Foreign object in a child's ear: 3 ways to safely remove foreign objects from a child's ear

Foreign objects in the ear are quite common in young children, especially between 2-6 years old, when children are curious to explore everything around them. According to statistics from ENT emergency facilities, foreign objects in the ear are one of the common reasons children need emergency care. Even a bean, a button, a toy piece, or an insect stuck in the ear can cause pain, tinnitus, hearing loss, or damage the ear canal if handled improperly.

If parents discover a foreign object in their child's ear, they often worry and try to remove it immediately with readily available items. However, improper handling can cause the foreign object to lodge deeper, rupture the eardrum, or cause infection. In this article, Tiptory will guide you on how to identify and safely handle foreign objects in the ear, when to provide first aid at home, and when to take your child to a medical facility immediately to minimize complications.

Method 1: Tweezers to remove foreign objects from a child's ear

Step 1: Check for foreign objects in the child's ear

Observe whether the foreign object in the ear is visible

• Take the child to a well-lit area or use a flashlight to clearly observe inside the ear.
• Look from multiple angles to determine if the foreign object in the ear is shallow or deep.
• If the foreign object is clearly visible to the naked eye and is near the opening of the ear canal, you may consider removing it with tweezers or by tilting the head to use gravity to dislodge it.
• Do not attempt to remove a foreign object if you cannot see it clearly or are unsure of its position.

Do not insert anything deep into the ear

• Never use cotton swabs, matchsticks, hairpins, or sharp objects to try to push or hook a foreign object in the ear.
• These actions can cause the foreign object to go deeper into the ear canal, scratch the ear canal skin, damage the eardrum, or increase the risk of infection.
• Improper handling can also make the process of removing the foreign object from the ear at a medical facility more difficult.

Take the child to a medical facility when necessary

• Take the child to a doctor immediately if you cannot see the foreign object or suspect it is lodged deep in the ear.
• Emergency care or a visit to an ENT specialist is required immediately if the foreign object in the ear is a button battery, a sharp object, or has sharp edges, as these foreign objects can cause serious damage in a short time.
• The doctor will use specialized tools to safely remove the foreign object from the ear, reducing the risk of damage to the ear canal and eardrum.

Step 2: Use clean tweezers to remove the foreign object

Prepare clean tweezers before removing a foreign object from the ear

• Use clean, blunt-tipped tweezers to reduce the risk of scratching the ear canal or damaging the eardrum.
• Before use, wash the tweezers with clean, warm water to remove dust and bacteria from the surface.
• If available, you can sterilize the tweezers with medical alcohol or hydrogen peroxide solution and let them air dry before attempting to remove the foreign object from the ear.
• Do not use rusted, sharp-tipped, or dirty tweezers as this can increase the risk of infection and cause ear damage.
• Only use tweezers when the foreign object in the ear is near the ear canal opening, clearly visible, and easy to grasp. If the foreign object is deep or the child moves a lot, stop and take the child to a medical facility for safe removal.

Step 3: Gently remove the foreign object

Carefully remove the foreign object from the ear

• Insert the tweezers gently into the ear and only perform the operation when you can clearly see the foreign object in the ear.
• Grasp the protruding part or an easily grippable surface of the foreign object to hold it more firmly, then slowly pull it out in the direction of the ear canal.
• Perform the action slowly, avoiding twisting, jerking, or pulling forcefully, as this can cause the foreign object in the ear to lodge deeper or damage the ear canal.

Keep the child calm throughout the process

• Reassure the child so they don't panic or move suddenly while the foreign object is being removed.
• You can give the child a toy, let them watch cartoons, or talk to them to help distract them and keep them still.
• If the child cries, struggles, or does not cooperate, stop trying to remove the foreign object from the ear to avoid causing injury.

Stop immediately if the foreign object cannot be removed

• If you have grasped it but the foreign object does not move or cannot be removed easily, do not try to pull it forcefully.
• Attempting to remove it with force can cause the foreign object to become more tightly lodged or tear the ear canal skin, potentially even affecting the eardrum.
• In this case, take the child to a medical facility or ENT specialist to have the foreign object in the ear removed with specialized tools.

Go to the hospital if the foreign object goes deeper

• If, during the procedure, the foreign object accidentally gets pushed deeper into the ear, stop all attempts to remove it immediately.
• Do not continue to use tweezers or any other tools to try to remove it, as the risk of injury will increase.
• Take the child to a medical facility as soon as possible so that a doctor can safely handle it and minimize complications to the ear.

Step 4: Use gravity to remove the foreign object

Try to let the foreign object in the ear fall out naturally with gravity

• This method is only suitable when the foreign object in the ear is near the ear canal opening and not lodged too deeply.
• Have the child tilt their head to one side so that the ear with the foreign object in the ear faces the ground.
• Maintain this position for a few seconds, then gently shake or tap the head very lightly to help the foreign object fall out on its own.
• If the foreign object falls out, recheck the ear for any remaining fragments and monitor whether the child experiences pain, bleeding, or hearing loss.

Do not continue if the foreign object does not fall out

• If the foreign object in the ear still does not fall out after a few gentle attempts, stop the procedure.
• Do not shake the head vigorously or use excessive force as this can cause the foreign object to lodge deeper or damage the ear canal.
• Take the child to a medical facility or ENT specialist to have the foreign object in the ear removed with appropriate tools, ensuring safety and minimizing complications.

Method 2: Oil or water drops to remove foreign objects from the ear

Step 1: Properly rinse the ear with warm water

Prepare tools before rinsing foreign objects from the ear

• If the foreign object in the ear is suitable for rinsing, prepare a specialized bulb syringe and a bowl of warm water.
• This tool helps introduce water into the ear canal with gentle pressure, reducing the risk of damage compared to homemade tools.
• You can buy a bulb syringe at a pharmacy or reputable medical equipment stores.

Only apply when safe

• Only use water to remove foreign objects from the ear if the foreign object is not a button battery, a sharp object, or an object that can expand when it comes into contact with water.
• Do not perform if you suspect the child has ear damage or are unsure of the type of foreign object in the ear.
• If there are any abnormal signs, prioritize taking the child to a medical facility for examination.

Do not use water or oil in the following cases

• Do not instill water or oil if the child has severe ear pain, ear bleeding, or discharge from the ear. These could be signs of serious conditions such as a ruptured or perforated eardrum, which require evaluation and treatment by a doctor.
• If the child has ear tubes (tympanostomy tubes), absolutely do not use water or oil to remove a foreign object from the ear, as this can increase the risk of infection and complications.
• In these cases, if the foreign object cannot be removed with tweezers when it is right at the opening of the ear canal and clearly visible, take the child to a medical facility or ENT specialist for safe removal.

Step 2: Rinse the foreign object out of the ear

Irrigate with water to rinse the foreign object from the ear

• Draw warm water into the prepared bulb syringe.
• Have the child lie down or rest their head on your lap, tilting their head so that the ear with the foreign object in the ear faces upwards.
• Place the tip of the bulb syringe at the opening of the ear canal, do not insert it deeply, then gently squeeze to let water flow into the ear.
• After irrigating, tilt the child's head in the opposite direction so that the ear with the foreign object faces downwards, allowing the water and foreign object to flow out by gravity.

Proceed gently and patiently

• It may be necessary to rinse the ear several times if the foreign object does not dislodge immediately.
• Each time you squirt water, use moderate force, avoiding strong pressure on the eardrum.
• Observe whether the foreign object has completely come out before continuing.

Stop if ineffective

• If the foreign object in the ear still does not come out after multiple rinses, stop the procedure.
• Do not continue to squirt water continuously or use more force as this can cause the foreign object to lodge deeper or damage the ear canal.
• Take the child to a medical facility or ENT specialist to have the foreign object in the ear removed with specialized tools, ensuring safety and minimizing complications.

Step 3: Use oil to remove insects

Only use oil when the foreign object is an insect

• If the foreign object in the ear is a live insect, you can use baby oil or mineral oil to help remove the insect.
• Warm the oil to near body temperature; it should be only slightly warm, and absolutely do not use oil that is too hot to avoid burning the ear canal.
• When instilled into the ear, the oil will help immobilize or float the insect, making it easier and safer to remove the foreign object from the ear.

Do not use oil for other types of foreign objects

• Do not use oil to remove foreign objects such as beans, buttons, toy pieces, button batteries, or other foreign objects from the ear.
• Some foreign bodies may swell or become more difficult to remove when exposed to liquids, increasing the risk of complications.

Do not apply if ear injury is suspected

• Do not instill oil if the child has severe ear pain, ear bleeding, unusual discharge, or suspected perforated eardrum.
• Children with ear ventilation tubes should also not use this method, as oil can enter the middle ear and increase the risk of infection.
• In the above cases, take the child to a medical facility or an ENT specialist for safe removal of the foreign body in the ear.

Step 4: Instill oil to remove the insect

Proper oil instillation when an insect is stuck in the ear

• Tilt the child's head so that the ear with the foreign body in it is facing upwards.
• Slowly instill about 1 tablespoon of lukewarm baby oil or mineral oil into the ear. Use only slightly warm oil, not hot oil.
• Gently pull the earlobe downwards and backwards to allow the oil to flow deeply into the ear canal, helping to cover the entire insect.

Wait for the insect to float out

• After instilling oil, maintain the position for a few minutes to allow the oil to take effect.
• The oil will cause the insect to stop moving and float up, making the foreign body in the ear easier to dislodge.
• Then, tilt the child's head to the opposite side to allow the oil and insect to drain out naturally.

Follow-up after foreign body removal

• Check if the insect has completely come out. If any part remains, do not attempt to remove it yourself.
• If the insect does not come out, the child still has ear pain, tinnitus, hearing loss, or bleeding after the procedure, take the child to a medical facility or an ENT specialist for safe treatment.

Method 3: When should you urgently take your child to the doctor?

Note 1: Have a doctor examine the child's ear

The doctor will examine to identify the foreign body in the ear

• When taking the child to a medical facility, the doctor will use specialized instruments to observe the foreign body in the ear, identify its position, size, and type.
• The examination helps to assess whether the foreign object in the ear has caused damage to the ear canal or eardrum, thereby selecting the most appropriate and safest method for foreign body removal.

Provide full information about the child's symptoms

• Please inform the doctor when the foreign body was discovered and its type if you know.
• Let the doctor know if the child has symptoms such as:
  • Ear pain or discomfort.
  • Bleeding or discharge from the ear.
  • Tinnitus or hearing loss.
  • Crying a lot, fussiness, or constantly touching the ear.

X-rays may be needed in some cases

• If the foreign body in the ear is too deep, difficult to observe, or complications are suspected, the doctor may order an X-ray or other imaging tests.
• The test results will help determine the exact location of the foreign body and select a safe removal method, minimizing the risk of ear damage.

Note 2: Discuss foreign body removal methods

The doctor will choose the appropriate foreign body removal method

• After identifying the type and location of the foreign body in the ear, the doctor will choose the safest treatment method.
• Depending on the case, the doctor may:
  • Irrigate the ear canal with water if the foreign body is suitable for this method.
  • Use a medical suction device to remove the foreign object in the ear.
  • Use forceps or specialized instruments to extract the foreign body.
  • Use a magnet if the foreign body is magnetic metal.

Check the ear after foreign body removal

• After removing the foreign body from the ear, the doctor will re-examine the entire ear canal and eardrum to detect damage such as abrasions, bleeding, or eardrum perforation.
• Post-procedure assessment helps to detect complications early and ensure the ear has been completely cleaned.

Treatment if there is a risk of infection

• If the ear canal is irritated or damaged, the doctor may prescribe antibiotic ear drops or appropriate medication to prevent and treat infection.
• Caregivers need to use medication at the correct dosage and duration as instructed by the doctor, and monitor for signs such as increased pain, discharge, or fever to bring the child back for follow-up if necessary.

Note 3: Re-examination if the ear has not recovered

Monitor the ear's condition after foreign body removal

• After the foreign body in the ear has been removed, continue to monitor the child's recovery over the next few days.
• If the child still complains of ear pain, tinnitus, hearing loss, or prolonged discomfort, do not be complacent as this could be a sign that the ear has not fully recovered.
• Observe for other symptoms such as discharge, bleeding, redness, swelling, or fever to detect infection risk early.

Take the child for re-examination if there are abnormal signs

• If the child's hearing is reduced after the foreign object in the ear is removed or symptoms do not improve, take the child back to a medical facility or an ENT specialist.
• The doctor may order a more in-depth examination or additional necessary tests to assess the condition of the ear canal, eardrum, and other internal ear structures.
• Timely re-examination helps to detect any remaining damage early, provide proper treatment, and reduce the risk of long-term effects on the child's hearing.

References

1. American Academy of Pediatrics. HealthyChildren.org. Ear Foreign Bodies in Children. American Academy of Pediatrics.
2. American Academy of Otolaryngology–Head and Neck Surgery. Ear Foreign Bodies: Evaluation and Management. American Academy of Otolaryngology–Head and Neck Surgery.
3. Merck Manual Professional Edition. External Ear Foreign Bodies. Merck & Co., Inc.
4. MSD Manual Consumer Version. Foreign Objects in the Ear. MSD Manuals.
5. Nelson, W. E., Kliegman, R. M., St. Geme, J. W., & Blum, N. J. (Eds.). Nelson Textbook of Pediatrics. Elsevier.
6. Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., et al. Clinical Practice Guideline: Acute Otitis Externa. Otolaryngology–Head and Neck Surgery.
7. Tintinalli, J. E., Ma, O. J., Yealy, D. M., et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. McGraw-Hill Education.
8. World Health Organization. Primary Ear and Hearing Care Training Resource. World Health Organization.
9. National Health Service (NHS). Foreign Object in the Ear. NHS England.
10. MedlinePlus. Foreign Objects in the Ear. U.S. National Library of Medicine.
    

Content editor: Lesley Collins Tran.

Information consulted and verified by expert: Isabella Moore.