Earwax, also known as cerumen, is usually a friend, not a foe. It is formed by secretions from the sebaceous glands lining the ear canal, plus a collection of the cells that slough off from the lining of the ear canal. Earwax has protective properties. It provides a barrier protecting the sensitive lining of the ear canal against water. It also contains infection-fighting elements that protect against bacterial and fungal infections. Yet, earwax can plug the canal, causing irritation and sometimes interfering with hearing. Earwax may also need to be removed if your doctor suspects an ear infection and needs a clear view of the eardrum.

The best way to handle earwax is to not handle it at all. Leave it alone. Do not go mining for wax in your child's ear. Do not ever stick a Q-tip inside the ear canal. Many eardrums have been ruptured either from an overzealous parent cleaning their child's ears, or a curious child sticking a Q-tip into their own ear "just like mom does".

Cleaning the ears. If you wish to, you may carefully use your finger or a Q-tip to remove any visible wax from the outside of the ear canal. Trying to use a Q-tip to clean wax out of the inside of the canal may achieve some results, but you will end up pushing even more wax deeper into the ear. This can lead to a totally blocked ear canal.

1. Trying to check the ears for infection. Wax can prevent your doctor from being able to see down to the eardrums to look for an ear infection. Your doctor may be able to remove enough wax to see around it.

2. Total blockage of the ear canal can decrease hearing. Wax can build up enough to completely block the ear canal. This feeling can be very uncomfortable for a person. It can also muffle the hearing, which is okay for a brief time, but not good if left alone. Children and adults need to hear optimally to function in life. If an infant or toddler goes for many months with blocked ears, this can interfere with speech development.

1. Your doctor can scoop out the wax using a light and a tiny earwax scoop. This does hurt if the wax is deep, because the ear canal is very sensitive down deep. An ENT (ear, nose, and throat) doctor can also scoop out the wax using an ear microscope, an earwax scoop, and a small suction device.

2. You can flush out your child's ears yourself. You can use hydrogen peroxide mixed half and half with water, or you can buy an over-the- counter solution called Debrox (use according to directions). The store-bought solutions are oilier, and sometimes won't flow down as deeply into the ear to get the deep wax. Follow these steps:

• Lay your child on his side with the plugged ear up. Let him watch TV or get ready to read a book to keep him company.
• Warm the drops slightly by holding the bottle in your first for a few minutes.
• Place the drops into the ear until you see the drops fill up the ear canal. It usually takes 5 to 10 drops. Put them in one at a time to let each one flow down deep. This will soften the wax.
• This may be uncomfortable for your child. Be ready for some protesting. Bribe your child with candy if you must (you didn't hear that from Dr. Sears!).
• Allow the drops to stay in the ear for 5 minutes. Less is ok for uncooperative children.
• Let the drops flow out.
• Repeat this once a day for 3 to 5 days.
• After the last day, sit your child in a bath or lean him over a sink and flush out the ear using lukewarm water (too hot or cold will be very uncomfortable). You can use a rubber bulb syringe to flush the ear. Squeeze as hard as you can. This type of syringe cannot create too much pressure that would hurt the ear. You can also use a water pick on low setting if careful.
• You should see chunks of wax flow out. If you don't, you may need to keep using the drops for a few more days. If your doctor tells you that your child's ear is completely blocked with wax, and you decide to flush at home, it's useful to have your doctor check it again a week after the flush to make sure this won't be a chronic problem.

For recurrent blockage problems, you can try putting the drops into the ears once or twice a month and flushing to prevent any major build up. This is only necessary for people who have a recurrent total blockage problem.