Swimming with Ear Tubes

Dr. Greene, my 4-year-old son recently had ear tubes placed. My doctor said that it is okay for him to go swimming (I think). My friends look at me horrified. They say he needs to wear custom ear plugs. Their doctors told them that their children with ear tubes shouldn’t let their ears get wet. My son loves the water. What should I do?
Scottsdale, Arizona

Swimming with Ear Tubes

Dr. Greene’s Answer:

Most parents of children who have had PE tubes placed are happy with the results. They report fewer ear infections, easier clearance when infections do occur, and less worrying about whether their children have ear infections or not.

For many parents, the most vexing issue is the need for water precautions. Neither making their children wear ear plugs nor limiting water exposure is very fun. For years otolaryngologists (ear, nose, and throat doctors) have cautioned against allowing water in an ear that has an open tube in the eardrum. Recently, some have begun to suggest that swimming precautions are unnecessary — that water does not get through the tiny tubes into the middle ear. Over the last few years there has been a flurry of articles arguing both points of view. Your quandary is the same one that faces experts.

In the late 1990s, an excellent study was published in the Archives of Otolaryngology and Head and Neck Surgery that shed light on this controversy. The investigators followed 399 children with PE tubes. They were divided into four groups at the beginning of the study. Children in the first group were encouraged to swim without precautions. Those in Group 2 received antibiotic ear drops each night after they had been in the water. Those in group 3 wore molded ear plugs whenever they were in the water. Children in all three of these groups were instructed against diving and swimming more than 6 feet beneath the surface (since water under pressure presumably enters the middle ear through the tubes more readily). The fourth group consisted of confirmed non-swimmers. All parents were warned not to allow soapy water to enter the ear during bathing (since the lower surface tension of soapy water could allow it to penetrate the tubes more easily. Also, soapy water could be more irritating to the middle ear if it gains entrance).

Drum roll, please…

Children in the three groups of swimmers experienced no intergroup difference in the incidence either of ear infections or of draining ears regardless of plugs or ear drops. There was also no difference found between the swimmers and the non-swimmers.

Conclusion — relax and follow your doctor’s advice. Let your son enjoy swimming. Forget ear plugs. If your son turns out to be one of the unfortunate few who gets frequent ear infections in the summer months even after tubes, you might want to try water precautions on the chance that he is particularly sensitive to water exposure.

Perhaps sometime soon, someone will do a study about whether diving, underwater swimming, and soapy bathwater precautions are all really necessary. In the meantime, better safe than sorry.

Exciting new update!!!:

More recent studies have concurred with the conclusion that ear plugs are not needed for routine, surface swimming.

To look at the impact of soapy water and deeper water swimming, one study used a model head in various settings. The study showed that showering, hair rinsing, and submersion in clean tap water did not increase water entry into the middle ear. However, soapy water and deeper swimming (over ~2 feet) did.

So it appears that recent studies agree that ear plugs are not needed for regular, surface swimming. However, one may consider ear plugs for soapy water baths and deep swimming until more research can clarify the situation.

Footnote References:
Salata JA et al. 122:276-280,Arch Otoloaryngol Head Neck Surg. March 1996Herber RL et al. Arch Otolaryngol Head Neck Surg. October 1998. Lee D et al. Laryngoscope. April 1999. Kaufmann TU et al. Schweitz Med Wochenshr. October 1999. Carbonell R et al. Int J Pediatr Otorhinolaryngol. December 2002.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Annie

    As a person with tubes, wear ear plugs when swimming! I just went swimming not knowing to put plugs in my ears and tubes filled with water it was excruciating pain clear down into my throat and I got extremely dizzy still 4 hours later I’m still in pain and cannot get the pressure or water out. Please put plugs in your child’s ears if they are going to be going under water!

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  2. Casey

    TOtally disagree. My son is 7 and has tubes. If he doesn’t use ear plugs, he gets a ton of pressure and water that doens’t come out.

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  3. Joanne

    My son is 8 years in 3 months and has just had surgery to insert his 2nd set of grommets (vents). His hospital nurse advised no swimming for 4 weeks although the surgeon advised that he COULD swim with cotton wool waterproofed with Vaseline (petroleum jelly). The hospital aftercare leaflet suggested “no swimming for a couple of weeks”. Brilliant!?! Doesn’t help me at all really. Swimming instructor advised ABSOLUTELY DO NOT USE EARPLUGS as they can cause a shrieking noise and severe pain in the ear.

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  4. Linda

    As an 53 year old who had tubes put in my ears and was not told “not to swim ” 3 months after my tubes was put in I went swimming and just dove down in the water maybe 3 feet and thought my head was going to explode . The pain was excruciating for the next day and a half.

    Linda

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  5. Carl

    Thanks for the info. My sons case is a little more complicated and I am hoping you can help. He had tubes and now has a hole in his ear that won’t heal. He eventually needs surgery to place a patch over the hole. I’m not in a rush to have this done. My question is can he swim in oceans? We use a silicone ear plug for swimming in pools and tubs. We are planning a trip to Florida soon and I am concerned about his open hole being an issue in the Florida ocean in August with the dangers of bacteria.
    Thanks

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    • Leslie

      What ever happened? My daughter has the same exact problem

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    • Hal

      As a 40 year old who had a hole in my eardrum from childhood till last year, I beg you to get your child’s ear drum patched as soon as possible. I was miserable my whole life with earl infections galore and it also allowed more sinus infections too. I have a loss of hearing now and when they went to patch it, the doctor had to reconstruct the eardrum because there was nothing left. Post surgery was miserable for about a year. I wish my parents would have had mine repaired 35 years ago!

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    • Krista

      This is late I know but I was told by my daughter’s ENT that lake and ocean waters you should wear ear plugs, pools and bathtubs were fine to go without.

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  6. ghlnk.com

    Very cool! Thanks for the introduction. I had no idea that these exist!

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  7. marilyn

    After tubes are out, a hole where the tube was, has not completely healed. Surgery in a year. Can this 4 year old still be able to surface swim?
    Thanks
    Marilyn

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  8. trndiik

    Hello, I´m 10 and i have ear tubes. My doctor tell me that I can´t swim. And he tell me that I would have the tubes for 1 year or more. I have those tubes in my ears (both) 10 months now. I´m really sad about that because I have all summertime lost. The things that I can do is: pennyboarding, longboarding, and other, but I can´t go to water with my ears (Aquapark, pool, etc.). I can swim but only with body in water :(.
    Can anybody please help me, what earplugs are the best and don´t allow water to go through?? Thanks. Mirek

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  9. Rachel

    What happens if water does enter the middle ear?

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    • jessica

      If you get water in your ear, after a couple days your ear will hurt, then it might feel like its closing up. If it hurts so bad you can’t wear headphones or you caint sleep, then go to your doctors or the hospital.

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  10. shailly

    I have 95% hearing loss. I like swimming… I swim without hearing aid.. Is there any way to swim while wear hearing aid??? I want to hear while on water..plzzz tell me what to do???

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  11. Donald Guillot

    Hello,

    My Son has had ear tubes (T-style) since he was 2 years old. He is now 7 years old soon to be 8 in 3 months. The pediatrician has been concerned about them being in so long and possibly some tissue growth, and expressed to consider removing the ear tubes. When taking him to the ENT (which performed the surgery and a big advocate of tubes), he stated they are still seated fine and doesn’t look bad. Our concern is the length of time and when will the fact that they haven’t fallen out within the standard 2-4 year period should there be concern. Also the ENT is a passionate advocate of ear tubes, so we want to make sure his personal/professional enthusiasm doesn’t overlook what may be the best path for our son. Tough topic….

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  12. Mrs H.

    My daughter has the molded ear plugs, one came out in the tub and water was submerged into the ear until I saw it had fallen out, what do I need to do?

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  13. Cameron

    I feel like m the only adult with a PE tube. I m also a swimmer. It is flip turns that I have a problem with. I use Mack wax plugs and a cap, but still I get water into my ear, and then deal with drainage issues (and hearing loss) until the fluid goes away, It’s a pin and I’d love solutions.

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    • Lisa

      I’m also an adult with PE tubes in both ears. It is very depressing for me as I love to swim. Need to find ear plugs that will work. I get an annual ear infection anytime I get water in my ear.

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    • Cameron

      I haven’t tried Cathy’s suggestion (Puddy Buddies and band). Macks are the best so far sometimes I have to change and replace mid work out.

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    • Cameron

      Thinking Macks are significantly cheaper, one time use only. Putty buddies are sold in one pair only, not sure if you can reuse.

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    • justmy2centsworth

      I just recently found out that I am to get tubes..i too am a swim coach and an avid masters swimmer (highly ranked) and it frightens me to say the least that my swimming career may be shelved…hoping not; maybe i just have to re-evaluate which races i swim moving forward..quite frankly this sucks..

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