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Quick reference medical handouts used by Pediatric offices

What Parents Should Know about Ear Wax

"Never put anything smaller than your elbow in your ear!"
"Cotton swabs are for cleaning bellybuttons--not ears."

---everyone's Grandmother!

"Ear wax," medically known as cerumen (sa-roo-men) is the name given to the sticky liquid produced by skin glands located inside the ear canals. The function of this substance, which is produced by all of us, is to serve as a water repellant and keep the ear canal (as well as the ear drum) free of any foreign materials. Because cerumen is sticky, anything that flies, crawls or is blown into the ear canal, such as dirt, small insects, bacteria, etc., is quickly trapped and immobilized. The wax then accumulates, dries out and comes out of the ear, carrying the dirt and dust with it. One can say that, most of the time, the ear canals are self-cleaning.  Under ideal circumstances, parents should never have to clean their children's ear canals. However, we all know this isn't always the case.
Ear wax can build up because of over-production or difficulty in the normal clearing of the wax. Some children have problems with ear wax throughout their lives while others suddenly develop "problem wax," without any obvious explanation. The buildup may occur in only one ear or both.

An abnormal buildup of ear wax can cause a number of medical problems. Wax can plug up the ear preventing sound waves from reaching the ear drum. This can cause partial or complete hearing loss, depending on the amount of blockage. Some children tend to form very hard wax, which can cause pain by putting pressure on sensitive ear canal walls. Finally, since the ear canal shares some of the same nerves with the throat, ear wax can provoke a "tickle in the throat" which can then lead to cough.

It is important for parents to realize that wax in the children’s ear is not bad. In fact, having too much wax is probably better than having none at all. The goal is to keep it from totally blocking the ear canal, not eliminating it all together. The first step, therefore, is to have the child’s doctor look into your youngster’s ears if you suspect a problem. Since all children produce wax, what the health care professional will be looking for is evidence that the wax is actually blocking off the ear canal.

Most pediatricians and family physicians will attempt to remove wax by irrigation (squirting warm water into the ear canal to wash out the wax) or by scooping the wax out with a curette (a very small, plastic ring at the end of a plastic handle.) Should the doctor be unable to dislodge the obstructing wax, an ear, nose and throat (ENT) physician will most likely be consulted. These specialists typically remove wax by suction and/or curette technique using a microscope to get the best possible view of the ear canals.

Using cotton swabs to clean out your child’s ear is potentially risky for a number of reasons. First, if your child has a lot of ear wax, placing the swab into the canal will only "pack it down," further into the ear canal. Furthermore, the child can suddenly move causing damage to either the ear drum or the ear canal. In addition, children are great imitators and a youngster who is pursued to having his or her ears cleaned out with a cotton swab may one day take matters into his/her own hands and attempt to use a cotton swab on his/her ears or a siblings ears.

Should your child chronically produce excessive wax, there are a number of over-the-counter drops that will help keep the ear canals clear. Check with your child’s doctor to see which one the office recommends. Below are some of the recommended ways to help keep wax from blocking your child’s ear:

  • Over-the-counter drops that help remove wax are basically oil and peroxide solutions (for example, Debrox or Murine). These preparations are best for those with small to moderate amounts of wax.
  • Tip your child’s head so the ear points toward the ceiling. Using an eye dropper, fill the ear canal with baby oil or mineral oil. Keep his/her head tipped for five minutes (or as long as you can), then cover the ear with a towel and have your child straighten up his/her head, so the liquid drips out. Repeat this process in the opposite ear as necessary once or twice a week.
  • 3% Hydrogen Peroxide will also help in excessive wax removal. Gently fill the ear canals with the peroxide, using an eye dropper, in the same manner that you instilled the oil. Peroxide is available at your pharmacy and will usually bubble out the ear wax once it has become soft. Following a few drops of peroxide in the ear, flush the ear with rubbing alcohol to dry the ear canal.

Remember, If you are concerned that your youngster is having symptoms from excessive ear wax, contact your child’s health care provider.



As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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