This is one of the commonest questions that I get from anxious parents. I recently saw a child who unfortunately, had a ruptured eardrum due to well intentioned attempts at removing wax by using a hair pin.I do hope that this article serves as a valuable guide to parents in taking care of a day to day issue while bringing up their children.

First a background on why people clean their ears. The auditory canal secretes wax in all human beings. This wax is protective as it traps dirt and other particles that enter the ear and prevent them from damaging the delicate eardrum. The eardrum is really thin in children and can rupture even more easily than in adults. Normally, the wax keeps getting pushed outward from the ear canal to the outside and is then washed away when we take a shower. Sometimes, the buildup of earwax is greater than the amount that is washed away and this can result in clogging of the ear canal.

Symptoms of a ear clogged due to ear wax

• In small infants and children, pulling and tugging at the ear.
• Digging with fingers into the ear.
• In older children and adults, there may a ringing in the ears or there may be muffled hearing.
• Pain in the ears.
• There may be discharge from the ear that is usually, yellowish or brownish in color.

Remember that these same symptoms can occur in a child who has middle ear infection though, such children usually will have fever or inability to sleep at night and the discharge from the ear may be pus like or bloody or even clear. It is best to show your child to your pediatrician if you notice these symptoms.

Care of the normal ear

There is no special care required. If you see wax on the outside of the ear, please wipe it away with a wet washcloth or cotton swab. Please do not use ear buds or hairpins inside the ear canal in any case. To examine the ear, just gently lift the ear outwards and behind the body. This straightens the canal and you can easily look inside. If it looks clogged then, please approach your child specialist or ENT surgeon and he / she will do the needful in no time at all.
In fact, it is not very jokingly said that do not put anything into the ear that is smaller than your

elbow! Ear buds inserted into the canal, push the wax further inside and makes it more difficult to remove. The cotton on the bud dries out the water in the wax, further impacting it.Dehydration causes the wax to become dry and impacted so please give your child adequate amount of fluids.

What are the ways that the doctor uses to get rid of impacted wax?

Your doctor may use any or all of the following methods:

• Use of ear drops that dissolve the wax and allow it to flow out freely.
• Use a gentle jet of warm liquid that dislodges the washes out the impacted wax.
• Use a variety of instruments that are specially designed for this purpose like a hook or small spoon etc (the last 2 methods are used by ENT surgeons)