Cotton ear buds: should they not be used at all or just infrequently ?

For what ????: Ear wax is made in the outer half of the canal & will usually fall out over time or can be pried out under direct vision. Cotton swabs will push the wax further into the canals for kids< ~ 9yo and lead to cerumen packed canals that become painful & obscure evaluation of the ear drum. I encourage parents to leave the ears alone & let me remove any wax i need to during exams.