Recurrent Ear Infections and Grommets in London
Most young children have several ear infections before the age of five, and most need nothing more than time, pain relief and, occasionally, antibiotics. Ear infections cluster in early childhood because a young child's Eustachian tube, the channel that drains the middle ear, is shorter and more horizontal than an adult's, which makes fluid and infection easy to get in and hard to get out. The question that actually matters is not how many infections your child has had, it is whether fluid is persisting between infections and whether it is affecting hearing, because that is a different problem with a different answer.
Glue ear — fluid behind the eardrum without active infection — is extremely common and usually clears on its own within three months. Where it persists beyond three months, particularly with a measurable hearing dip, it starts to matter for speech and language development, and that's the point where grommets become a genuine option. At The Online GP your child is examined with an otoscope at every visit, and where infections or fluid keep recurring, a hearing test and ENT referral are arranged directly. A first consultation is a full 45 minutes with a consultant paediatrician, £395 in person or £350 by secure video.
Get your child properly assessed on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
When an ear problem needs urgent, not routine, assessment
Book a same-day appointment for a fever with an ear that is visibly bulging or discharging, ear pain severe enough that your child cannot be settled, or any ear infection in a baby under three months. Swelling, redness or tenderness behind the ear, particularly with fever and a child who looks generally unwell, needs same-day assessment, since this can indicate the infection has spread to the bone behind the ear, an uncommon but serious complication.
Routine booking is appropriate for a straightforward ear infection with pain and fever in an otherwise well child, for a third or fourth infection this year prompting the "is this normal" question, or for a parent's concern that a child is not responding normally to sound, is turning the television up, or seems to be falling behind with speech.
Is it a straightforward infection, glue ear, or something recurrent enough to act on
Acute otitis media, a straightforward middle ear infection, causes sudden ear pain, fever, and sometimes discharge if the eardrum perforates, and the pain typically peaks within the first day or two and settles within a week, with or without antibiotics depending on severity and age. This is common, usually self-limiting, and does not on its own indicate a bigger problem, even when it happens two or three times in a winter.
Glue ear, medically otitis media with effusion, causes no pain and often no fever at all, which is exactly why it is missed. The main sign is a change in hearing, a child who says "what?" more often, sits close to the television, seems inattentive, or has speech that is not progressing as expected, and it is often picked up incidentally during an examination for something else.
Recurrent acute otitis media, generally defined as three or more infections in six months or four or more in a year, and persistent glue ear lasting more than three months are the two patterns that shift the conversation from "wait and treat each episode" to "investigate why this keeps happening and what it is doing to hearing."
Ask what your child needs on WhatsApp or email team@thewellnesslondon.com.
What else can look like recurrent ear infections
Teething is very commonly blamed for ear-pulling and unsettled behaviour in babies, and while teething causes genuine discomfort, it does not cause fever above a mild level or true ear infection, so a persistently high temperature alongside ear-pulling deserves an actual ear examination rather than being written off as teething. Enlarged adenoids, tissue at the back of the nose that can block the Eustachian tube opening, are a common underlying reason a child develops recurrent glue ear in the first place, and are assessed alongside the ears rather than separately.
Referred pain from teeth, throat infections, or even a foreign object a young child has pushed into their own ear can all present as "ear pain" without being a true ear infection, which is exactly why a proper otoscope examination, rather than a description over the phone, is the starting point every time. Wax alone very rarely causes pain or fever and is a common but usually incorrect explanation parents are given for a child who is genuinely unwell.
What actually gets checked, and what a hearing test involves
Otoscopy, examining the eardrum directly, distinguishes a red, bulging, actively infected eardrum from a dull, retracted eardrum with fluid behind it, from a normal eardrum, and this single examination does more diagnostic work than any symptom description alone. It is performed at every ear-related appointment, not reserved for complicated cases.
A hearing test, tympanometry to measure how the eardrum moves and whether fluid is present, combined with an audiogram to measure actual hearing thresholds, is arranged where glue ear is suspected or where infections are recurrent, because it turns "seems a bit fluidy" into an actual measurement that either supports watchful waiting or supports referral. This is arranged with a paediatric audiologist, with the appropriate fee confirmed directly at the time of booking.
Where recurrent infections or persistent glue ear are confirmed, referral to a consultant paediatric ENT specialist is made directly, rather than left for a routine pathway, and the ENT team is the one who makes the decision on grommets based on the hearing test results, the duration of the problem, and the impact on your child specifically.
When do grommets actually get considered
Grommets are generally considered where glue ear has persisted beyond three months with a confirmed hearing loss on testing, particularly where it is affecting speech and language development or a child's behaviour and schooling, or for genuinely recurrent acute infections that are significantly disrupting a child's life despite appropriate medical management. They are a decision made by an ENT specialist based on measured hearing and the specific impact on your child, not something arranged from a GP appointment on the basis of parental concern alone, however reasonable that concern is.
It is worth knowing that many cases of glue ear resolve on their own within the three-month watch period, which is why persistent, confirmed fluid with a measured hearing dip, rather than a single diagnosis of glue ear, is what moves the conversation toward surgery.
Book a same-day appointment if:
Fever with a bulging or discharging ear
Severe pain that cannot be settled
Any ear infection in a baby under 3 months
Swelling, redness or tenderness behind the ear with fever
Worth raising even without pain:
Turning the TV up, sitting close to the screen
Saying "what?" more than usual, seeming inattentive
Speech not progressing as expected for age
Send us your tracker on WhatsApp or call 020 3951 3429.
What does the assessment cost privately in London
A private consultant paediatric ENT appointment in the Harley Street district commonly runs £250 to £450 before any test is arranged, and a standalone paediatric hearing test booked separately at a diagnostics-only provider adds further cost again, confirmed at the time of booking since providers vary. Grommet surgery itself, once genuinely indicated, is a day-case procedure typically arranged through the ENT consultant, with the fee quoted directly by the surgical team once the specific procedure and any anaesthetic requirements are confirmed.
At The Online GP the otoscope examination is done in the room, at every visit, and referral for hearing testing or ENT assessment is arranged directly once a genuine pattern is confirmed. All figures below are from prices, verified against current published pricing.
First consultation, 45 min, full history, otoscope exam, written plan same day — £395 in person / £350 by video
Follow-up, 30 min — £340 in person / £295 by video
Referral for paediatric audiology hearing testing — arranged directly, fee confirmed at booking
Referral to consultant paediatric ENT specialist — arranged directly, fees confirmed by specialist team
Same-day and next-day appointments at 10 Portman Square, Marylebone, 3 minutes from Baker Street.
Why choose The Online GP
Because every ear-related appointment includes an actual otoscope examination, so glue ear, which causes no pain and is easy to miss over the phone, gets picked up rather than assumed away because "there's no infection this time."
Because the decision to investigate further is based on a genuine pattern, three or more infections in six months, or fluid persisting beyond three months, rather than parental worry being dismissed or, conversely, every single infection triggering unnecessary referral.
And because when a hearing test or ENT referral is needed, it happens directly from this appointment with your child's history already documented, rather than starting the explanation again from scratch with whoever you see next.
Book an assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
How many ear infections is too many for a child
Recurrent acute otitis media is generally defined as three or more infections in six months, or four or more in a year. Below that, occasional ear infections in early childhood are common and not on their own a sign of an underlying problem.
What is glue ear and how is it different from an ear infection
Glue ear is fluid sitting behind the eardrum without active infection, causing no pain or fever, and it is mainly noticed through changes in hearing rather than illness. An ear infection causes pain and fever and settles within about a week. Glue ear lasting beyond three months, particularly with a measured hearing dip, is what prompts further investigation.
Does my child need a hearing test
If ear infections are recurrent, if glue ear has been present or suspected for more than a few weeks, or if you have noticed your child turning up the television, saying "what?" often, or falling behind with speech, a hearing test gives an actual measurement rather than a guess.
When are grommets needed
Grommets are generally considered where glue ear has persisted beyond three months with a confirmed hearing loss affecting speech, language or schooling, or for genuinely recurrent infections significantly disrupting a child's life. This decision is made by a consultant ENT specialist based on hearing test results, not from a single GP appointment.
Can teething cause ear infections
No. Teething causes genuine discomfort and can make a baby unsettled, but it does not cause true ear infection or significant fever. A persistently high temperature alongside ear-pulling should be assessed with an actual ear examination rather than attributed to teething.
The Online GP is a private GP service providing GMC-registered doctors from our Marylebone clinic and by video across the UK. Referral for paediatric audiology and ENT assessment is arranged with named specialists. If your child has a fever with a bulging or discharging ear, severe unsettled pain, or is under 3 months with any ear symptoms, seek same-day assessment. This article is general information and not a substitute for medical advice about your child's health.
Enquire now on WhatsApp or email team@thewellnesslondon.com .
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