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Should Your Child See a Doctor?

Ear Congestion

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Definition

  • 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

Causes 

  • 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.


References

  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.

Disclaimer

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.

Last Reviewed: 8/1/2010

Last Revised: 9/14/2010 1:06:04 PM

Copyright 1994-2011 Barton D. Schmitt, M.D.

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