Ear - Congestion

Is this your child's symptom?

  • 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

Causes of Ear Congestion

  • Common Cold. A viral infection of the nose is the most common cause. The nasal congestion also blocks the ear tube (eustachian tube). The ear tube normally keeps air in the middle ear.
  • Ear Infection. Middle ear pus can also cause muffled hearing on that side. This commonly happens with an ear infection.
  • Middle Ear Fluid. Fluid may remain in the middle ear after the infection is cleared up. It can last for months. The main symptoms are popping and crackling noises in the ear.
  • Blowing the Nose. Blowing too hard can force secretions into the ear tube.
  • Allergic Rhinitis. Hay fever is an allergic reaction to pollens. It causes nasal congestion, clear drainage and sneezing. It also can block the ear tube and back up secretions in the ear.
  • Airplane Ear. If the ear tube is blocked, sudden increases in air pressure can cause the eardrum to stretch. The main symptom is ear pain. Sometimes, it just causes congestion. It usually starts when coming down for a landing. It can also occur during mountain driving.

When to Call for Ear - Congestion

Contact Doctor Within 24 Hours

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

Contact Doctor During Office Hours

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

Self Care at Home

  • Ear congestion most likely from blocked ear tube

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Ear Congestion

  1. What You Should Know About Ear Congestion:
    • 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.
  2. 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.
  3. 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. An example is Afrin.
    • 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 another choice. They can also open a stuffy nose and ears. Side effects: they may make a person feel nervous or dizzy. Follow the package directions.
  4. Allergy Medicines:
    • Nose allergies can cause ear stuffiness.
    • If your child has hay fever or other allergies, give an antihistamine.
    • Use a long-acting one, such as Zyrtec. Age limit: 2 and older.
    • See the Nose Allergy (Hay Fever) care guide for detailed advice.
  5. 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.
  6. Prevention During Air or Mountain Travel:
    • It's safe to fly when your child has a cold.
    • Most symptoms happen when the airplane is coming down in altitude. This is the descent of the plane during the 15 minutes before landing.
    • Keep your child awake during takeoff and descent.
    • Swallow during descent using fluids or a pacifier.
    • Age over 6: can chew gum during descent.
    • Yawning during descent also can open the middle ear.
    • Drink lots of fluids throughout the flight. This will prevent the nasal secretions from drying out.
  7. Call Your Doctor If:
    • Ear pain occurs
    • Ear congestion lasts more than 48 hours
    • You think your child needs to be seen
    • Your child becomes worse

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

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.