Parents often feel the instinct to clean earwax (cerumen) from a child’s ear canal. However, most children’s ears are designed to be self-cleaning, and intervention is rarely necessary. The primary concern when addressing ear hygiene is safety, as cleaning attempts can unintentionally cause harm. For most children, a simple, routine bathing process is sufficient to maintain healthy ear canals.
Understanding Earwax: Why It’s Necessary
Cerumen is a natural, protective substance produced by specialized glands in the outer ear canal. This waxy secretion serves several biological functions, including lubricating and moisturizing the skin within the ear canal. Earwax also acts as a shield, trapping dust, dirt, and foreign particles before they reach the delicate eardrum.
The substance contains antimicrobial properties, helping to prevent bacterial and fungal growth. Under normal circumstances, jaw movements associated with talking or chewing help move the wax slowly out of the ear canal. Once it reaches the opening, the wax dries up and falls out or is washed away during bathing.
Dangerous Cleaning Methods to Avoid
The most common and dangerous tool parents use for cleaning is the cotton-tipped swab. Inserting a cotton swab into the ear canal often pushes cerumen deeper inside, leading to a blockage called impaction. This blockage can cause pain, hearing loss, or a feeling of fullness in the ear.
Cotton swabs pose a significant risk of physical trauma to the ear structure. Studies show that cotton swab use sends an estimated 34 to 35 children to the emergency room daily in the United States for ear injuries. These injuries include bleeding ear canals, abrasions to the sensitive skin, and perforated eardrums, which can lead to permanent hearing loss.
Other hazardous methods, like ear candling, should be avoided. Ear candling involves lighting one end of a hollow cone and placing the other end in the ear, claiming to use suction to pull out wax. There is no scientific evidence to support this claim, and the practice carries a high risk of causing burns from the hot wax or flame. Sharp objects like hairpins, keys, or pen caps should never be inserted into a child’s ear, as they can easily scratch the canal or rupture the tympanic membrane.
Safe Techniques for Gentle External Cleaning
For routine hygiene, only the outer ear—the part visible outside the canal opening—requires cleaning. During a bath or shower, parents should use a soft, warm, damp washcloth draped over a finger. Gently wipe the outer ear, including the earlobe and the folds, to remove any wax that has naturally migrated out.
If a child has a visible wax buildup causing minor discomfort, a pediatrician may recommend a gentle softening regimen. This involves using a few drops of a cerumenolytic agent to help break down the wax. Options include mineral oil, baby oil, or a solution of equal parts hydrogen peroxide and water.
These drops are administered once or twice daily for several days to soften the hardened wax. These methods only loosen the wax, allowing the ear’s natural movement mechanism to expel it over time. Before starting any drop regimen, a parent must confirm with a doctor that the child’s eardrum is intact, as drops can cause problems if a perforation exists. For children under six years old, eardrops or flushes should only be used under the guidance of a healthcare provider.
Signs That Require a Doctor’s Visit
While most earwax issues resolve naturally, certain symptoms indicate a child needs professional medical attention. Persistent ear pain, a feeling of fullness or pressure, or a sudden change in hearing should prompt a visit to a healthcare provider. Parents should watch for signs of infection, such as discharge of pus or blood from the ear canal.
Other concerning signs include a foul odor emanating from the ear or visible dizziness or unsteady walking. If a parent suspects a severe blockage, or if the child is tugging at their ear and is irritable, the wax should be examined by a pediatrician or an otolaryngologist. These specialists have the tools to safely remove impacted wax using methods like irrigation, micro-suction, or specialized instruments.