritation. It can also signal infection or irritation within the ear canal, sometimes from granulation tissue, which is usually benign. Heavily bloody drainage could indicate a more significant issue, such as a scratched ear canal or, less commonly, a ruptured eardrum.
When to Contact Your Doctor
While some ear drainage with tubes is normal, certain signs require prompt medical attention. Always trust your instincts as a parent and contact your child’s healthcare provider if you have concerns.
Seek medical advice if drainage persists for more than seven days or significantly increases in volume. Foul-smelling drainage, or a noticeable change to green, thick, or bloody discharge, also warrants a call, as these often suggest an active infection.
Additional symptoms prompting consultation include a fever over 102°F (38.8°C), increased ear pain not relieved by medication, new hearing problems, balance issues, or significant behavioral changes like increased irritability, lethargy, or difficulty sleeping.
Caring for Your Child’s Ear
When your child’s ear with tubes is draining, proper home care helps manage the situation and promote healing. The goal is to keep the outer ear clean and administer any prescribed medications effectively.
Gently clean the outside of your child’s ear with a damp washcloth to remove visible drainage or crusting. Avoid inserting cotton swabs or other objects into the ear canal, as this can push debris further in or damage the ear. For thick drainage, use a cotton-tipped swab dipped in hydrogen peroxide or warm water to gently wipe the outer ear.
If your doctor prescribes ear drops, administer them as directed. Warm the bottle by holding it in your hand before use, as cold drops can cause discomfort. Have your child lie on their side, place the drops into the ear canal, and gently press the tragus (small flap in front of the ear) a few times to help the drops move deeper.
During active drainage, keep the ear dry. Avoid swimming or submerging the head in bathwater until drainage stops. You can use a cotton ball coated with petroleum jelly to cover the ear canal opening during bathing to prevent water entry.
Preventing Future Drainage
While ear tubes significantly reduce the occurrence of middle ear infections, they do not eliminate the possibility entirely. Proactive measures can help minimize future drainage episodes and support your child’s ear health.
Water precautions are an important consideration. While some guidelines suggest earplugs are not always necessary for routine bathing or swimming in chlorinated pools, many specialists recommend their use, especially for children who are frequently submerging their heads, diving, or swimming in lakes, rivers, or other untreated water. Soapy water, with its lower surface tension, can also enter the tubes more easily than plain water, making ear protection advisable during baths with suds. Silicone putty earplugs or custom-molded earplugs, often paired with a swim band, can provide effective protection.
Managing allergies and addressing conditions that affect the Eustachian tube function can also help prevent fluid buildup and subsequent drainage. Enlarged adenoids, for example, can contribute to Eustachian tube dysfunction and may sometimes be removed during ear tube placement. Reducing exposure to common colds and upper respiratory infections, which often precede ear infections, can also indirectly lower the risk of drainage.
Regular follow-up appointments with your child’s ENT specialist are important to monitor the tubes, ensure they are functioning correctly, and address any potential issues early. These visits allow for timely intervention if a tube becomes blocked or if new concerns arise, contributing to the long-term success of the ear tube placement.