As a Pediatric Ear, Nose and Throat Specialist, I am not only a self-proclaimed “snot queen” but also a “wax queen!”
Earwax serves many functions. Our entire ear canal is lined by skin and, to prevent this skin from becoming “pruny” (much like your fingers after swimming), the ear produces earwax. If the skin were to become “pruny,” tiny cracks may appear allowing the natural bacteria that lives in our ear canal to enter, causing “Swimmer’s Ear” or otitis externa.
Of course, too much wax could “block” the ear canal such that air can’t reach and vibrate the eardrum. If you are constantly asking your child to turn the TV down and repeating yourself, your child may have a large buildup of wax impacting their hearing. Too much wax can also cause itchiness, discomfort and odd feelings when a child yawns or opens their jaw widely as it shifts around in the ear canal and rubs up against the ear drum.
Bottomline is that we need wax, but too much buildup may cause issues.
A SIMPLE WAY TO CLEAN A BABY’S EAR
For babies less than one year old.
- After bathing, if you see yellowish or brownish wax on the outside of the ear—in the “conchal bowl” or “cupped” part of the ear—you can gently wipe it away with a washcloth. DO NOT insert a Q-tip into the “meatus” or opening of the ear canal.
Note: Babies who have excessive wax really need an ENT Specialist to examine their ears under a magnified microscope and use special tools to gently clean out their ear canal without causing any trauma to the skin or worse, the ear drum and related structures.
5 STEPS TO CLEANING YOUR CHILD’S EARWAX
For children older than a year.
It is important to note first that you should clean your child’s ear no more than 1 - 2 times per week. There is no need for daily cleaning, even though many of us adults do it as a habit. In addition, different people make different types of wax. Some wax is dry and flaky, some is moist and it comes in all different colors! A yellow, orange or dark brown color does not mean anything.
- The best time to clean ears is after showers and baths, since warmth and humidity will likely soften the wax. After your child bathes, tell them what you are doing and ask them to sit still. If your child won’t stay still, please DO NOT wrestle with them while trying to use a Q-tip, so as not to cause unintended injury.
- Gently pull the ear slightly backward and upward to straighten out the ear canal and allow the Q-tip to be gently inserted (no more than 4 - 5 mm).
- If your child’s ear canal is big enough, you can make a “circular” rotation/motion with the Q-tip. DO NOT go so deep that you cannot see the cotton swab; use the tip of the cotton swab only. If your child says “ouch,” then you’ve gone too far or are being too forceful. PLEASE STOP.
- Look at the Q-tip when you are done to make sure the cotton tip did not come off the plastic stick and is left in the ear canal. This can happen. (I do not buy the “cheaper” brands for this reason).
For excessively hard wax, go see an ENT so they can gently remove it or suction it out in office with special equipment under magnification to avoid trauma. To make it easier for the ENT to remove wax on the day of the appointment and less painful for your child, put 2 - 3 drops of baby oil in each ear canal at bed time for 3 nights before the appointment.
- Once you are done with the cleaning, put all the Q-tips away. Children younger than 6 years old should not be playing with them or trying to clean themselves.
Note: In case of accidental Q-tip injury resulting in crying, pain and even some bright red bleeding, you may need to take your child to see a physician to see if there was perforation of the eardrum.
WHY I DON’T USE IRRIGATION
Many ENTs, family doctors and pediatricians recommend water, vinegar or hydrogen peroxide to gently flush the ears. People, including children, can get very dizzy and have vertigo as a “caloric response” from warm or cold liquid touching the eardrum. Also, the experience can be very scary and traumatic to children.
I do not use irrigation in my office and I rarely recommend parents perform irrigation at home. Irrigation can work for some people but requires gentle application and is best for adults, not children.
WHY I DON’T RECOMMEND CANDLING
Ear candling is an alternative therapy. The tapered end of an ear candle is placed in the ear while the other end is lit. It is believed that this method creates a partial vacuum that draws out earwax.
I do not recommend candling in children for fear of burn injuries. There are other, safer options that I’ve listed above to clean your child’s ear of excess wax.
Daily complaints about ear itchiness, pain or difficulty hearing are not normal, so if your child is not getting better despite trying to clean their ears, go see an ENT or Pediatric ENT. With the right diagnosis, right tools and right treatment, your child can get better quickly.