Episode 3: What is the Cause of Fluid in the Ears (Otitis Media)?

In today’s “What is series?” am tackling the topic of fluid in the ears.

A lot of children have fluid in the ears as a problem and a cause for their speech and language delay. The technical term for fluid in the ears is Otitis media. The reason why children tend to have fluid trapped in the middle ears is because of the anatomy of a child’s face. The anatomy of the face of a child is that their nose is almost at the same level as the ear. So if there is ever any congestion as a result of cold, the fluid that comes as a result of the congestion, does not drain as properly as it should. 

Once the child gets older, the ear slightly moves up and is no longer at the same level of the nose which aids in proper drainage of fluid. The fluid no longer sit in the ears. 

How fluid in the ears causes speech and language delay

A lot of children who experience speech and language delay have fluid in the ears as the cause for this delay. This is because, a child is not in a position to get a clear enough sound signal when there is fluid trapped in the pathway between the outer ear and the inner ear (that houses the hearing organ).  A child who has fluid trapped in their ears can hear but is not in a position to receive clear sound signals required to develop speech. 

Please note that a child with fluid in the ears may not complain about an ear infection. They may only do so when the ear infection is so severe. Your child may silently be trapping fluid in the ear without you realising it. If your child is not achieving their speech and language milestones at the expected time or are having a problem with their pronunciation, you may need to have their hearing checked.

Please visit this post to find out the number of words your child should have from between 12 months to 4 years

Hearing tests

Your speech therapist may recommend a hearing test if your child is experiencing a speech and language delay.

In Kenya, the test that is used to determine if there is fluid in the middle ear is standard to the hearing tests that most audiologists would do. At Gertrude’s Children’s Hospital, the test will be carried out for the middle and the inner ear. It is recommended to test both the middle and the inner ear for accurate results. This test that is used to determine if their is fluid trapped in the middle ear is called tympanometry. 

Please check out this blogpost to find out more about hearing tests. 

The tympanometry test is a pretty simple test that helps determine whether your child has fluid in the ears or not. My expert advise would be to repeat the test after a month. Another piece of advise would be to make sure that you test your child when they have a clear nose and not when they are experiencing a cold as they are most likely to fail the test. This is because, children tend to have fluid in their middle ear when they have a cold and this usually clears as the cold clears but for some children the fluid may remain trapped, particularly for children who have enlarged adenoids.

Visit this post to learn about what enlarged adenoids are and how they impact speech and language development. 

STT Web Strip ADs 17•04•20216

What you should do if your child has fluid in the ear?

If your child has fluid in the ears, repeat the test after one month to make sure that it is not chronic Otitis media. Should they fail the second test, you should have them checked by an ENT.

To correct fluid in the ears, your child may undergo a procedure known as Myringotomy, where they drain the fluid from the middle ear.  Myringotomy involves use of tubes known as grommets which are placed inside the middle ear. These tubes sit inside the middle ear to open the ear drums to enable draining of fluid. Once the fluid has been drained from the ear, these grommets usually fall out by themselves. 

After a myringotomy, you are advised to visit/revisit your speech therapist to begin the journey of speech and language therapy. I recommend a repeat of the tympanometry test after a month as a matter of precaution after a myringotomy to ensure that fluid is not continuing to be trapped in the ears or to ensure that the grommets have not clogged inside the ear. A test known as the impetus test is usually recommended to check whether the eardrum is compliant.

STT Web Strip ADs 17•04•20211

Hi, I'm your teacher

Lorna Muthamia-Ochido

I run a family-centred speech-language therapy clinic, the largest in East and Central Africa. I’ve helped 15,000+ children optimise their communication outcomes (in other words, I make children smarter ☺).

Get your child talking in no time.

Access Module 1 of the Late- Talker’s Bootcamp course and get started with growing your own child’s language skills completely FREE!


A little girl eating water melon

I encounter many children in Nairobi who are not able to chew solid food or have difficulty chewing solid food. These 2-year-olds and 3-year-olds are


Episode 27: My Opinion about How a Shadow Teacher can Improve Your Special Needs Child’s Learning I decided to tackle this topic of a shadow


Well, the jury may still be out on this, or is it? Don’t we all have our own very specific ideas of what would make