As with most ailments affecting babies, their inability to clearly communicate with us, beyond crying and screaming (and giggling, however rare it may be), can make it both difficult, and at times frustrating, to determine what exactly the problem is. Many parents are stuck with the question of “How to clean baby ears?”, which stems from our quite sensible fear of doing something to them that either makes matters worse or harms them further.
When it comes to infant ear wax build up, simply diagnosing the issue in the first place can be a challenge, let alone treating it and implementing some sort of preventative measure to reduce future blockages. Here we hope to clarify some of these problems and hopefully provide you with some of the best advice for baby ear wax removal.
Below is a small table of the primary topics covered in this article. If you’re in a hurry, click on the links to jump to those sections more closely meeting your concerns.
- Distinguishing Infant Ear Wax from an Infection
- Is Excessive Ear Wax Normal For a Baby?
- Can too much Wax Cause any Long or Short Term Problems for my Baby?
- What are the Best Baby Ear Wax Removal Treatments?
- How do you Prevent Blockages from Happening in the Future?
1. Distinguishing Infant Ear Wax Build Up from an Infection
Lacking the ability to tell you exactly how they’re feeling certainly can make this difficult. There are, however, some very clear signs that what your precious child is suffering from is more than just a simple ear wax blockage. It is crucial to be on the lookout for the following signs as infections, besides being exceedingly painful, can also lead to scarring and extended damage to the ear drum.
- One of the more the obvious ways of establishing whether your baby’s ear trouble is due to an infection or not is if he/she becomes more irritable when being laid down. Lying down puts added pressure on the Eustachian tubes which are particularly sensitive to pain when inflamed due to common ear infections. Place your baby in a seated position for about 10 to 15 minutes and monitor their behaviour. Then simply lay them down. If they immediately start crying or screaming, they very likely have a painful inner or middle ear infection and you should get them to a doctor as soon as possible.
- Checking their temperature is another quick and easy way of determining an infection. A healthy temperature is 98.6°F or 37°C. Anything above 99.5°F (or 37.5°C) measured in the mouth, 99°F (or 37.2°C) measured under the arm, or 100.4°F (38°C) measured rectally is considered a fever. Even if not caused specifically by an ear infection, you should still get your baby checked out by your doctor or paediatrician immediately if their temperature is elevated.
- Clear fluid, pus or blood discharging from the ear is a very obvious sign that something is wrong, although it is not always present with infections. This is often caused by a punctured eardrum. The most common of infections in babies and young children, that of the middle ear (otitis media), leads to the accumulation of fluid behind the drum. When pressure from this fluid reaches a high enough level, the drum can burst. The fluid, including blood and pus, will then drain from the ear. It is also important to ensure that if wax is a dark brown color that it is not confused with coagulated blood.
- Another sign is that they’re just generally more irritable than usual. This is not as clear an indication as the previous points but may be a warning sign that something is wrong. Try, as suggested above, laying them down after being seated for a few minutes. If you suspect their odd disposition is caused by an ear problem, they will quite likely become more upset when being laid down. If they do, get their ears checked by your GP.
- Further general indicators of infection are reduced appetite, problems with sleeping, vomiting and diarrhoea. Tugging of the ear may be yet another sign, although it is not all that reliable on its own as many annoyances can cause this.
2. Is Excessive Ear Wax Normal for a Baby?
It is fairly uncommon for a baby to have problems with ear wax build up. However, they may have inherited overactive cerumenous glands, unusually hairy ear canals or other factors which simply make them more predisposed to blockages than others. If your baby does suffer from earwax problems, this certainly doesn’t mean they’re odd, and it doesn’t guarantee that they’re going to have ear issues for the rest of their lives. It could simply be a transient issue. Besides, there are far worse conditions for a child to suffer from.
2.1. What Causes Impacted Ear Wax in Babies?
Several factors can cause blockages in infants besides the genetic ones mentioned above. The infamous cotton earbuds (or Q-tips) being one of the more common causes when well-meaning parents attempt to clean their baby’s ear, but end up instead ramming and plugging the wax deeper into the canal. Never, especially with babies and young children, put anything into their ears. Besides increasing the chance of wax blockages, their sensitive eardrums are more easily ruptured leading to extreme pain and a lot of tears.
3. Can too much Wax Cause any Long or Short Term Problems for my Baby?
As mentioned above, simple ear wax build up in babies doesn’t automatically mean your child will suffer from the issue all their life. If overactive sebaceous glands or excessive ear canal hair growth are the cause, with age these conditions may normalise, and blockages may then become a thing of the past.
Excessive wax may, however, increase the potential for infections as bacteria are drawn to the growing plug of oil, hair and skin in the ear. This fact is often debated but I prefer to be cautious, particularly when it comes to young children. Babies are also inherently more prone to ear infections as their immune systems are still in development. Furthermore, fluid and germ accumulation in their middle ear is more likely to occur than for older children and adults due to their undeveloped Eustachian tubes, which are the passageways between the middle ear and throat. This also increases their chances of getting an ear infection after having a general cold or flu.
4. What are the Best Baby Ear Wax Removal Treatments?
First thing’s first. As regular readers of this site already know, if any fluid is leaking (clear liquid, pus or blood) from your baby’s ear, do not attempt any home remedy, not even simple ear drops for infants. Take your child to your doctor immediately.
4.1. How to Clean Baby Ears at Home?
With that firm warning out of the way, listed below are the safest and most effective means for how to clean baby ears at home.
Ear Drops for Infants
It is recommended to only use the mildest of over the counter ear drops for babies as the more aggressive types will tend to dry the skin of the duct leading to itchiness and irritation. As discussed in an earlier post, the gentlest class of drops are oils and fats, the most commonly used of which for loosening wax are: olive oil, mineral oil, baby oil and glycerine. Any of these are safe for use in baby’s ears (assuming an ear infection or eardrum tear is not present) provided they are specifically sterilized. Cooking olive oil or mineral oil for general use are not sterilized and can increase the risk of infecting your child’s ear.
The following is a suggested method for administering the oil drops into a baby’s ears:
- Warm the bottle of oil drops by rolling it between your hands for a few minutes. Too warm or too cold drops may upset your baby and can cause dizziness and vertigo.
- Gently lay your baby on his or her side and with a sterile dropper draw up a small volume of the oil or glycerine.
- Drip one or two drops into baby’s ear and gently keep them laying on their side for two or so minutes to allow the oil to work its way down into the canal.
- Then take a small amount of tissue and wipe away any excess oil. Turn your baby and lay him/her on their other side holding the tissue against the ear that the drops were just administered to catch any oil and wax that may fall out.
- Again, add one or two drops to your child’s other ear and allow the oil to work down the canal.
- Repeat two or three times a day until the wax clears.
The oil should effectively loosen the blockage and allow it to be washed out during baby’s normal bath. Be sure to wipe the outside of their ears while bathing to clean away any expelled cerumen.
Foaming agent drops such as Debrox® (carbamide peroxide) have also been reported as safe for babies. It is however recommended on this site that oil drops be attempted first. If the issue is not effectively cleared up using these drops together with the gentle syringing protocol described below, then consult with your paediatrician as to whether peroxide or sodium bicarbonate based drops may provide better results, and whether he/she feels they are safe.
If the oil drops do not clear the build up on their own, mild irrigation can also be used after the drops have been given a chance to work for a two or three days. For this, distilled water gently heated to body temperature (do not use cold or hot water!) is drawn into a sterile syringe, which is available at most pharmacies. The water is then very delicately syringed into your baby’s ears to rinse the wax out. It is best to do this during baby’s bath for obvious reasons. Beware, however, that too much pressure applied during syringing can cause pain and potentially damage the ear. If you are worried about this at all, rather allow your doctor to perform the irrigation.
4.2. How Professionals will Likely Clean Baby Ears
Most often, a paediatric ear doctor will use a mild irrigation procedure, similar to that described above and will often prescribe ear drops to soften the wax. He/she may also use a small, narrow instrument together with an otoscope to very carefully scrape any wax out of the ear if it is particularly compacted. This procedure is known as an aural toilet.
Mild microsuction might also be used by the professional, and the exact technique they use will depend on their experience and perceived effectiveness of the particular method.
5. How do you Prevent Blockages from Happening in the Future?
Regular bathing of your baby should be enough to prevent buildups in general, together with gentle wiping of the outside of the ear with a warm, damp cloth. One of the best ways for adults to prevent blockages is to ask their doctors to clean their ears during their annual check-up. This, however, may not be best for a baby. A paediatrician will know this and it is better to ask him/her to inspect your child’s ears during normal check-ups and then make a decision as to whether a cleaning should be done.
One to two drops of sterilized oil/glycerine based drops once a week may also help prevent compactions if your baby seems prone to them. Mild syringing with warm, distilled water every few weeks may further help in reducing blockages. It has also been reported that dehydration may lead to an increase in the thickness of earwax, and so ensuring your baby is properly hydrated may also be a suitable preventative measure.
Although ear wax issues are fairly uncommon in infants, they certainly do not need to be a major cause for concern. It is essential that they are not confused with an infection, and if there are any doubts, reference should be made immediately to your health care practitioner. This article did however highlight several simple techniques you can try at home to more definitively distinguish between infections and ear wax build up.
Two at home treatments were also described, focussing on the use of mild softening drops, and if necessary, the implementation of very gentle irrigation. Oil/glycerine based ear drops for infants should be tried first, followed by the somewhat more aggressive foaming agent class of cerumenolytics. As usual, if home remedies are unsuccessful, professional medical treatments should be sought.
Prevention is always the best strategy, and regular bathing together with ear inspections during routine checkups at the doctor should, on their own, keep blockages at bay. Administering a couple of drops of sterilized oil every one or two weeks might further help keep blockages at bay.
I hope this post has helped put your mind at ease about the issue of earwax in your baby. Please comment or share if you liked what you read or think someone else might find this information useful.