Spotting Your Child’s Cold and Flu Symptoms at Every Age

When adults get hit with the flu, there’s no mistaking it. You’re feverish, your head feels stuffed up and you ache everywhere. But with kids, the signs aren’t always as easy to detect.

“Young children with the flu can run the whole gamut of symptoms,” says Dr. Martha Snyder, a pediatrician and assistant professor of pediatrics at Duke University School of Medicine. “Some children have the mildest of mild symptoms, while for others, symptoms are very severe.”

Below is your guide to spotting flu symptoms no matter what your child’s age, and ways to bring relief.

Infants Under Six Months

Babies in the first six months of life are at the greatest risk of complications from the flu, says Snyder, because their immune system is not fully mature yet and their very small airway makes it easy for them to experience respiratory distress.

If your infant has a fever, call your doctor and watch for other signs of illness, such as dehydration. “When babies this age don’t feel good, they usually don’t want to drink,” she adds. Provide plenty of water to keep an infant hydrated.

Children Six Months to 2 Years

Kids under the age of 2 who come down with the flu often have respiratory symptoms (cough, runny nose, sneezing), high fevers (sometimes as high as 104 F), diarrhea and vomiting. “But while many kids have all of these symptoms, others may only have one,” says Snyder.

Recognizing the early signs in toddlers is especially important, she says, because they can also get dangerously dehydrated very quickly. In addition, because of their smaller airways, babies can quickly progress to having wheezing and labored breath, which requires medication. Signs that a child’s breathing is compromised include wheezing, fast breathing or shortness of breath, and nose flaring.

Children 2 to 4 Years

A child who can’t talk yet (or can’t talk well) obviously can’t tell you that his body aches all over, so you need to be alert for behavioral changes, says Snyder. For instance, in many cases, children with the flu will have shaking chills and refuse to walk, because their legs are very achy.

“With kids under the age of 4, you really have to watch them to see how they’re acting. Respond to anything that seems out of the ordinary,” adds Snyder. “Young kids often have a limp look to them. Or they’re so uncomfortable they just want to be held.”

Children 4 to 6

Once kids can tell you how they feel, listen for complaints similar to an adult’s. But be aware that if your child is under the age of 6, oral over-the-counter cold and flu medications are not recommended. “You should never give children this age decongestants, cough suppressants and other OTC cold remedies, because of the side effects,” says Snyder.

But there are other things you can do. “It’s OK to give your child acetaminophen or ibuprofen for fever or pain reduction,” adds Snyder. It’s also safe to apply topical soothers to help relieve symptoms. And some children don’t mind saline nasal sprays for stuffy noses but be careful not to use them too often (more than six times a day), since overuse can cause swelling of a child’s nasal passages.

Other beneficial non-drug treatments for colds and flu include chamomile tea with honey, and a cool mist humidifier. Just be sure to use one that has a humidity gauge and to keep the level at no higher than around 50 percent to avoid a mold problem.

Children Over 6

For children over the age of 6, symptoms are essentially the same as adults’. And at this point, OTC decongestants and cough suppressants are generally safe, although they’re not recommended for children with certain health conditions. For instance, if your child is taking medication for ADHD, ask your doctor before giving your kid a decongestant, since the combination of the two drugs has been shown to cause heart problems.

In addition, kids with asthma or any kind of respiratory problem should stay away from cough suppressants, says Snyder, because these products may make it harder for them to clear secretions from their lungs, which can lead to pneumonia.

 

How to use antibiotics safely and wisely

Since the first discovery of penicillin, antibiotics have been a useful and beneficial tool in fighting a wide variety of bacterial infections. But antibiotics must be used wisely and safely and only used when medically necessary in order to get the most benefit from them. For the last decade or more, health care professionals have been concerned because antibiotics have been over-prescribed, overused and misused for so long that many of them are losing their ability to fight illnesses. Many types of bacteria have already become resistant to some of the older “first-generation” antibiotics making them almost useless against some illnesses. New antibiotics are being developed but bacteria can adapt and become resistant to them to them too, if they are not used carefully. Doctors are trying to their part to stop antibiotics from being overused by not prescribing them unnecessarily. We can help, too, by learning more about these “miracle drugs” and how to use them properly and safely.

What Do Antibiotics Do?

Antibiotics fight bacteria. (Think of them as “bacteria-busters”!) There are many different kinds of bacteria that cause many different illnesses. Because of the wide variety of bacteria, there is also a wide variety of antibiotics that have been developed to treat them. When your doctor diagnoses a bacterial infection she will determine which antibiotic is appropriate for that particular infection.

If your doctor diagnoses a bacterial infection, ask her if it is absolutely necessary to use an antibiotic. Some bacterial infections can be cleared up without antibiotics when under a doctor’s supervision. For example, antibiotics used to be routinely and automatically prescribed for ear infections in young children. However, research has shown that many of these infections can heal on their own without antibiotics as long as a doctor is monitoring the infection. Talk with your doctor about the necessity of using an antibiotic, the pro’s and con’s of using one versus not using it, then follow her advice and directions.

Not all infections are bacterial. Most common, minor illnesses are caused by viruses. Viral and bacterial infections may share some of the same symptoms but they are very different infections and must be treated differently. If your doctor diagnoses a viral infection, it is unwise to pressure her into giving you a prescription for an antibiotic because antibiotics are useless against viruses. It would be a waste of money and would contribute to the problem of resistant bacteria due to antibiotic misuse.

When You or Your child is Prescribed an Antibiotic

The questions that you need to ask your doctor include:

• The name of the medicine (both brand name and generic name)
• The amount to be given (dosage)
• The times to be given (schedule)
• Possible side effects
• Potential drug interactions with any other medicine you are taking
• When to call or come back in if symptoms have not improved

Be sure that the doctor is aware of any other medications (including over-the-counter medications and herbal supplements) that are being used. If the antibiotic is for your child, ask about the taste and if it can be mixed with juice or food to disguise a bad taste. (We have been blessed with a pediatrician who tastes tests medicines so he can be honest with his patients about whether they are yucky or not. And if he has a choice of what to prescribe, he gives them the best tasting one.)

When You Go to the Pharmacy

Ask the pharmacist to give you written instructions on:

• When to take the medicine (schedule)
• How long you need to take it for (most of the time you will continue until all of the antibiotic is gone)
• How much to take (dosage)
• Side effects

Also ask whether or not the medicine:

• Can be taken with or without food
• Needs to be refrigerated
• Needs to be shaken well (if a liquid)
• Can be mixed with food or liquid to disguise a bad taste

Make sure the name of the medicine and the amount and times to be given on the label match what your doctor told you. Liquid medications need to be measured precisely, ask for a measuring device if you don’t have one. If other medications/supplements are being used, tell the pharmacist and ask about drug interactions. Some medications can be dangerous when mixed.

Taking or Giving the Antibiotic at Home

When giving or taking the antibiotic at home, make sure to stick as closely as possible to the scheduled times. If a dose is missed, do not double dose. If it is almost time for the next dose, then do not take the skipped dose, just take the next one on time. If it is still a few hours until the next dose, take the skipped one and then adjust the time to take the next one accordingly. If two or more doses have been skipped, call your doctor for instructions. Always call the doctor or pharmacist if you have questions.

Be sure to use a medication measuring cup, dropper, or oral syringe for liquid medications. Kitchen teaspoons and tablespoons can vary widely so don’t use them to measure medicine. (I wonder how many times we got the wrong dose when our moms gave us medicine using kitchen spoons?) Do not cut pills in half or crush them unless you have been told to or have checked with the pharmacist first because it could alter the effectiveness. Do not mix the antibiotic with juice, milk, or anything else to make it taste better unless the pharmacist says that it is okay to do so because certain antibiotics have to be taken on an empty stomach. Also, calcium and vitamin C can lessen the effectiveness of some antibiotics.

Always finish all of the prescribed antibiotic unless the doctor has instructed otherwise. Just because the symptoms may be alleviated after a few doses and you feel better, it does not mean that the infection is completely gone. Not finishing an antibiotic allows the remaining bacteria to learn how to adapt to the antibiotic and become resistant against it.

Side Effects

Common side effects of most antibiotics include: mild diarrhea, nausea, abdominal discomfort, and headaches. All antibiotics have the potential for side effects but that does not mean that every person will have the same ones. Most of the time, side effects are mild. If you have side effects that are moderate to severe, contact your doctor or pharmacist. Don’t stop using the medication without checking first. If your doctor instructs you to stop taking the medicine before it is finished, throw out the remaining amount. Do not save it for another illness.

Storing Antibiotics

Keep antibiotics (and, of course, all other medications) out of the reach of children. Put them in a cool, dry, dark, safe place or if it needs refrigeration, put it on the highest refrigerator shelf. Bathroom medicine cabinets are exposed to too much humidity which can lessen the effectiveness of some antibiotics.

If you have leftover antibiotics in your medicine cabinet, do not use them. Using or giving an antibiotic to one person that has been prescribed for another person can be very dangerous, even life-threatening. You would not have a full course of treatment and the antibiotic may not even be effective against the specific bacteria causing your illness. Instead, ask your pharmacist how to properly dispose of any leftover antibiotic. Do not throw any medicine in the trash because small children and pets could have access to them there.

When All the Medicine is Gone

Hopefully you will be feeling much better by the time you have finished all of your antibiotic. If, however, your symptoms haven’t cleared up and you are still feeling sick, call your doctor. She may want you to come back in for a re-check visit or she may call in a different, stronger antibiotic for you.

These guidelines are of a general nature and not intended to replace the advice and supervision of your physician or pharmacist.

Be a Parent and Not a Referee: Simple Tips to End the Fighting

It’s the soundtrack to parenthood: the battles, the bickering, the rivalries. Mom- she’s touching me! He’s looking out my window! Tell her to get out of my room! Even on the best of days these sibling squabbles can make you want to pull your hair out. Add in busy schedules and mounting stress and coming home to conflict and contention can just be too much to handle. So what can you do when your living room more closely resembles a war zone rather than the relaxing retreat that it should be?

Though you can’t force your siblings to be best friends, you can get a handle on their squabbles and create a (relatively) harmonious home.

As you probably know already, just saying ‘You kids stop your fighting!’ isn’t going to cut it. Kids respond to firm boundaries and clear cut directives. So what you have to do is lay out some non-negotiable rules and enforce them…period.

There are four simple house rules that will result in a (temporary, at least) cease-fire on all the fighting. The key to successful implementation: consistency, consistency, consistency! (Did I say consistency?)

No yelling. Instate a ‘vow of yellibacy’ in your house and enforce it. When tempers flare and feelings are hurt, the volume decimal tends to rise, causing arguments to quickly escalate and get out of hand. Just remember: the ‘no yelling’ rule isn’t only for the kids, it goes for you too. Parents have to set the example for staying calm and collected when they are upset or angry as well. This should be rule number one. All family members must use calm voices only—no yelling allowed. And if talks get heated, anyone can make a time-out hand sign hinting that he needs to cool down. When cooler heads prevail, arguments get resolved much more quickly and in a way that is less stressful for everyone.

No taking without asking. Property ownership can be a BIG deal to little ones, and the time honored “Mooom, she’s touching my stuff!” complaint can be frequent in multi-child households. This can be a particularly touchy issue for tweens and teens- especially if there is a younger sibling in the house. Older siblings can get pretty upset when their iPods and laptops are confiscated by tiny sticky (literally!) fingers. Insist that permission of the owner must be granted before borrowing, using, or taking any property. Not only will this cut down on the conflict, but it will also make it easier to resolve any arguments that may come up. If permission was not asked for and granted, then you know who broke the rule. Simple as that.

No hurtful behaviors. With bullies and mean girls running the schools, it’s important that you set the standard for you home to be a safe haven for your kids. It should be a place free from hurtful behaviors. Set a strict policy: name-calling and hitting will not be tolerated, under and circumstances and they will result in a consequence. Tolerating hurtful behavior inside your home only encourages your kids to display it when you aren’t around as well- and that’s not a character trait any parent wants to encourage. This rule should stand for each child in your home, no matter what age they are. The consequences may differ according to the age group: for a younger child, a display of hurtful behavior will result in a time-out. If your child is older, then it means the loss of a privilege. While hitting and hurtful words are sure to happen when it comes to siblings, it’s up to you to make them understand that you will not tolerate it under any circumstance.

No involvement without evidence. If you are the parent of siblings, you’ve probably also spent a good deal of time playing referee. Kids are quick to run to a parent’s aid to help settle their disagreements and if you weren’t a witness to the incident itself, then it can be hard to know exactly what to do. Borba says you should get involved in the conflict only if you actually saw or heard it occur. This will help to keep you neutral and will encourage your kids to adopt strategies to help them work things out for themselves. If your kids seek your help, but you don’t have any evidence, then step away. Instead, suggest that they use Rock, Paper, Scissors to work out their problem. This prevents you from having to choose sides or take one kid’s word over another’s—and it will also teach them to work things out for themselves. After all, you won’t always be there to help them resolve their problems, so it’s better that they acquire the skills at home so they are ready when the time comes.

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Dr Borba’s book The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries, is one of the most comprehensive parenting book for kids 3 to 13. This down-to-earth guide offers advice for dealing with children’s difficult behavior and hot button issues including biting, tantrums, cheating, bad friends, inappropriate clothing, sex, drugs, peer pressure and much more. Each of the 101 challenging parenting issues includes specific step-by-step solutions and practical advice that is age appropriate based on the latest research . The Big Book of Parenting Solutions has recently been released and is now available at amazon.com

In Memory of Noah…please watch your children around cars

Travis is in the Air Force and we were stationed at Scott AFB in Illinois for quite some time. Illinois was the only place Noah had ever lived…but he was used to moving. We had to move several times from one house to another. This time it was from one house on base (that was scheduled to be renovated) to a brand new house that had just been built down the road. We were all excited, we had never lived in a brand new house before nor one so big. Noah was worried about how we were going to get all of our stuff to the “Empty House”.

Looking back in my memory files, I realize that I don’t have a lot of memory of the day of the accident. Not of the little stuff. I don’t even remember what day of the week it was.

Thursday I think.   July 26, 2007.

There was a buzz in the air that morning. Everyone was excited. Noah just celebrated his 5th birthday the day before, and he was anxious to play with his new scooter.  I had a lot of things to do. Noah had some birthday cake for breakfast. Sure! Why not. I didn’t want to fuss and argue that day. Happy as a lark he was.

I filled up the back of the van with boxes of kitchen stuff to bring to the new house. Noah added a couple of things to put in his new room. The girls helped. I brought several loads of small things down to the new house that morning…setting everything up just right. The bigger stuff would come later when Travis could get off work and we could rent a truck.

I remember backing into the double garage with a little bit of difficulty because the driveway was curved. I didn’t think much about it. I couldn’t bring much in the van because everything had to be weighed so we could get paid from the Air Force for this move. So I headed back home where all the kids in the Cul-de-sac were playing. It was a beautiful, sunny day.

All the kids got out of the road. I had my windows rolled down and I could hear the older kids shout, “Car”. Everyone would dart into the yards and wait for the car to go by and park. They had a good system going.

I backed the van up to the house and parked it. Noah was playing on his new bright colored scooter. I walked down the driveway to check the mail and saw Noah at the top of the driveway, beside the van getting ready to take off like a rocket down my way towards the road. I ran up beside him and gave him a “Smoochie” and told him “I love you.” “Thanks Mom” he said, and away he went. I will be forever glad I said that to him.

The girls were fussing in the house. That was nothing unusual. We were watching a friend’s dog. I had forgotten about that until just now. Lucky was the dogs name, and he happened to be hanging out at our place so I didn’t have to go back and forth to let him out. This is where I draw a blank some.

I just remember after coming home, that I went upstairs in my room and lay down in bed. I was tired already, and the thought of all the work ahead of me for that day made me even more tired. My ear bothered me. It was plugged and in a little pain. I thought I was getting an ear infection.

Travis came home. Noah was excited and followed him up the stairs to where I was. He wanted to talk about the money he got for his birthday. $30.00 is a lot of money to a 5 year old. I heard Noah tell his dad…” You know dad I’m richer than YOU! I have a Million Dollars!” Travis asked him what he was going to do with that Million Dollars. Noah said he was going to buy Orange Tic-Tacs – his favorite treat to get when he went to the Shoppette with his Dad. We all got a great laugh out of that. Noah climbed on the bed with me, and Travis started changing his cloths. Sooner or later Noah was told to go play outside.

Travis and I made plans to go get the truck. Travis knew of a place to rent trucks in the town, not too far away. I kind of dreaded getting up off the bed, because I really didn’t feel well. But I did. I was excited to move into the new house, and there was a lot to be done. I told the girls that we were going to go get the truck, and that I would have to drive the Van so their dad could drive the truck back. I was outside by the van when I asked Beth if she would watch Noah. She didn’t want to and Noah wanted to go with us. I was perfectly fine with him going with us. I didn’t mind at all. It shouldn’t take long after all.

Noah was excited. He was dressed in new cloths that he got from Gramma, and told me after he got buckled into his seat that he “Looked Hot”. Something he undoubtedly picked up from his sisters.

When we pulled into the truck rental place I wondered if the place even rented trucks, because it looked more like a place that just had storage units to rent. I didn’t see any trucks. The parking lot was covered with white rocks. They crunched when I drove over them and parked. Travis got out and went in to do business.

Noah hummed and chattered away behind me in his car seat. It was taking longer than he thought it should so he unbuckled his seat-belt and walked up to stand next to me while I was sitting in the driver’s seat. Noah asked where we were, and I told him this is the place where we are going to borrow a truck so we can take all our stuff to the new empty house. Satisfied with that he wanted to go in and be with his Dad. I told him that was fine, and I would watch him walk to the door. He went in and I called my mother on the phone to tell her that we were moving that day, and we talked a little bit. I saw Travis come out of the building. There was a vehicle on both sides of the van so I couldn’t see Travis after a couple of seconds. I figured Noah was with Travis, happily trotting behind him.

Some time went by and I saw Travis driving the moving truck in my rear-view mirror. I thought they were ready to go because it looked like Travis was setting up the truck to pull out into traffic. I assumed that Noah was in the truck with Travis. But Travis had told him to go wait by the doors to the building. I told my mother that I had to go, because Travis was getting ready to leave. I snapped my cell-phone shut and threw it in the empty seat next to me. I put the van in reverse, threw my arm over the passenger side seat and backed out of the parking spot by looking out the back window.

I heard a bump. I thought it sounded like I ran over a box, but I thought to myself I hadn’t gotten out of the van to put a box behind the van. Suddenly I realized what might have happened, quickly, faster than I could ever explain, I threw the van in drive and parked it again in the spot it was in. Terrified, I jumped out of the van and ran to the back of it. I could hear Travis screaming “NO” as he got out of the truck.

Noah was laying on his belly with his head turned to the left side on the hot rocks that made the parking lot. I tried to pick Noah up, but Travis screamed for me not to. Noah was then on his back, unconscious. I ran into the building where I screamed for someone to call 911! I couldn’t speak anything but that. “My son has been hurt, call 911”

I know someone called, I remember seeing them calmly talking on the phone, but I couldn’t calm down. Travis stayed with Noah, shading his head from the sun. I could not compose myself and ended up crumpled on the floor in the building screaming.

It seemed like it took a very long time for the ambulance to come. I couldn’t watch when they did get there. I was far too out of it. I know they took Noah into the ambulance and they were breathing for him and doing what they could until the helicopter got there. Again it seemed to take a long time. I didn’t feel like we had this kind of time to waste waiting…Something had to be done. I tried to go in the ambulance to keep an eye on my boy, but the police officer wouldn’t let me. He told me it would be better for Noah if I was not in there while I was so upset. I went back into the building. I think I passed out. Blood was on the walls. My glasses were gone. A police officer came in and talked to me. I remember telling him that I didn’t see Noah. I didn’t know he was there! He tried to comfort me, but I think I was beyond needing a pat on the back. I heard the helicopter coming. Before it landed in the road, I tried to see Noah again. The officer standing by the ambulance still would not let me get in.

Quickly they moved Noah from the ambulance to the helicopter and away he went to Childrens hospital in St. Louis. I was left feeling panicked with a strong need to GO! I needed to GO to the hospital. But we could not drive because Both Travis and I were too upset. Someone from Travis’s office came to drive us to the hospital. By this time, almost everyone who needed to know what happened knew. The drive to the hospital was painfully long. I just cried.

When we got to the hospital I plowed through the front doors, Travis was behind me with my purse. I didn’t even realize I had gone through a security check point until Travis told me to wait up. I just needed to get to my son! I asked someone where Noah Allen was. They knew who he was and were expecting us. I remember being led to a small waiting room. No one else was in there. It was quiet…just Travis and myself. I sunk to the floor. Travis stood crying. I didn’t want to be in that room. I couldn’t believe what just happened. I don’t know how much time had passed when someone came in and gave us an update, and told us that Noah was in a coma. I was somehow relieved that at least he was sleeping and not feeling any pain. She took us to the trauma room where they were working on Noah. They were getting him ready to have a CT scan done, and bring him into surgery.

My poor boy lay there on that bed, a nurse breathing for him, and other nurses and doctors rushing around fussing over things I couldn’t even begin to understand. I felt better that I was with Noah. I had decided that he was going to be OK. And we are just going to have a long road of recovery. He might never be the same, but at least I would still have my son.

I don’t remember if they took him away, or if we were taken out of the room. A nurse approached me and asked if I was Dawn Allen. Just like in the movies, I started crying. I thought she was going to tell me that Noah had passed away. I didn’t recognize her as one of my friends until she told me who she was. She just happened to be working in the ER that day. It was time to go to another waiting room on another floor because Noah was going into surgery. The next thing I remember is being wheeled out of a different ER room where I was admitted as a patient. Evidently in the elevator on our way up to the next floor I passed out.

When Travis wheeled me out of the room there were a lot of people from the base there to support us. I remember seeing them and feeling comforted by the fact that they were all there. Everyone introduced themselves. I remember that most everyone were Pastors, Fathers, and the such. We were waiting to talk to the doctor. We didn’t wait very long. The doctors came in the room still in their surgical garb.

The only thing I remember is one doctor telling Travis and I was that Noah was a very sick little boy. Everything after that is a blur. Noah was in Children’s ICU, being kept alive with life support.

During the next couple of days family showed up from out of state, and we had a huge amount of support from the base, and the local church we attended. There were always two people at the hospital with us for the whole time we were there…sometimes more. I hardly left Noah’s bed, as his body continually got worse.

Finally on Saturday, July 28th 2007, tests had shown that Noah’s brain was no longer functioning. We had life support turned off. Family and friends gathered around his bed. Noah’s “million dollars” and his Orange Tic-Tacs lay next to him. We all said our goodbye’s.

We had two funerals for Noah. One was for our Air Force family and our Church family in Illinois. Then the next day Noah’s body was flown to Maine for his final funeral at his grave side. This is where I draw a blank. I have almost no memory for about 6 months after we had the life support turned off. I rely on what my family and friends tell me happened. Travis remembers it all. He was/is my rock. Travis had to make the arrangements. I was useless with grief and guilt and the desire to end my life. I do remember feelings more than I remember events. I remember I hated waking up. It meant I was still alive.

To this day – two years and 7 months later, I still struggle. I have terrible memory problems, major depressive episodes, guilt, hallucinations and super anxieties. Sometimes I feel as though I am a terrible burden to my family. Travis is still my foundation…my rock. We share a bond stronger than ever. I am so blessed to have him.

I am told I am my own worst enemy. No charges were ever brought upon me because it clearly was a horrible accident. Guilt and sorrow are overwhelming at times, and there are still times when I wish someone would run over me and I could be done with this world and go to my baby boy in Heaven, Lord willing.

For now, until I can meet with my son again I have sentenced myself to life.

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Note from Pediatric Safety: Our love and support go out to Dawn and her family…and we are grateful to her for sharing her story to help others. Tragedies like this happen way too often. For more information and how you can help, please visit http://www.kidsandcars.org

Cleaning Your Kids Ears: Are Q-Tips Safe?

A friend once told me with great disdain, while watching me wiggle a cotton swab deep in my ear canal with great satisfaction, “I never use Q-tips to clean out my ears.” Apparently a doctor once told him never to put anything smaller than his elbow into his ear, and he took these words as gospel.

Do you ever have the feeling when someone tells you some great truth, a law of the universe that you’ve been breaking for years in ignorance, that it’s remarkable that you have survived this long, having missed out on some basic manual on life along the way? I often wonder if the parents in my practice feel this way as I spout my wisdom on general health issues, and they look chagrined at having broken the rules with their child. The good news is, it’s hard to break your child. ..especially with things like the management of ear wax.

So what are the rules of proper ear hygiene? Though I think that my friend’s doctor was a bit dramatic, I do agree that for the most part, cotton swabs do more harm than good for children’s ears.

Here’s the lowdown.

Ear wax (otherwise known as cerumen) is icky, and sometimes smells quite foul, but it actually serves several important functions. It is created in the outer half of the ear canal, where it serves to lubricate the skin of the ear canal, and prevents flaking and itching. It also has antibacterial properties and protects the skin of the ear from infections like otitis externa, commonly known as swimmer’s ear.

Ear wax almost always comes out of the ear on its own accord. There are small hairs, called cilia, lining the outer half of the ear canal which act as a conveyor belt, pushing the old wax out as the new wax is formed. And so under most circumstances, ears clean themselves.

What is the harm of a little friendly assistance? There are several potential problems caused by good intentions. Often, especially in children’s small ear canals, using a cotton swab actually pushes the wax deeper into the canal, to the far recesses where there are no hairs to help remove it. In children who make a thick, moist wax, their ears often become so clogged with wax that their hearing becomes dulled, which can impact speech development in younger kids and learning and behavior in older kids.

And then there are those over-eager toddlers who wiggle a little too hard and deep and puncture their eardrum. This common injury usually heals very well, but sometimes the tiny bones that are essential for proper hearing are damaged or the membrane fails to heal and an innocent cleaning exercise can have profound impact on the life of a child.

In the end, though I was chagrined myself when I first heard this advice, I too now recommend avoiding q-tips or cotton-tipped swabs for ear hygiene.

Tips for Parents:

• The secret to clean ears is to use a wash cloth only on the outer, visible part of the ear to clean the wax as it naturally comes out. Internal cleaning is not necessary, and may be harmful.
• If you are concerned about your child’s hearing, visit your doctor to see if they have ears plugged with wax.
• Never allow your children to play with cotton swabs or place anything else (carrots included) in their ears.
• Itchy ears are often caused by over-zealous cleaning habits. A few drops of mineral oil can help soothe them while you wait for the ear’s natural lubricant to return.

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