Eustachian Tube Obstruction (Child)

The eustachian tube is located behind the eardrum. It connects the middle ear to the back of the throat. The tube is usually closed. But it opens during yawning or swallowing. This helps make the air pressure in the middle ear the same as outside the ear. The tube also drains mucus made in the middle ear. A blocked tube is called a eustachian tube obstruction. This condition can be common in babies, whose eustachian tubes are small and still forming.

A eustachian tube that is blocked causes pressure, pain, and loss of hearing. Sounds may be muffled. The ear may feel full. A nonverbal child may cry and pull at the ears. An older child may complain of pain, dizziness, pressure in the ear, or trouble hearing. The child may hear humming or ringing. A blockage can sometimes lead to an ear infection.

Sometimes the blockage goes away on its own without treatment. In other cases, treatments may be given to help reduce swelling within the tube. These may include a nasal decongestant, antihistamine, nasal spray (prescription steroid or over-the-counter saline), or allergy treatment. An ear infection may be treated with antibiotics. A blocked eustachian tube is usually a short-term problem. In certain cases, surgery may be needed to place a special tube in the eardrum. The tube helps to drain fluid from the middle ear. This may lower the risk of hearing loss and future ear infections.

Home care

Medicines may be prescribed to reduce fluid and inflammation or to treat an ear infection. Follow instructions for giving these medicines to your child as directed by your healthcare provider.


  • Keep your child's head upright when bottle-feeding. This is to prevent formula from entering the eustachian tube. Don't lay your baby down with a bottle.

  • Don't smoke and don't let others smoke around your child.

  • Keep your child’s ear canal dry. Have your child wear ear plugs when taking a bath or playing in a pool.

  • Teach your child to swallow or yawn to open their eustachian tubes to equalize pressure.

  • Take steps to reduce painful pressure in the eustachian tubes when your child flies on an airplane. Pressure can build up in the eustachian tubes during air travel, especially during takeoff and landing. This can be very painful for children. If you have a baby, try breast- or bottle-feeding during takeoff and landing. Teach your children to swallow or yawn at these times to help equalize pressure.

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to seek medical advice

Unless advised otherwise, call your child's healthcare provider if:

  • Fever (see Fever and children, below)

  • Hearing loss or trouble hearing

  • Symptoms last longer than a few weeks

  • Redness or swelling in the ear gets worse

  • Pain gets worse

  • Foul-smelling fluid drains from the ear

  • New symptoms develop

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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