Q: Every time I clean my baby's ears, he coughs. Why? This may not be very important, but it's something I'm wondering about.
A: A cough is the result of a complicated reflex that can start in a number of sites in the upper body, including the ear canal. Most coughs are triggered by receptors (sensing stations) in the lining of the throat or air passages. A receptor sends a message to the cough center in the brain, which sends out the many signals necessary to create a cough. The cough may clear air pathways of mucous or other obstructions. However, there are also receptors with connections to the brain's cough center in many other sites, including the ear canal. You must be stimulating a cough receptor when you clean your baby's ears. The resulting cough has no health significance.
Your question brings up another issue that is important, though. If you are reaching the cough receptor in the ear canal, you may be cleaning your baby's ears too deeply. We don't recommend putting any small object, even a swab, into the ear. Your baby may turn suddenly, causing the swab to poke through the ear drum and to damage the structures important for hearing. Use a washcloth-covered finger to clean your baby's ears. Your finger is large enough so that it can't intrude dangerously far into the canal. The cough should stop, too.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center.