“My advice is to wait until your child is old enough to participate in caring for the earrings and the discussion of whether or not they want this done to their body,” University of Rochester Medical Center pediatric emergency medicine doctor Elizabeth Murray tells PEOPLE.
According to the American Academy of Pediatrics, “Ears may be pierced for cosmetic reasons at any age” and “there is little risk” involved if the piercing is performed cared for using the proper sanitary procedures and precautions.
The AAP does recommend using a round earring with a gold post to reduce the risk of infection and allergic reactions and, “as a general guideline,” to hold off on piercing a child’s ears until they are “mature enough” to care for the modification themselves.
Explains Murray about the benefits of waiting until a child is older, “I have seen far too many infants and toddlers choke on or swallow earring parts. I’ve also seen a large number of earrings end up in a toddler’s nose!”
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According to a 2017 set of recommendations from the AAP for adolescent tattoos and piercings, in one study, up to 35 percent of people with ear piercings had one or more complications, broken up as such: minor infection (77 percent), allergic reaction (43 percent), keloid formation (2.5 percent) and traumatic tearing (2.5 percent).
“At this point practitioners really need to form their own opinions about ear piercing,” Johns Hopkins pediatric resident Suzanne Rossi said in 2015, adding that the AAP’s point on maturity is “clearly the best way to reduce the risk of infection” to the affected area.
“I usually try to recommend to families that they get past the six-month immunizations to reduce their risk of tetanus and blood-borne infections,” she explained. “We also make sure the parents are taking [children] to a reputable place to decrease the risk of infection.”
Johns Hopkins also noted that complications can include discharge (which happens in almost one-fourth of all cases), backings embedded in the earlobe and bleeding.
To avoid infection and other complications, the AAP recommends having a medical professional perform a piercing, using rubbing alcohol or some form of disinfectant. Then, alcohol or antibiotic ointment should be applied to the affected area twice daily for “a few days,” which the AAP states “will cut down the chances of infection and hasten the healing process.”
Rotating the earring gently every day is also important, says the AAP, as well as holding off on removal until four to six weeks after the procedure and seeking medical attention immediately if the site turns red and/or painful.
Regardless of safety and care recommendations, there have long been debates surrounding the actual age it’s okay to pierce a child’s ears. In 2013, Today reported about a letter signed “Leave Those Kids Alone” in the Pittsburgh Post-Gazette‘s advice column that referred to infant ear piercing “borderline child abuse.”
The letter sparked a huge online discourse over the relatively common practice, with many agreeing with the letter but others stepping in to defend ear piercing by citing its significance in their cultures.
“For Latina moms, piercing their baby girls’ ears has nothing to do with vanity. It’s simply a cultural tradition,” co-founder of Spanglish Baby and Bilingual is Better coauthor Roxana Soto in a blog post. “So much so that I freaked out when I learned my first child was a girl because I had no idea where I would take her to get her ears pierced.”
Murray tells PEOPLE, “If piercing an infant’s ears is culturally important, then go ahead using the [proper] safety guidelines. Otherwise, remember you are changing your child’s body for something that has no benefit other than appearances.”