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Ear, nose and throat problems are among the most common reasons parents seek advice from a GP or an ENT specialist. Children’s ears, noses and throats are still developing, and differences in their anatomy, such as a shorter, more horizontal eustachian tube, make them more prone to infections and blockages than adults. Most of these conditions are minor and settle with simple treatment, but a few need specialist input to prevent longer-term problems with hearing or breathing.

We spoke to Consultant ENT Surgeon Ravinder Natt to create this guide which covers the common ENT conditions in children, organised by ear, nose and throat, with the usual causes, treatment options and home remedies for each, along with guidance on when to see a paediatric ENT specialist.

Common Ear Conditions in Children

The ear is made up of four parts: the outer ear and ear canal, the middle ear, and the inner ear. Because a child’s middle ear and Eustachian tube are still developing, fluid and bacteria drain less easily than in an adult’s ear, which is why ear infections and glue ear are so common in young children.

Glue ear in children

Glue ear (known clinically as otitis media with effusion) happens when sticky fluid builds up in the middle ear, behind the eardrum, without necessarily causing an active infection. It’s one of the most common ENT conditions in children under seven, and often follows a cold or a run of ear infections.

Common signs:

• Muffled hearing, or appearing not to listen
• Speaking more loudly than usual, or turning up the television
• Behaviour or concentration changes at nursery or school, often linked to mild hearing loss

Solutions: Many cases of glue ear clear on their own within three months, so a GP or ENT specialist may recommend a period of watchful waiting with a follow-up hearing test. If glue ear persists beyond this, or is causing hearing loss that affects speech or schooling, grommets (tiny tubes inserted into the eardrum to drain fluid and equalise pressure) are a common and effective treatment. Hearing aids are occasionally used for children who aren’t suitable candidates for surgery.

Home care: There’s no medicine that clears glue ear on its own, but you can support your child while it’s monitored: keep the ear canal dry when bathing or swimming, and treat colds and nasal congestion promptly, since a blocked nose makes glue ear more likely. During this watching period, guidance from bodies such as NICE points to one particular non-drug approach worth trying: a small nasal balloon your child blows up through the nose, known as autoinflation, which can help fluid drain from the middle ear. It’s often worth asking your GP about this before considering further treatment. Persistent symptoms lasting more than a few weeks should always be reviewed rather than left to resolve on their own.

Ear infections in children

Ear infections are among the most common childhood illnesses, and most children will have at least one before the age of five. The medical term for a middle ear infection is acute otitis media. It usually develops when a cold or upper respiratory infection spreads to the middle ear, causing inflammation and a build-up of fluid behind the eardrum.

Common signs:

• Ear pain, or pulling and tugging at the ear in babies
• Fever and irritability, or disturbed sleep
• Fluid draining from the ear canal, a sign the eardrum has perforated, which usually heals on its own

Solutions: Most ear infections are viral and clear up within a few days without antibiotics. Where a bacterial infection is suspected, particularly in younger children or where symptoms are severe, a GP may prescribe a short course of antibiotics or ear drops, alongside pain relief such as age-appropriate paracetamol or ibuprofen. Children with repeated infections, generally classed as three or more ear infections in six months, or four or more in a year, should be assessed by an ENT specialist, as repeated infections can sometimes be linked to glue ear or enlarged adenoids and may need a more lasting solution such as grommets.

Home remedies: A warm, not hot, flannel held against the outer ear can help relieve pressure and ease discomfort. Keep your child upright during feeds if they’re prone to ear infections, as this reduces the chance of milk or fluid reaching the middle ear. Avoid inserting anything into your child’s ear canal, including cotton buds, which can push wax further in or damage the eardrum.

Earache and ear pain in children

Earache is one of the most common reasons parents bring a child to see a GP, but it isn’t always caused by infection. Ear pain in children can come from wax blockage, foreign bodies lodged in the ear canal (children are notorious for inserting small objects into their ears and noses), pressure changes during flying or swimming, or referred pain from teething or a sore throat. Balance problems and dizziness caused by the inner ear are less common in children than in adults, where conditions such as ‘benign paroxysmal positional vertigo’ are more typical, but any dizziness alongside ear symptoms is still worth a specialist review.

Solutions: Because the cause of ear pain varies so much, the right treatment depends on an accurate diagnosis. A GP or specialist will examine the ear canal and eardrum, take a brief medical history, and check for signs of infection, wax build-up or a foreign body before deciding on the most appropriate treatment. Severe pain, a high fever, or pain that doesn’t improve within 24 to 48 hours are reasons to seek a same-day appointment at a children’s urgent care centre rather than waiting it out.

Home remedies: Age-appropriate pain relief, a warm compress against the ear, and keeping your child sitting slightly upright rather than lying flat can all help while you arrange to be seen. Never attempt to remove wax or an object from your child’s ear canal at home, as this can damage the eardrum or push the object further in.

Common Nose Conditions in Children

Nasal problems are just as common as ear infections in childhood, largely because children catch more colds than adults and their nasal passages are narrower, so even mild swelling causes noticeable nasal obstruction. The blood vessels lining a child’s nose also sit closer to the surface, which is part of why nosebleeds are so common.

Nosebleeds in children

Most childhood nosebleeds come from the front of the nose, where blood vessels are delicate and easily irritated. They look alarming but are rarely serious.
What causes nosebleeds in children: The most common causes are nose picking, dry indoor air (especially in winter), colds and allergic rhinitis, and minor bumps or knocks. Less commonly, recurrent nosebleeds can be linked to a sinus infection or, rarely, an underlying blood vessel condition, which is why nosebleeds that keep coming back are worth getting checked. We can test for allergic rhinitis, among other allergies, with a skin prick allergy test at our dermatology clinic in London.

Solutions: Sit your child upright and leaning slightly forward, not tilted back, and pinch the soft part of the nose, just below the bony bridge, for 10 to 15 minutes without releasing to check. A cold compress on the bridge of the nose can help constrict blood vessels and slow the bleeding. If bleeding doesn’t stop after 20 minutes, is unusually heavy, or follows an injury, seek urgent medical attention.

When to see an ENT specialist: If your child has frequent nosebleeds, an ENT specialist can examine the inside of the nose, identify which blood vessels are involved, and in some cases treat them directly to stop the problem from recurring.

Blocked nose in children

A blocked nose, or nasal obstruction, is usually caused by swelling of the tissue lining the nose, most often from a cold, allergic rhinitis, or enlarged adenoids. In young children, chronic nasal obstruction can also affect feeding and sleep quality, as babies rely on nasal breathing while feeding.

Solutions: Where allergic rhinitis is the cause, a GP or specialist may suggest antihistamines or a short course of nasal sprays suitable for children. Saline nasal sprays or drops are safe for regular use and help clear mucus without the side effects of medicated sprays. If enlarged adenoids are causing persistent nasal obstruction or contributing to sleep-disordered breathing, meaning snoring, snorting, or pauses in breathing during sleep, a specialist may recommend an assessment for adenoid removal.

Home remedies: Saline drops or sprays, a cool-mist humidifier in the bedroom, and raising the head end of the cot or bed slightly can all ease nasal congestion. For older children, steam from a warm bath can help loosen mucus. Nose filters, worn during high-pollen periods, are sometimes used by families managing allergic rhinitis, alongside allergen avoidance such as keeping windows closed on high pollen-count days.

Runny nose in children

A runny nose is usually the first sign of a common cold, but persistent or recurrent runny noses in young children are also frequently caused by allergic rhinitis, particularly if it’s accompanied by sneezing and itchy eyes.

Solutions: Most runny noses linked to a viral cold resolve within seven to ten days without treatment. If a runny nose lasts longer than two weeks, occurs alongside a blocked nose and facial pressure, or comes with discoloured discharge and a fever, it may point to sinus infections rather than a simple cold, and is worth a GP review.

Home remedies: Saline drops help loosen mucus in babies and young children who can’t blow their nose. Keeping your child well hydrated, using a humidifier, and gently wiping rather than repeatedly blowing a sore nose can all help. If symptoms persist beyond two to three weeks, or your child’s symptoms include facial pain or a high fever, book a GP or specialist appointment.

Common Throat Conditions in Children

Sore throats and tonsil problems are among the most common ear, nose and throat complaints in childhood, largely because tonsils are proportionally larger in children and play an active role in fighting off the many new viruses a young child’s immune system encounters.

Sore throat in children

A sore throat is one of the most common ENT complaints in children and is usually caused by a viral infection, though a bacterial infection such as strep throat is responsible in a proportion of cases, particularly in school-age children.

Solutions: Most sore throats settle within a week without antibiotics. Where a bacterial infection is suspected, particularly with a high fever, white spots on the tonsils, or swollen neck glands, a GP may take a throat swab and prescribe antibiotics if needed. A sore throat that doesn’t improve after a week, or one accompanied by difficulty breathing or swallowing, should be reviewed promptly.

Home remedies: Warm fluids, ice lollies, and soft foods can soothe a sore throat while it heals. Honey in warm water is a safe and effective remedy for children over one year old; never give honey to babies under 12 months. Age-appropriate pain relief can help if your child’s symptoms include discomfort with swallowing.

Tonsillitis in children

Tonsillitis is inflammation of the tonsils, usually caused by a viral or bacterial infection, and is one of the most familiar ENT disorders in school-age children.

Common signs:

• Severe sore throat and pain when swallowing
• Swollen, red tonsils, sometimes with white or yellow patches
• Fever, swollen glands in the neck, and bad breath

Solutions: Treatment depends on the cause: viral tonsillitis is managed with rest, fluids and pain relief, while a confirmed bacterial infection is treated with antibiotics. Children with recurrent tonsillitis, generally defined as several severe episodes over one to two years, may be referred to an ENT clinic to discuss a tonsillectomy, particularly if episodes are affecting school attendance or if enlarged tonsils are contributing to sleep-disordered breathing.

Home remedies: Soft, cool foods, plenty of fluids and rest help while the infection runs its course. Gargling with warm salt water can ease discomfort in older children who can safely do this without swallowing it. As with any throat problem, seek medical review if your child’s symptoms persist beyond a week, they can’t swallow fluids, or they’re finding it hard to breathe.

When to See a Paediatric ENT Specialist

Most ear, nose and throat problems in children settle with time, simple home care or a short course of treatment from a GP. However, it’s worth arranging an ENT specialist assessment if:

• Your child has repeated infections, including sinus infections, over the space of a few months
• Hearing loss, muffled hearing, or delayed speech development is a concern
• Nasal obstruction or a blocked nose has lasted more than a few weeks
• Snoring, noisy breathing, or sleep-disordered breathing is affecting your child’s sleep
• Symptoms persist despite treatment, or a bacterial infection keeps recurring
• Your child has severe pain, foreign bodies in the ear or nose, or a nosebleed that won’t stop

An ENT specialist can carry out a thorough examination, arrange hearing tests where needed, and advise on the most appropriate treatment, from watchful waiting through to surgical intervention such as grommets or a tonsillectomy where this is genuinely the right next step.

How We Can Help at St John & St Elizabeth Hospital

Our paediatric ear, nose and throat team offers consultant-led assessment and treatment for the full range of ENT conditions in children, from hearing tests and diagnosis of glue ear and recurrent ear infections, through to tonsil and adenoid problems. Care ranges from home-care advice and monitoring through to surgical procedures such as grommets or a tonsillectomy at our ENT Clinic, when this is the right option for your child. We accept both self-pay and insured patients, and appointments are usually available quickly.

Frequently Asked Questions About Children’s ENT Conditions

Why are ENT conditions so common in infants and young children?
Children’s eustachian tubes are shorter, narrower and sit more horizontally than in adults, so fluid and bacteria drain less easily from the middle ear. Their tonsils and adenoids are also proportionally larger relative to their airway, and their immune systems are still building up exposure to common viruses. Together, this makes ear, nose and throat infections far more frequent in early childhood than at any other age.

What are common paediatric ENT issues?
The most frequent are glue ear, middle ear infections, blocked or runny noses, nosebleeds, sore throats and tonsillitis. Most are linked to colds, allergies or the after-effects of a viral illness, and the majority resolve with simple treatment or time.

My child has had multiple ear infections in six months. Is this normal?
Occasional ear infections are very common in young children, and most clear up on their own or with a short course of treatment. However, three or more infections in six months, or four or more in a year, is generally considered recurrent, and it’s worth having this assessed by a specialist, who can check for glue ear or other underlying causes and discuss whether further treatment, such as grommets, would help.

How do doctors tell if a child has an ear infection?
A doctor will typically look inside the ear with an otoscope to check whether the eardrum is red, bulging or has fluid behind it. They’ll also ask about symptoms such as ear pain, fever, irritability or reduced hearing. In some cases, hearing tests, including tympanometry, which measures how the eardrum moves, are used to confirm fluid build-up and check for acute otitis media, particularly for suspected glue ear.

How can I tell if my child’s sore throat is tonsillitis or something milder?
A general sore throat from a cold usually improves within a few days and comes with other cold symptoms, such as a runny nose or cough. Tonsillitis tends to cause more severe throat pain, visibly swollen or white-coated tonsils, fever and difficulty swallowing. If symptoms are severe, last more than a few days, or keep recurring, it’s worth getting it checked rather than assuming it will pass on its own.

Why does my child keep getting nosebleeds?
Nosebleeds are common in children because the blood vessels inside the nose are close to the surface and easily irritated by nose-picking, dry air, colds or minor bumps. Most stop within 10 to 15 minutes with simple first aid and aren’t a cause for concern. Frequent or heavy nosebleeds, or ones that are hard to stop, are worth discussing with a specialist to rule out other causes.