Dirty ears and itchy skin: How to keep your kid clean, a paediatrician explains

How often should you clean your child’s ear? Should you be doing it at home at all?

Why do children get an itch in the perianal (near the anus) area?

How easily can an infection spread from one eye to the other?

Sometimes, parents tend to struggle with some of the most basic questions, like the above, about their kids’ cleanliness and how to deal with it. It could either stem from our own lack of understanding of our bodies, or wrong practices we learned as kids and continue with even as parents.

It is estimated by the US Centre for Diseases Control (CDC) that simply washing hands with soap and water reduces diarrheal disease-associated deaths globally by up to 50%. A large percentage of foodborne disease outbreaks are spread by contaminated hands. From pinworms which lead to an itch in the perianal area to decaying tooth, simple methods of maintaining a clean body can keep several hygiene-related diseases away. But keeping a child’s body clean is not easy – they are not easy customers. And there are also several myths and misunderstandings about our body which lead to bad practices.

To guide us through our confusion and give us some simple pointers on this is Dr Radha Rajagopalan, Senior Consultant in Paediatrics, Apollo Hospital, who has helped thousands of children be safe and healthy throughout her 35 years of medical experience.

First, the golden rule to keep your kids clean – they learn from what you do, so you have to do it right first. “Children will do what their parents do, so first they have to make sure they have the right habits,” Dr Radha says. And here are some of those right habits – from the obvious to the unknown.

Rubbing in the infection

Eye infections in children are not unusual, and the most common habit which worsens eye infections is rubbing the eye. “Eyes might be watery, but you have to teach the child that if there is irritation in the eye, you should just wash it off with cold water. Do not rub the eye much,” Dr Radha says, “There are some non-irritant drugs which can be used if required.”

The most common infection is conjunctivitis. Viral conjunctivitis is also seen among children and can be a lot more contagious.

Conjunctivitis spreads through contact, and sharing towels and such objects. We should also ensure that if one eye is not infected, it should be protected from the other infected eye. An important point to keep in mind while applying eye-drops, which are invariably prescribed by doctors, is that the same bottle of eye-drops should not be used for both eyes. “We have to use different bottles for different eyes in case one is infected and the other is not,” the doctor says.

Dirt and ear wax

The ear canal is a small passage which connects the opening of our ear to the ear drum, a sensitive membrane which needs protection. The canal has fine cilia, fine hair like structures, which only move outwards. So, any dust coming towards the ear is automatically pushed out. Our body has its own mechanism to keep the inner ear clean. And yet, it is very common among adults to try and clean the canal all the way to the ear drum. This is not necessary, and can be dangerous. “Our tendency is to put our finger, or the back end of the pen, or anything else to ‘clean’ the ear is not at all good idea,” Dr Radha explains, “You must only clean the outer part of the ear.”

The same goes with our kids too. “If you want to clear the outer part of their ear, you can use a wet ear bud, and you must immediately dry it up. You should not push anything inside the year through the canal – that is the most important thing,” the doctor warns.

Further, the brown-yellow substance we often see as ‘dirt’ inside the ear is ear wax. The secretion of the ear wax is for the protection of the ear, so it must remain in the ear in small amounts.

“However, some children have too much secretion, it is more than what is required. Occasionally the quantity may be so much that it can block the ear, that the child cannot even hear, so cleaning is required. This cleaning has to be done by a specialist using a special probe, and not at home by parents,” the doctor says.

Worms in the tummy, itchy behind

Contaminated food or consuming food with dirty hands leads to worms in a kid’s intestines. While cases of tapeworm, which can get into the body due to contaminated vegetables or meat, have considerably reduced over the years, pinworm infections continue to be one of the most common forms of worm infections in the world.

Do you remember scratching your perianal area as a kid? Don’t you still see a lot of kids doing it around you? That’s most likely due to pinworm infection.

Pinworms can sometimes get into our intestines through contaminated food, or by us just accidently swallowing or breathing pinworm eggs around us. They are most likely to occur in children between the ages of 5 and 10. Once infected and while the children are asleep, the pinworms move from the intestines to the anus and deposit their eggs on the skin just outside the anus, the perianal area. And that’s what causes ‘itchy bums’. It may not lead to any serious illnesses, but in rare cases it can lead to weight loss or urinary tract infections.

“Kids tend to scratch the itchy patch of the skin near the anus, thereby transferring the eggs to their fingers. If they don’t wash their hands after, the eggs are transferred to other kids around them,” Dr Radha says.

The easiest way to prevent this is by having uncontaminated food, cleaning hands before eating and washing bed linens and clothes regularly. “Deworming drugs can be taken every six months or so,” Dr Radha adds.

Keeping the private parts clean

Teaching our kids to keep their private parts clean at an early age ensures that they develop the habit for life. Among boys, the foreskin of the penis can sometimes be longer and adhesive to the underlying tissues, which makes the foreskin too tight to be pulled back over the head of the penis. This condition is called phimosis. While this is normal in babies and toddlers, in older kids it could lead to hygiene issues due to residual urine, which can cause infections.

"Initially, parents have to be taught how to retract the skin and clean it, and as the child should also learn as he grows,” Dr Radha says.

Among girl children, there could be some secretions in the cervical area due to the presence of mucous glands, and the child must be taught to clean the area and keep it hygienic.

Brush twice, avoid feeding bottles

“Dental hygiene is very, very important,” Dr Radha emphasises, “and there are two things I want to point out – brushing teeth twice a day, and avoiding feeding bottles.”

Despite “brush your teeth twice” being a common refrain, neither all children nor all adults do it. “They should be taught how to brush the teeth, and very little paste should be used. They just need a little bit of fluoride, but they should not swallow too much,” she says, “They should also not eat anything after brushing in the night.”

In younger children, who are still fed milk, feeding bottles are to be avoided.

“We have discouraged the use of bottles anyway, but particularly beyond 1.5 years. When the child goes to sleep with the feeding bottle in their mouth, the milk is constantly on the front four upper teeth, so the bacteria are on it and dental caries set in. We often see that children who go to bed with feeding bottle lose their front four teeth very soon,” she points out.

This article was created by TNM Marquee in association with Apollo Hospitals.