From the Research
Middle ear effusion is not directly caused by teething in infants, and its presence is more commonly associated with upper respiratory infections, allergies, or dysfunction of the Eustachian tube. While teething can cause symptoms like irritability, drooling, and mild fever, it does not typically lead to fluid buildup in the middle ear. Middle ear effusion (also called otitis media with effusion) is a condition where fluid accumulates in the middle ear, and it can be caused by various factors, including upper respiratory infections, allergies, or dysfunction of the Eustachian tube, which connects the middle ear to the back of the throat. Infants are particularly susceptible to middle ear effusion because their Eustachian tubes are shorter, more horizontal, and less functional than those of older children and adults, making it easier for fluid to accumulate and harder to drain.
Some studies have investigated the causes and treatments of middle ear effusion, including the use of antibiotics and tympanostomy tubes. For example, a study published in 2023 1 found that the use of antibiotics compared to no treatment may have a slight beneficial effect on the resolution of middle ear effusion at up to three months, but the overall impact on hearing is very uncertain. Another study published in 2006 2 found that adenoidectomy may be beneficial in treating otitis media in children who are older than 4 years of age and who have previously undergone tympanostomy-tube insertion.
If an infant has symptoms of ear discomfort, such as ear pulling, irritability, sleep disturbances, or hearing concerns, especially with concurrent cold symptoms, parents should consult a healthcare provider for proper evaluation. The timing might coincidentally overlap with teething, but teething itself is not the cause of middle ear effusion. Treatment depends on the underlying cause and may include watchful waiting, as many cases resolve spontaneously, or medical intervention if necessary. It is essential to note that the evidence for the use of antibiotics for middle ear effusion is of low to very low certainty, and the long-term effects of antibiotics are unclear 1.
Key points to consider:
- Middle ear effusion is not directly caused by teething in infants
- Upper respiratory infections, allergies, or dysfunction of the Eustachian tube are more common causes of middle ear effusion
- Infants are particularly susceptible to middle ear effusion due to their shorter, more horizontal, and less functional Eustachian tubes
- Treatment depends on the underlying cause and may include watchful waiting or medical intervention
- The evidence for the use of antibiotics for middle ear effusion is of low to very low certainty, and the long-term effects of antibiotics are unclear 1