If a small child has an ear knot, the first thing to look at is whether the child is cooperative with the treatment and also the size of the knot. If the child is cooperative, you can go to the hospital to see the size of the knot. If it is small, you can directly remove the knot with gun tweezers or a cerumen hook. If the knot is large, you can use sodium bicarbonate ear drops to soften and soak the knot, and then remove the knot with suction or rinsing. If the child is unable to cooperate, there is usually no need to treat the knot in the ear, regardless of its size; however, care must be taken to avoid getting water in the ear. Once water gets in, the larger ear knots will swell up and can be very hard to get rid of. If the knots are small, they can drain out on their own when swallowing and do not require special treatment. If the knot is large and the child cannot cooperate, the knot should be removed when the child is old enough to cooperate.