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Pediatric - Ear Congestion

Ear - congestion

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Does this describe your child's symptoms?

  • Sudden onset of muffled hearing
  • Crackling or popping noises in the ear
  • A stuffy, full sensation in the ear
  • Usually no ear pain, except with air-travel type
  • Unusual complaint until after age 4 or 5 years


  • Blockage of ear tube (eustachian tube) during nose allergies, a cold or over-vigorous nose-blowing
  • Sudden increases in air pressure, which occur in descent from mountain driving or airplane travel
  • Middle ear fluid can also be seen with a resolving ear infection

If not, see these topics

When to Call Your Doctor

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
  • Earache
  • Possible foreign body in ear canal
  • Ear congestion lasts over 48 hours
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Blocked ear wax suspected
Parent Care at Home If
  • Ear congestion (probably from blocked eustachian tube) and you don't think your child needs to be seen

  1. More Chewing and Swallowing: Swallow water or other fluid while the nose is pinched closed. (Reason: creates a vacuum in the nose that helps the Eustachian tube to open up.) After age 6, can also use chewing gum.
  2. Decongestant Nasal Spray:
    • If chewing doesn't help after 1 or 2 hours, use a long-acting decongestant nasal spray. You can ask your pharmacist to recommend a brand.
    • Don't use more than 5 days. (Reason: rebound swelling)
    • An oral decongestant (e.g., pseudoephedrine) may help if the nasal spray is not available (See Dosage table). Do not use under age 2 years.
  3. Antihistamines: If your child has hay fever or other allergies, give an antihistamine.
  4. Expected Course: The symptoms usually clear within 2 days (48 hours) with treatment. It's safe for your child to swim.
  5. Prevention for Airplane/Mountain Travel:
    • Swallow during descent using a pacifier or fluids
    • Children over age 6 can chew on gum during descent
    • Yawning also can open the middle ear
  6. Call Your Doctor If:
    • Ear pain occurs
    • Ear congestion lasts over 48 hours
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 6/24/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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