When should I have my baby’s ears pierced, and who should do it?

The Pediatric Insider

© 2014 Roy Benaroch, MD

I was surprised this past week to learn that a new baby,  just a few weeks old, was transferring out of my practice. Mom was happy with me and my staff, but apparently she was surprised to learn that we didn’t pierce little newborn ears. So she was transferring care to a different pediatrician who would do that procedure.

If Piercing Pagoda starts offering breastfeeding advice and jaundice care, my business is doomed. But I don’t think they will. Because they’re not actually pediatricians. And, in fact, I’m not an ear piercer, or whatever people who pierce ears are called.

I don’t do ear piercings at my office. I’ve been offered the kits for sale many times, and I’ve seen how high the markup is. But really, my training is more-or-less limited to pediatrics. I am not a trained ear-piercer, and even if I read the instructions with the kit and practiced on a stuffed animal or something, there’s no way I would ever get particularly good at doing it. I get asked about this maybe a few times a year. Dusting off a kit and trying to pierce ears once every few months is not the way to get good at doing it well.

My advice? Go to the mall or to some place where they pierce dozens or hundreds of ears a day. Find someone who’s been doing this for years, who routinely pierces little baby earlobes and who yawns at the excitement of doing it for the hundredth or thousandth time. Choose a pretty little stud, made of gold, and go for it. Jewelers and mall earring stores use the same single-use, sterile kids that are used in doctors offices. You’ll get a better selection of earrings and a much more experienced piercer at Claire’s than at your doctor’s office.

When is a good time to pierce a baby’s ears, or should families wait until the kids are older? It’s really up to you. In many cultures little girls have their ears pierced shortly after birth; in other places families wait. I don’t think it matters very much. There’s very little risk with this procedure, and I couldn’t find medical reports hinting at any increased risk when piercing is done on young babies. In fact, just about the only study I could find showed an increased risk of keloids when piercing takes place after age 11. Whenever you decide, make sure to follow the instructions to keep the ears clean, using the sanitizing solution afterwards. Personally, I have never seen earring issues in babies, but I’ve seen a whole lot of infected or neglected earrings in teenagers. If safety is your worry, it’s probably better to get a baby’s ears pierced when parents know they’ll take care of it rather than trusting a teenager.

I’ve been asked: should we wait until after vaccines? There’s really no reason to—as much as I support vaccination, I’ll tell you that none of them are likely to prevent any sort of problem after ear piercings. Yes, one of them does prevent tetanus (which is caused by an infected, dirty wound), but ear piercings are done in the developed world with a sterile, one-use pointed post. Tetanus and other vaccine-preventable illnesses shouldn’t be a concern with ear piercing.

It turns out that the AAP’s stance on this is at odds with mine. Though I couldn’t find an “official” AAP policy on earrings, this post on one of their affiliated sites says that piercing should be delayed until the child can take care of her ears herself, and that a doctor or nurse or “experienced technician” should do the deed. I don’t think this makes much sense, and it’s certainly not supported by any evidence.

My recommendations:

  • Get your daughter pierced when you think the time is right, or not at all. You can wait until she can decide for herself, or if you’d prefer you can do it earlier. This isn’t a huge deal either way.
  • Have someone do it who’s done tons of these and is very comfortable with your child’s age.
  • Buy good, gold earrings.
  • Follow the instructions for after-care.
  • If they get red or gooey, go see your pediatrician.
  • Mom, if you’re piercing a little baby at a jeweler, pick up something nice for yourself too. You deserve it.
  • And: don’t pick a pediatrician based on his or her cosmetology skills.
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4 Comments on “When should I have my baby’s ears pierced, and who should do it?”

  1. I wondered about where to go when my little girl gets interested in pierced ears. Thanks!


  2. Lissette Woodward Says:

    I’m surprised the mom left your practice for this reason. We knew we wanted a doctor to do ours and that you really didn’t do ear piercings. And we knew we definitely were not taking our baby girl to the mall. But after an online search we found a pediatrician who does hundreds of these. We went once, paid $50 for the piercing and procedure and that was it. And you’re still our pediatrician.


  3. Kerry Says:

    My mother wouldn’t allow me to get my ears pierced until I was ten because she thought it looked tacky on children younger than that. They gave me a solution I was supposed to apply for two weeks but I think I used it four times tops and they got a little infected so I agree with your recommendation not to trust the child to take care of them herself!

    How common is it for earrings to get ripped out? Since you didn’t mention that possibility as a consideration I’m hoping not very..


  4. Dr. Roy Says:

    Kerry, I don’t think earrings get ripped out very often– I’ve never actually seen that happen. If they’re pulled, usually the back just pops out.

    What I have seen (like you said) are earrings getting infected, especially shortly after ears are pierced, and especially when not taken care of. I’ve also seen a few earrings that have “grown into” the earlobe, again from neglect. These have to be surgically taken out.

    So: at whatever age you get your ears pierced, don’t neglect the care instructions.


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