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When Can You Pierce a Baby’s Ears?

There are some ground rules to baby ear piecing, but for the most part it’s totally safe.

Parents across many cultures pierce their baby’s ears right out of the womb, but infant ear piercing is not that simple, according to the American Academy of Pediatrics. The AAP discourages piercing ears until children are old enough to make the decision for themselves. However, this has more to do with children’s self-empowerment than safety or physical pain. So, when can you safely pierce a baby’s ears? The simple and technical answer is around 2 months, as long as moms and dads follow a few rules. As casual as that may seem for a painful procedure, these guidelines have come a long way since pediatrician Dr. Norina Ocampo was a newborn.

“A little old Italian lady from up the street came to my house, put ice cubes on the earlobes, heated up a needle on the gas stove, and pierced it right through,” Ocampo recalls. Despite the AAP’s concerns, many cultural rituals prove that baby ear piercing is “actually very, very safe,” she explains.

In fact, infant ear piercing at 2 months is arguably an ideal time because it coincides with the first round of vaccinations, including the tetanus vaccine. Although that’s a comforting precautionary measure, Ocampo notes there is very little risk a baby would get tetanus in any case.

“Babies can’t localize pain, so even though it might be a little bit painful, they can’t reach up and touch their ears and pull the earring out,” Ocampo says. “The pain usually goes away within a couple of days.”

Older babies, around 5 or 6 months old, however, can localize pain. They may be more apt to tug and pull at the earrings. That’s made even more problematic if their fingers and hands are dirty. And the older a child is, the more likely they will be stressed or frightened when it comes to piercing, even if they have made their own decision to have the procedure done.   

“These 4- and 5-year-olds want their ears pierced, but then they’re crying because they’re afraid of the pain,” says Ocampo. “I think it’s better to do it as a baby when they don’t know, and then it’s done.”

Ocampo notes that some pediatricians are willing to pierce a baby’s ears in the safety of their office. However, if parents can’t find a doctor to do it, they should insist on several guidelines wherever the piercing occurs. That means not only a clean environment but also 24-karat medical-grade gold-plated studs. This will help prevent infection and allergic reactions.

“Twenty-four-karat gold is pure gold; you will never have a reaction to pure gold,” Ocampo stresses. “People who are allergic … are not allergic to the gold — 14-karat and 18-karat are not 100 percent pure, so they add other alloys like nickel. It’s usually the nickel they have an allergic reaction to.”

And, barring an allergic reaction, once a child’s ears are pierced, they will remain so permanently if the earrings are kept in for at least a week after piercing. During that time, parents can prevent rare cases of infection by cleaning around the earring with alcohol and rotating the studs in their holes twice daily.

Signs of infection include redness and tenderness, and possibly a pus-filled discharge, but Ocampo is quick to put parents at ease. “There’s nothing in that area that has bad bacteria that’s going to cause a bad infection,” she says.