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Piercing a Baby's Ears: What You Should Consider

Medically Reviewed by Dr. Gina Jansheski, MD, FAAP
Updated
Here's everything you should know about baby ear piercing.

If you’ve asked around about piercing your baby’s ears, you have likely heard a range of varying opinions. Some people feel very strongly about the subject but don’t have any evidence for or against their opinions.

We’ve been in your position and are here to help you find answers.

With guidance from an experienced pediatrician, we’ll explain the arguments for and against baby ear piercing and offer a balanced view of the benefits and potential risks.

Our pediatrician will also offer advice for the procedure and aftercare should you go ahead with piercing your baby’s ears.


Why Do Some Parents Do It?

For many, piercing a baby’s ears is a matter of personal preference or even a family or cultural tradition.

Some do it because it looks cute. Others use it as a gender identification method, so strangers won’t come up and tell them what a lovely baby boy they have.

Many see it as a way to honor cultural values. In Latin and Indian cultures, parents usually pierce their daughter’s ears before her second birthday.

Some cultures have relatives do the piercings. Some prefer having a pediatrician do it soon after birth or before leaving the hospital (1). Even if parents hold off and let the child decide when she is older, it’s such a deep-rooted tradition in some cultures that girls will likely grow up and want their ears pierced anyway.

What do the Experts Say?

If you ask medical providers, the first response is generally that this would be considered an elective procedure, meaning it’s not necessary for the health and well-being of your child, and you are “electing” to have it done.

As with every medical procedure, the next step is to review the risks versus benefits and understand them before deciding to proceed.

Benefits

  • The procedure may fulfill the expectations of a family or cultural tradition.
  • Many believe that piercing an unmoving infant’s ears will be easier on them than when they are old enough to remember the pain.
  • Parents can care for the ears afterward to ensure they stay clean while following the recommendations for ongoing care.
  • With earrings, your baby will be more easily identified as a girl.
  • The family feels that earrings are cosmetically pleasing.

Potential Risks

Your pediatrician may bring up the following points for you to consider:

1. Infection

Ear piercing could potentially lead to a range of infections, from mild and superficial to the formation of an abscess requiring drainage. These are some concerns you should discuss with your pediatrician.

  • Whenever the skin is pierced, any bacteria living on the surface can be pushed inside and begin to multiply, creating an infection.
  • A baby’s earlobe is not a very clean place. Babies spend a lot of time in a reclining position, where drool and spit-up tend to drip toward the ears and earlobes, creating a favorable environment for bacterial growth.
  • Babies tend to grab their ears very often after their fingers have been in their mouths, introducing mouth bacteria into the area.
  • Babies’ immune systems are not yet fully developed, making it easier for an infection to start and more difficult to fight.
  • Vaccinations are a work in progress during the first year of life, and tetanus is a possibility, though rare. Many doctors recommend waiting until the tetanus series is complete before taking that risk.
  • There have been reports of Hepatitis B and C spreading through ear piercings, possibly due to unclean needles or piercing equipment (2).
  • There are risks related to underlying medical conditions, such as congenital heart disease and immunodeficiencies. In these cases, an infection could cause much more harm to your baby than usual. With an immune deficiency, the chance of a bloodborne infection is much greater, making it more likely to infect other body parts. And with congenital heart disease, a bloodborne bacteria could set up shop on a heart valve, creating a serious condition called endocarditis. The earlier you do the piercing, the less likely these medical conditions will have been discovered in a baby.

2. Trauma

It’s common for babies to accidentally injure the ear by pulling on their earring or earlobe. Blankets or clothes can also catch on the earring and rip the delicate earlobe tissue.

3. Embedded earring

Sometimes the back of the earring becomes embedded into the earlobe. This can occur due to laying on the ear while sleeping, if a spring-loaded gun was used for the piercing, or if the earlobe is very thick and the earring is a bit tight, a little swelling of the area will serve to make it worse. This can cause inflammation and lead to pain, tissue damage, and infection.

4. Aspiration

Besides infection, aspiration is probably one of the more serious risks of ear piercings. As babies grow, they grab anything they can get their hands on and put it into their mouths.

There are moments when you are not directly observing your baby, such as while you are driving or sleeping, or even if you are occupied with something while she is in the room with you. This can happen in just a few seconds.

All it takes is a little loosening of the earring, and your baby can grab it and potentially choke on it or breathe it in and have it land in her airway. This is called aspiration and is not all that rare in babies and toddlers (3).

5. Allergic reactions

Many babies have allergic reactions to earring materials, such as low-quality steel or nickel. Even high-quality gold or steel earrings can have studs made from nickel that can cause contact dermatitis in the area and on other sensitized body parts. Besides the itching and discomfort, chronic inflammation of the areas also increases the risk of infection.

6. Scarring

A keloid is a type of skin repair reaction that causes a scar that appears “heaped up” and remains indefinitely. We cannot know whose bodies will make keloid scars. Some people have more of a tendency to heal in that way than others. It is challenging to deal with keloid scars because any further break in the skin, even by a corrective procedure, runs the risk of causing another keloid to form.

7. Pain

Ear piercing involves a brief period of pain, and the ears may be sore for a day or so afterward, especially if touched. In addition, cleaning the earlobes with alcohol will sting initially, but that will improve as the skin heals.

8. Poor cosmetic result

Ear piercing is considered cosmetic, which means it is a medical procedure to enhance your baby’s outward appearance. It is important to remember that there are some reasons why the outcome may not be as expected. For example, babies’ earlobes are small compared to those of older children, making it a little more likely to misplace the piercing and create an unbecoming effect. Another thing that increases the risk is that babies move and cry, especially when being held down.

If You Decide to Go Ahead with the Piercing

You have reviewed all the risks and benefits, spent some time thinking it over, and decided that you would like to go ahead with piercing your baby’s ears. Let’s review the things to consider while preparing and planning for ear piercings.

Who Should Pierce My Child’s Ears?

Most people go to a vendor or jeweler to get their ears pierced. But when piercing a baby’s ears, it’s best to seek help from a pediatrician who offers the service (4).

One of the main reasons is that not all facilities offering piercings have the proper equipment or staff for these tiny customers.

Consider the ear-piercing gun — it’s not always possible for staff to sterilize it properly. In the worst-case scenario, your baby could contract hepatitis or another disease that spreads through blood (5).

Ask your pediatrician to perform the procedure or to recommend someone who can do it in the safest conditions.

If a pediatrician does it, they will typically use a sterile needle. They begin by cleaning the area. Then they will likely make a small dot with a marker to know where to insert the needle.

Then the doctor will puncture the skin and insert a pair of sterilized earrings. These are typically made from hypoallergenic surgical steel, titanium, platinum, or 24-carat gold, which will minimize the chance of any adverse reactions. It’s also important to consider using safety-backed earrings to keep your baby from accidentally pulling them out, creating an opportunity for choking.

Will the Procedure Hurt My Baby?

Babies feel pain the same way we do, and if you’ve ever gotten a piercing, you know they tend to hurt.

For ear piercings, the pain is not excessive, which is also why doctors don’t give a shot of anesthesia. An anesthesia injection would likely hurt more than the piercing!

Many moms say their babies cried more when they got their vaccines than the piercing.

That said, you can ask your pediatrician to apply some topical anesthesia cream to the earlobe. This will take the edge off the pain.

It also helps when a professional is doing the job. They know where to insert the needle, can anticipate how and when the baby is likely to move and can do it fast.

If your baby is older and eating solids, it’s a good idea to bring a favorite snack to use as a distraction or tasty reward afterward. Just make sure there is nothing in her mouth when beginning the procedure.

You can help everything go smoothly by holding your little one tight so they won’t move. At the same time, talk to them gently, sing a song, or read a book with them. Remember to stay calm — if you freak out, they will, too.

Caring for the Area After Piercing

Following the procedure, it’s important to take good care of and observe the areas. Ask your pediatrician what they recommend. They will usually tell you to leave the earrings in the ears for at least six weeks so that they can heal (6).

Here are some things you should do during this time:

  • Wipe around the earlobes with alcohol: Ask your doctor, but they generally recommend wiping the area twice a day with rubbing alcohol or another antibacterial preparation.
  • Twist or rotate the earrings: At least once a day, gently twist or rotate the earrings in the ear. This will prevent them from becoming stuck.
  • Dry the area after each bath: It’s essential the piercings don’t stay damp. After each bath, grab a clean towel and gently pat the area dry.
  • Make sure the clasps are not too tight: The earrings should have some give from front to back in the openings, and the backing should not be pressed up too tightly against the earlobe. This can cause pressure on the tissues and affect their blood supply, interfering with healing and increasing the chance of infection.
    Keep a close eye: Watch the areas daily, and don’t forget to look behind the earlobe regularly. Be aware of the signs of infection, which would be more redness and tenderness developing each day instead of the expected improvement.
  • Don’t press on the ear: Avoid applying any pressure while cleaning or rotating, as this could be painful.

When Can I Switch Earrings?

After six weeks, your little one’s earlobes should be healed. Now you can remove the first earrings and place your own.

You should still be mindful of the earring material, especially if your baby is young. Many parents opt for metal earrings.

Gold or silver earrings are the safest option if you choose to use metal. Doctors generally recommend earrings that are at least 14-karat gold. Be sure the stud and the backing are not made of low-quality steel or nickel. Gold, platinum, titanium, and surgical-grade steel are less likely to cause dermatitis or contribute to the development of an infection.

Here are some other things to look for:

  • Shape: Choose earrings that are small, flat, and round with no sharp edges.
  • Fastener: The earring fastener should cover as much of the back side as possible. It is safer to use earrings with locking or screw-style backs to reduce the risk of them coming off. Keep in mind that your baby could swallow the earring if it comes off and makes its way into the mouth.
  • Avoid hanging or dangling earrings: At some point, all babies begin to tug at their ears. In this case, imagine the potential risk and damage if your little one gets hold of a dangling earring.
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Headshot of Dr. Gina Jansheski, MD, FAAP

Medically Reviewed by

Dr. Gina Jansheski, MD, FAAP

Dr. Gina Jansheski is a board-certified pediatrician with over 20 years of experience treating infants and children of all ages in many different settings. Dr. Jansheski is the mother to three sons, has sponsored a young girl in India for the past 7 years and has also devoted her time to a new charity that she founded, Helping Hands M.D. feeding street animals in Thailand and India.