The GAPS sources describe three different ear patterns that are easy to blend together: glue ear, an active infection and repeated infections. Glue ear is mucus trapped in the middle ear and may affect hearing. An active infection adds earache and a high temperature. A recurring pattern is the cycle that returns because, in the book’s account, the mucus and abnormal nose-and-throat flora remain.[1][2]
Use this checklist to keep dated notes on hearing, pain, fever and repeated episodes. It is a written history, not a diagnostic score. My ear-infections guide explains the GAPS account and when to get help; my ear-infection food guide covers diet, kefir and dairy introduction.
How to Use This Checklist
For each observation, mark yes, no or unknown and add the date. Keep what you observed separate from what you think caused it. “Hearing seemed muffled on Tuesday” is an observation. “Gut flora caused the hearing change” is a conclusion this checklist cannot make.
Record the glue-ear, active-infection and recurring-pattern sections separately. A child can have middle-ear mucus between painful episodes, so one blank section does not cancel another.
Glue Ear Signs to Record
- Hearing seems reduced or muffled.
- The child has an established hearing difficulty while middle-ear mucus is present.
- Speech development is delayed in the same period.
- General learning ability is affected in the same period.
- Middle-ear mucus or glue ear has been identified even when there is no current painful infection.
Fluid in the middle ear can dampen sound. Campbell-McBride connects persistent glue ear with hearing difficulties and with learning or speech delays in the children she describes. In your notes, record the hearing, speech or learning changes you have actually noticed and when they began.[2]
Signs of an Active Ear Infection
- Earache or ear pain is present.
- A high temperature appears with the ear pain.
- The painful, febrile episode begins after or alongside a known glue-ear pattern.
Campbell-McBride’s 2020 ear section describes inflammation and blocked drainage first, followed by an infection that may bring earache and a high temperature. Record the symptoms you notice and any examination findings already given to you.[1]
Recurring Ear Infections
- Another ear infection appears soon after an antibiotic course ends.
- Ear infections keep returning while middle-ear mucus remains.
- Grommets or ear tubes have been recommended or placed because drainage remains a problem.
- The pattern includes several ear infections within one year.
The expanded book reports that about one-third of the children who have ear infections experience more than four in a year. Campbell-McBride describes antibiotics clearing an acute infection while fluid remains, and ear tubes providing another drainage opening without changing the underlying flora in her explanation.[2]
Food Allergies and Ear Symptoms
- A food allergy has already been identified.
- Cow’s milk is a known or suspected trigger.
- A specific food reaction appears in the same dated record as the ear pattern.
Campbell-McBride names food allergy, particularly cow’s-milk allergy, as another contributor in her expanded ear chapter. Record an identified allergy, a suspected food and an observed reaction as separate details. My ear-infection food guide explains ordinary milk, introduced kefir and the dairy steps.[2]
Digestive Signs to Record Alongside Ear Symptoms
In her expanded Gut and Psychology Syndrome book, Campbell-McBride describes digestive problems alongside the conditions she discusses. Examples include colic, belching, bloating, gas, diarrhea, constipation, undigested food in stool and abdominal discomfort. Record what is present and the age when it began.[3]
- Colic or belching in the first year.
- Diarrhea or constipation beginning around weaning or later.
- Bloating, gas or abdominal discomfort.
- Undigested food, unusual odor, foam or other recorded stool changes.
- Another documented food-reaction pattern.
These details give you a fuller history than an ear-infection count alone. Keep the timing clear, including symptoms that were present before the ear trouble began.
Early Feeding and Treatment History
Campbell-McBride’s 2020 book describes gut-flora development during pregnancy and further contributions during birth, breastfeeding, the introduction of solids and later contact. She also discusses antibiotics, other medications and processed foods as influences on flora.[4]
Record what happened without assigning blame:
- Birth route and early feeding history, when known.
- Age when solids began and the first digestive changes appeared.
- Antibiotic courses, including dates and the condition being treated.
- Long-term medications or repeated medicine syrups, when known.
- Major changes in food or digestion around the same period.
If you know the birth, feeding and treatment history, include it with the dates you can establish. Leave unknown details marked “unknown.” The useful starting point is the sequence of events, not a conclusion that one feeding decision caused the ear symptoms.
Swollen Adenoids
If swollen adenoids have been identified, record that separately. The GAPS FAQ discusses a child with dust-mite allergy whose adenoids became swollen after starting GAPS. Campbell-McBride says immune-system restructuring is one possibility in that case and describes probiotic powder, a nightly saline nose rinse and speaking with an experienced homeopath.[5]
Adenoids and the tubal tonsils at the Eustachian-tube openings are different structures. Keep the name you were given in your record so the two do not get mixed up.
A One-Page Record for Each Ear Episode
| Record | Exact Detail |
|---|---|
| Date and side | When it began and which ear was involved, if known. |
| Glue-ear signs | Hearing change, identified middle-ear mucus, speech or learning changes in the same period. |
| Active signs | Earache and high temperature. |
| Recent treatment | Antibiotic name, dates, syrup ingredients and whether symptoms returned after the course. |
| Food context | Known allergy, suspected cow’s-milk trigger and exact food response with date. |
| Companion signs | Digestive, stool and food-reaction observations actually present. |
| Drainage history | Identified middle-ear fluid, hearing findings or ear tubes already documented. |
| Your next question | For example: Has middle-ear fluid been identified? What changed after this episode? Which food or dairy step needs checking? |
Use one page for each episode, including the period between painful infections. That makes it easier to see whether hearing changes continued, symptoms settled, or another episode followed. Keep “unknown” where a detail has not been established.
Making Sense of Your Notes
- Keep your own observations separate from a diagnosis or examination finding.
- Look at dates and repeated patterns rather than adding up a score.
- Write down the specific hearing, food or treatment question you still need answered.
For hearing or current pain and fever, use the ear-infections guide, including its section on when to get help. For a GAPS starting point or dairy question, use the food guide. Keep medication decisions separate from the number of boxes checked.
Turn Daily Signs Into a Usable Record
My Reading Your Child’s Signs course is listed in the WFLI shop. It is designed to help you keep short, dated observations and useful follow-up questions together.
Frequently Asked Questions
Does Glue Ear Always Cause Pain or Fever?
The sources separate trapped middle-ear mucus from the infection that may arrive later. Pain and high temperature belong to the active-infection description, while glue ear may already be affecting hearing.[1][2]
Do Four Ear Infections Diagnose a Flora Problem?
No. The book’s more-than-four figure describes the children discussed in that passage. It is not a diagnostic cutoff. Your dated history is more useful than trying to reach a particular count.
Does a Hearing Change Prove Glue Ear?
No. Middle-ear fluid can affect hearing, but this checklist cannot identify the cause of a hearing change. Record what you noticed and any findings from an ear or hearing examination.
Does Cow’s Milk Have to Be the Trigger?
No. Campbell-McBride discusses food allergy, particularly milk allergy, as one contributor. Record a known allergy or suspected food alongside the symptoms and dates; an ear infection alone does not identify a milk allergy.
Start Your Ear Symptom Record
Start one dated episode page with the details you know today. Include hearing changes between infections as well as current pain, fever and treatment. Then choose the ear-infections guide for the wider explanation or the food guide for the diet question you wrote down.
References
- Campbell-McBride, Natasha. Gut and Physiology Syndrome (2020), “Ear infections.”
- Campbell-McBride, Natasha. GAPS: Gut and Psychology Syndrome, expanded second edition (German edition, 2015), “Ear Infections and Glue Ear.”
- Campbell-McBride, Natasha. GAPS: Gut and Psychology Syndrome, expanded second edition (German edition, 2015), digestive-problem patterns in GAPS children.
- Campbell-McBride, Natasha. Gut and Physiology Syndrome (2020), “Where Does the Gut Flora Come From?” and later flora-damage factors.
- Campbell-McBride, Natasha. Official GAPS FAQs, question 22, swollen adenoids after starting GAPS.


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