Tips to examine the eardrum of the squirming, angry child

Tips to examine the eardrum of the squirming, angry child

Let me tell you a secret. Examining eardrums in a squirming, angry child is really difficult—if not impossible. If the doc in your screaming, struggling child’s ear for a half-second, it’s unlikely that anything useful was seen.

Sometimes, it is just impossible to get a decent exam. But there are ways that parents (and doctors!) can help at least increase the chance that we can get a good look.

First, work together to help keep the child relaxed. No one should rush, and no one should immediately start holding anyone down. The minimum hold is best—more of a reassuring hug than a hold, really. And even before that, I like to give toddlers a chance to look in my ears, and mom’s ears, and their teddy bears ears. Look look look, and practice first. Parents can even buy a cheap otoscope to practice with at home, on themselves and kids and plastic dinosaurs. If it has ears (of even if it doesn’t), Junior should practice looking in them and telling stories about what they see.

About stories: I used to see monkeys in ears, and over the years the monkey stories have gotten more and more elaborate. Now the monkeys are opening presents and eating lunch and watching movies. I’ve found if I tell kids what the monkeys are up to, in a quiet but excited voice, they sometimes hold very still to see what will happen next.

Don’t even think about saying the word “hurt.” That word ought to be banned from pediatrician’s offices forever. You might say “This won’t hurt,” but I guarantee all the child hears is “HURT PAIN HURT HURT PAIN”.  Another thing not to say: “He hates having his ears examined.” I already knew that. Thanks for reminding us.

Children of every age pick up on the mood of the parent and doctor. Calm, confident, secure—that’s the way to go. Don’t fret or apologize or wave toys at the child. Even if you think things won’t go well or aren’t going well, pretend that they are.

About earwax: It’s natural, it’s normal, everyone has some, and some kids have more than others. Parents are not at fault if Junior has earwax that’s blocking the view. To help keep wax at bay, wash ears with a soapy washcloth, and be sure to rinse the ear canals gently afterwards. Don’t use Q-tips or swabs—those just pack the wax tighter and push it farther in.

Some kids find ear-looks (and doctor visits) more worrisome than others, just like some parents and some doctors are more worried or rushed than others. Some visits don’t go well, but there are always ways that we can all try to make the next visit better. I, personally, find it very satisfying to get a good, tear-free ear look in a child—bonus points for a smile!

Roy Benaroch is a pediatrician who blogs at The Pediatric Insider. He is also the author of Solving Health and Behavioral Problems from Birth through Preschool: A Parent’s Guide and A Guide to Getting the Best Health Care for Your Child.

Image credit: Shutterstock.com

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  • LBENT

    Kudos on this post! As a pediatric ENT, I cannot agree more. It’s always best to stabilize the head against Mom’s shoulder for younger kids who still sit on parent’s lap, or a back rest for older kids.

    I would add one more thing. If you do see wax, don’t try to remove it if you don’t have the skill or the equipment. You (and others) will not get near that head again.
    I like the monkey stories. Do you mind if I use them, too? :-)