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  • Ear – Congestion


    • Sudden onset of a stuffy or plugged up feeling in the ear
    • Crackling or popping noise in the ear
    • Hearing is often muffled
    • No ear pain, except with air-travel type
    • Rare complaint before age 4 or 5 years


    • Blockage of ear tube (eustachian tube) during nose allergies or a cold
    • Blowing the nose too much can also cause blockage of the ear tube
    • Sudden increases in air pressure. This can occur in descent (coming down) when mountain driving or flying.
    • Middle ear fluid can also cause this. This sometimes happens with ear infections.

    Pain Scale

    • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
    • Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
    • Severe: The pain is very bad. It keeps your child from doing all normal activities.

    When to Call Us for Ear – Congestion

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen
    • Earache
    • Could be a foreign body in the ear canal
    • Ear congestion lasts more than 48 hours

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • Could be blocked with ear wax

    Parent Care at Home If:

    • Ear congestion most likely from blocked ear tube

    Care Advice for Ear – Congestion

    What You Should Know:

    • Most often, this is from a blocked ear tube (eustachian tube). This tube normally drains the space behind the eardrum. It is usually not caused by an ear infection.
    • Here is some care advice that should help.

    Swallow and Chew More:

    • Swallow water or other fluid while the nose is pinched closed. Reason: Makes a vacuum in the nose that helps the ear tube open up.
    • After age 6, can also use chewing gum.

    Decongestant Nose Spray (Age 12 years or older):

    • If chewing doesn’t help after 1 or 2 hours, use a long-acting decongestant nose spray. You can ask your pharmacist to suggest a brand.
    • Dose: 1 spay per side, 2 times per day as needed.
    • Don’t use for more than 3 days. Reason: Can cause rebound swelling in the nose.
    • Decongestants given by mouth (such as Sudafed) are not advised. They may lessen nose and ear congestion in some children. However, they also can have side effects.

    Allergy Medicines:

    • Nose allergies can cause ear stuffiness.
    • If your child has hay fever or other allergies, give an allergy medicine. An example is Benadryl. See Dose Table.
    • See Hay Fever guide for other advice.

    What to Expect:

    • The symptoms most often clear within 2 days (48 hours) with treatment.
    • It’s safe for your child to swim or fly.

    Prevention for Airplane/Mountain Travel:

    • Swallow during descent (coming down) using fluids or a pacifier.
    • Children over age 6 can chew on gum during descent (coming down).
    • Yawning also can open the middle ear.

    Call Your Doctor If:

    • Ear pain occurs
    • Ear congestion lasts more than 48 hours
    • Your child becomes worse

    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.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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