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 be present 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 (Age 12 years or older):
    • 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.
    • Dosage: 1 spay per side, 2 times per day as needed.
    • 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).
  3. Antihistamines:
    • Nasal allergies can cause ear congestion.
    • If your child has hay fever or other allergies, give an oral antihistamine such as Benadryl (See Dosage table).
    • See Hay Fever topic for details.
  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: 9/15/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.