Should Your Child See a Doctor?

Ear Congestion


  • 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

When to Call Your Doctor for Ear Congestion

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

Home Care Advice for Ear Congestion

  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 6 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 spray per side, 2 times per day
    • 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 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 "When to Call Your Doctor" symptoms.


  1. Brown TP. Middle ear symptoms while flying: Ways to prevent a severe outcome. Postgrad Med. 1994, 96:135-142.
  2. Daly KA, Hunter LL, Giebink GS. Chronic otitis media with effusion. Pediatr Rev. 1999;20:85-93.
  3. Weiss MH and Frost O. May children with otitis media with effusion safely fly? Clin Pediatr. 1987;26:567-568.


This information is not intended to 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 1994-2015 Barton D. Schmitt, MD. All rights reserved.