What to Expect the Toddler Years (167 page)
Read What to Expect the Toddler Years Online
Authors: Heidi Murkoff
PIERCED EARS
For some, piercing a baby daughter’s ears is a cultural or family tradition. For others, it’s a way of making it perfectly clear to the world—before there’s enough hair to clip into a barrette—that their child is a daughter and not a son. Whatever the motivation, it’s popular to pierce a little girl’s ears when she’s barely out of the cradle. But while the practice may fare well in popular opinion, it doesn’t fly as well in the medical community.
One reason is concern that an infection at the site of the puncture could get out of hand in a young child before the parent is aware of it. Infections are common in the first few months after piercing, and most young children are unable to report that an ear is itchy, sore, or tender (though some will pull at their ears or cry when earrings are inserted). As a result, the early signs of infection can easily go unnoticed.
The earrings themselves can also pose a problem; A young child could take them out to play with (or they could fall off in her hands), then stick herself with or swallow one or more of the parts. So most doctors recommend that the procedure be put off until a child is at least four, and preferably closer to eight years old.
If you do opt to get your toddler’s ears pierced, be sure the procedure is performed under sterile conditions, by someone who is qualified (your daughter’s doctor may be able to pierce them in the office). After the procedure, clean the lobes daily by dabbing them with a cotton ball saturated with rubbing alcohol or with hydrogen peroxide (which may be less drying) and rotate the earrings each morning (to keep them from sticking to the holes). If you notice any signs of infection (redness, swelling, pus or crusting, tenderness, or bleeding) call your child’s doctor. And do not allow your child to wear dangling earrings: They can be pulled by other children (or by the child herself), possibly tearing the ear lobe. If your child starts trying to remove her earrings or play with them, stop inserting the earrings and let the holes close up. You can always have the ears pierced again when your child is a little older and more responsible.
Routine Care.
To keep your toddler’s ears in the best condition possible:
Be alert to signs of hearing loss (see page 488) and report any such signs to your child’s doctor. A parent’s observations are extremely important, and can often detect an as yet undiagnosed hearing problem. But medical exams are essential, too. Research is being done to develop a hearing screening test for newborns, but such a test is not yet available. A formal hearing test is not usually performed until age four, unless a hearing problem is suspected earlier, but at each checkup your child’s doctor will note (and ask you) how your child responds to sound. If a hearing deficit is confirmed, be sure it is treated promptly.
At bath time, clean the
outside
crevices of your toddler’s ears with a damp, soft cloth or cotton swab, and check ears carefully for foreign objects (toddlers have been known to stick items into their ears; see page 668). Do not probe the inside of the ear with a finger, a cotton swab, or (as the old saying goes) anything smaller than your elbow. Such probing could puncture the eardrum and/or push wax further into the ear.
If you notice a wax build-up (a waxy, yellowish material can be seen in the ear canal), check with the doctor, who will either remove it or recommend drops to
help you remove it at home. Don’t, however, try the home removal without explicit instructions and never try to use a cotton swab to remove it.
SIGNS OF A HEARING PROBLEM
Many toddlers may seem not to hear at least half of what their parents say, but in most cases, it’s just a matter of selective listening or inattention. The child who truly doesn’t hear well usually exhibits one or more of the following signs of hearing loss (although some of these may also be exhibited by a child with normal hearing):
An apparent inability to hear what is said by others, all or part of the time.
Difficulty hearing when the sound comes from the side or the rear and when not facing the speaker directly; many hearing impaired children instinctively learn some rudimentary lip reading and so understand more when they can see the speaker’s lips.
A
consistent
lack of response when spoken to quietly.
A
consistent
inattentiveness to any verbal or other auditory cues.
An apparent inability to follow any directions (more so than is age-appropriate).
A limited vocabulary—both receptive (the words that are understood) and spoken—compared to peers (see the age-appropriate “What Your Toddler Should Be Doing”). The child may be mislabeled “slow” because of this developmental delay.
A lack of response to music—the child doesn’t clap, sing along, or move rhythmically to music, or enjoy or recognize frequently played tunes, even those designed especially for children.
Lack of response to the nuances of language (can’t seem to tell from the tone of your voice whether you are angry, sad, joking, and so on).
Lack of response to environmental sounds (the ring of the telephone or doorbell, the buzzer on a timer, the song of a bird, the howling of the wind).
Difficulty distinguishing between similar-sounding words (door and store, Sue and shoe, fake and shake), particularly when the words begin with
f
,
sh
, or
s
.
A tendency to give inappropriate answers to questions (“Do you want to play with a puzzle?” “No, I not hungry.”)
A tendency to favor one ear when turning toward a sound.
An inability to hear very low sounds, such as the ticking of a watch.