Posted tagged ‘earrings’

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

January 9, 2014

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.

The ears, they are a-piercin’

January 9, 2010

The Pediatric Insider

© 2010 Roy Benaroch, MD

BB has mixed feelings about getting her daughter’s ears pierced: “What are your thoughts on the safety of piercing a baby or toddler’s ears? I’ve read mixed info about the ‘best’ age to pierce a young girl’s ears. I’d like to know what pediatricians typically recommend. I know this isn’t likely a pressing medical issue, but I want to make a safe, wise, informed choice for my daughter.”

Early or later piercing are both safe, so it’s mostly just a matter of family choice. Some families prefer to pierce early, before a baby could remember it; others want to let a child decide for herself when to do it. Some people like to pierce ears even in the newborn period, and I’ve never seen or heard of any sort of important complication from early piercing.

In fact, the few complications I have seen have been in teenagers rather than babies. Teens aren’t always as good about keeping new piercings clean (new piercings are far more likely to get infected than old, established holes.) I’ve seen a few teens (boys, naturally) ignore their posts completely, so skin grows over the front or the back. Also, teens are more likely than young children to develop keloid scars after piercing.

Whenever you do pierce, follow the instructions on keeping the area clean and using an antiseptic solution. It’s best to do the first pierce with good gold posts, and leave them in for a long while; don’t swap them over to little skinny loops until the hole is mature. The backing should never be tight against the back of the ear—leave a little wiggling for growth and to allow good air and blood circulation. Though the backing shouldn’t be tight against the ear, it does need to be tight on the post to keep the earring in the ear and out of a young child’s mouth. If there are signs of infection like increasing pain, warmth, redness, swelling, or drainage, go see your doctor.

Every once in a while, I get asked about doing ear piercing in my office. I’m not so sure that’s a great idea. Personally, for my own daughters, I’d rather have a piercer who does these all day, every day.

What about piercing other body parts? Holes through ear cartilage are somewhat more likely to get infected, and those infections can be more difficult to treat. Still, they’re usually fine. Lips and noses and eyebrows don’t seem to lead to many problems. However, tongue pierces can increase the risk of some very serious infections—like brain abscesses—and can cause speech problems and broken teeth. As for more exotic piercings south of the mouth—I don’t even want to know.