Ear wax and ear pain: some frequently asked questions

Ear wax and cleaning the ears

Many parents are concerned that their child has too much ear wax. Just like some people have oily skin and others have dry skin, some children have thick, oily wax and other children make very little. Ear wax is not bad; it actually protects the ear canal by trapping debris.

 How much ear wax a child has doesn't have anything to do with whether he or she is prone to ear infections. The best way to get excess wax out of your child's ear is to have them lie back in the bathtub every time they take a bath. When they sit up again, the water will drain out, taking a little bit of wax with it every time. There are "cleansing" ear drops available at drugstores for this purpose, but are probably an unnecessary expense.

Ear infections: two types

Usually, when we talk about ear infections in children, we are referring to middle ear infections ("otitis media"). However, children (usually school age or older) can also have outer ear infections ("otitis externa"), also called "swimmer's ear." A middle ear infection generally requires an antibiotic taken by mouth for ten days to clear it up, but an outer ear infection can be treated with ear drops put directly into the ear.

Ear pain without an ear infection

Ears can still hurt even several days after an ear infection has cleared up. Even if there has been no ear infection recently, a child can have truly significant ear pain. Tension headaches and sore jaw muscles (such as from chewing gum for too long) can cause referred pain to the ear. Uneven pressures between the outer ear and middle ear can cause ear discomfort, similar to the ear "popping" sensation felt on airplane rides. Many things can cause uneven pressure, such as colds, allergies, sinus inflammation, etc.

 These kinds of ear pain are treated by addressing the underlying cause. Until then, you can offer your child some acetaminophen or ibuprofen to take the edge off the pain. If your child is old enough to understand, have him or her try self-insufflation (pinching his nose, blowing out his cheeks, and swallowing.) This can sometimes help "unpop" the ear. For very severe ear pain, we can prescribe analgesic ear drops, as long as the ear drum doesn't have any holes in it.

Babies pulling at their ears

Newborn babies have almost no awareness of the nature of the world around them, or even of their own bodies. As babies mature, they discover that their bodies have different parts, and that those parts feel different from each other. They discover these differences by touching and playing with things. When babies tug on their ears, they're not necessarily doing it because their ears hurt, as a toddler or older child might press on a painful ear. They may be simply experimenting with their newly "discovered" ears. True ear pain would be expressed simply through crying and fussiness.