An ear block is usually preceded by a fullness in the ear, gradual loss of hearing and eventually pain. From my experiences in the chamber, I have drawn the conclusion that most ear blocks are a result of not knowing how to properly equalize the pressure in the middle ear, or trying to fly with a cold. During sleep, the rate of swallowing slows down. For this reason, it is advisable to awaken sleeping passengers prior to descent for the purpose of permitting them to ventilate their ears. Infants should be given a bottle or pacifier to aid in equalization.
Small children can avoid difficulty by chewing gum.
If these actions fail to equalize the pressure, a Valsalva maneuver should be performed. The Valsalva maneuver is performed by closing the mouth, pinching the nostrils closed and blowing air through the nose. This will force air up the eustachian tube and into the middle ear. This is not a dangerous procedure and should not be delayed until the pressure in the ears becomes painful, otherwise it may be extremely difficult to open the eustachian tube. Painful ear blocks generally occur when the descent rate is too rapid.