Earwax, medically known as cerumen, is a natural, protective substance produced by glands within the outer part of the ear canal. This material serves an important function by lubricating the delicate skin of the ear canal and keeping it moisturized. It also traps dust, dirt, and other small particles, preventing them from traveling deeper into the ear toward the eardrum. The ear is naturally self-cleaning, with the ear canal skin slowly migrating outward, carrying the old wax and trapped debris out of the ear. When this natural process is disrupted, or when a toddler simply produces more wax than average, it can lead to a buildup.
When to Remove Earwax and Essential Safety Rules
Most of the time, earwax does not need to be removed and should be left alone to perform its protective functions. The wax naturally works its way out of the ear canal through jaw movements like talking and chewing. Removal is generally only necessary if the wax becomes impacted, meaning it completely or nearly completely blocks the ear canal, leading to discomfort or hearing problems.
Buildup may also need to be addressed if it is causing pain, persistent itchiness, or if a doctor requires a clear view of the eardrum to check for other issues. In children, a buildup is often caused by an object being inserted into the ear, which pushes the wax deeper and causes it to become tightly packed. The first rule of ear care for toddlers is to never put anything inside the ear canal.
Avoid inserting any object into a toddler’s ear, especially cotton swabs. Cotton swabs do not remove wax; instead, the soft tip often pushes the cerumen deeper into the narrow canal, causing impaction against the eardrum. Inserting objects risks scratching the fragile ear canal skin, causing bleeding, or potentially rupturing the eardrum, which can lead to infection and hearing loss. Parents should also firmly avoid using unproven methods like ear candling, which is ineffective and carries a risk of burns to the ear canal.
Step-by-Step Safe Home Removal Methods
If a toddler is experiencing mild symptoms of wax buildup, or if a pediatrician has specifically recommended home treatment, the safest approach involves softening the wax. This process is intended to loosen the cerumen so the ear’s natural cleaning mechanism can take over and move it out. A few drops of a softening agent, also called a cerumenolytic, can be applied to the affected ear.
Safe softening agents include mineral oil, baby oil, or over-the-counter earwax drops, such as those containing carbamide peroxide. To apply the drops, have the toddler lie on their side with the affected ear facing up. Gently administer two to five drops into the opening of the ear canal and keep the head tilted for five to ten minutes to allow the solution to penetrate the wax.
After the wax has been softened, it will usually migrate out on its own. The only safe way to clean the ear is to wipe the outer ear and the opening of the ear canal with a soft, damp washcloth or cotton ball. Never attempt to clean inside the canal or remove wax you cannot easily see and reach. Parents should generally avoid using bulb syringes or water irrigation to flush the ear canal in toddlers unless a pediatrician has explicitly advised it. This is because it can be difficult to control the pressure, which risks damage to the delicate eardrum, especially if there is an underlying perforation.
Symptoms That Require a Doctor’s Visit
While home softening methods are effective for mild buildup, some symptoms indicate that professional medical intervention is necessary. Parents should seek medical attention if the toddler experiences severe or unmanageable ear pain. Other concerning signs include any discharge from the ear, such as pus or blood, or a persistent fever.
Symptoms like persistent hearing loss, a sensation of fullness or ringing in the ears, or dizziness should also prompt a visit to a healthcare provider. The doctor will use specialized instruments to examine the ear canal and may perform professional wax removal using tools like a scoop, suction, or controlled irrigation. These procedures ensure the wax is removed safely without damaging the fragile structures of the inner and middle ear.