My 6 month old daughter seems to have a lot of ear wax, more than my son did. Is this something to be concerned about or just keep picking it out as it comes? Kinda gross, I know.

Excessive ear wax production is not typically a problem. The body makes the wax (cerumen) to offer protection and a self-cleaning process for the ear canal. If there is more than needed, it just overflows out of the canal and causes the sticky yellow-brown mess that your daughter is experiencing. The most likely potential problem that could arise from higher wax production would be an accumulation that forms an impaction, or hard plug in the canal, which could cause pain or hearing difficulties until removed. This is especially likely when a cotton swab is used in an attempt to clean the ears, as it pushes wax further into the canal more than it can bring it out. The cotton tip can actually get stuck in a person’s canal and need to be removed in the office, and it can be a source of infection if that happens. Most of the parents who mention wax concerns to me in clinic are reassured when they hear that the eardrums are easily visible and the ear is functioning exactly as it should. If you have concerns, please voice them to your daughter’s pediatrician so that they can be sure to check her ears and answer any more questions you might have.

Are vitamins necessary for kids?

Vitamins and supplements, along with anything else that can have an impact on a child’s health, should be looked at as a medication. Most healthy children with a balanced diet do not need vitamin supplementation, though certain age groups (infants under 1 year old, girls going through puberty) are much more likely to need them. The daily requirement of vitamin D, for instance, is 400 IU for infants and 600 IU in older children. Unfortunately, vitamin D and iron are not filtered well from the mother into her breast milk, so no matter what the mother’s levels of these nutrients are, exclusively breastfed babies need supplementation to attain levels needed for optimal growth and development. The same holds true for formula-fed babies taking less than 32 ounces per day of iron-fortified formula. Most children over 1 year old, even if exclusively receiving breast milk for fluid intake, should be able to meet the recommended levels of nutrients within a balanced diet. The iron requirements increase for pubertal girls once they begin menstruating, so emphasizing iron-rich foods during adolescence is important. Despite increased needs, most adolescents still will not require supplementation if they are eating a well-balanced diet.

Mega-doses of vitamins can cause unnecessary side effects or even be dangerous.  Even the popular high doses of vitamin C to ward off illness can cause headaches, cramping, and diarrhea. Fat-soluble vitamins (A, D, E, and K) are especially prone to causing side effects or serious problems if taken in mega-doses.

Please discuss with your child’s doctor if you feel your child might benefit from supplemental vitamins due to picky eating, special dietary needs (vegetarian, no dairy, use of cow’s milk alternatives, allergies), or symptoms that you would like to address—ideally before starting the supplement.

It is important to remember that vitamins and supplements can have significant benefits and side effects, so always tell your child’s doctor everything that he or she is taking, not just prescription medication.

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