Piercing Infants and Small Children

I covered this in the former blog - I will pierce minors but .... a parent and child guide but recently I've been getting an increasing number of parents contact me asking if I pierce infants and small children. I'm not sure what is triggering this sudden surge but I felt that it might be best to write a blog on the subject. As a parent I understand the drive to not only fulfill all of our child's wishes but to do so in a way that is safe and health. However, there are a number of things that need to be considered before considering having your child pierced and here are few:

Ear Piercing Devices aka Guns:

Ear Piercing Device present a number of issues that I have covered more than a few times on this site. There are a number of reasons why using these devices to pierce isn't the best option and to a degree is dangerous. Most of these problems started with the development of the device which was not for human uses. The fact is that what has been used to pierce ear lobes since the 1970s was originally designed for large scale farm animal tagging. In the designing of these devices there was no consideration to trauma/damage to the tissue, consideration of different sizes in anatomy or the risks of cross contamination from one individual to another. Though this should have been taken into consideration when the uses of the device moved from animal to human, it wasn't. 

Before the rise of the body piercing industry in the 1990s, there was really no other "professional" option though before the wide spread uses of the devices many retail jewelry stores and department stores, offered a weekly or monthly piercing service. In these cases, a certified nurse would come into the store and do piercings with clean and sterile equipment. Prior to 1975 most ear piercings were either done in this way, by a doctor or in the at home method of a needle and a potato or some other protection. With the wide spread introduction of the ear piercing "guns", retail outlets were provided with a cheap, easy to use device that took minimal employee training. Thus the employment of those in the Medical Industry to do ear lobe piercing went the way of the Milkman and the Iceman.

With the rise of the Body Piercing Industry came a better understanding of the risks of these devices. The manufactures have responding to bring law suits against those that spoke out against their uses and lobbying to restrict Body Piercing legislation to omit references to the ear lobe or the uses of the device. The one positive thing they have done is to create a single uses system that reduces the contact the clients tissue has with the reusable section of the device. Thus cutting down on the risks of cross contamination. However, this doesn't address the fact that a majority of those operating these devices  have absolutely no training on cross contamination.

If you consider the difference between going to a small retail outlet at the local mall and the experience you would have going to a well trained piercer, there is a vast difference in how the items are handled, stored and used. The most obvious difference is that any item that might come in contact with the client is wrapped and sterilized. While the equipment is set up great care is taken to insure that the items do become contaminated with contact with contaminated items and surfaces. Then after the piercing is done, the used items are disposed of properly or decontaminated, wrapped and sterilized again before being used on another client. This isn't by accident, there is years of training that have lead to these habits. Habits that most of those using the ear piercing devices are completely unaware of or have ever considered and it isn't their fault they just haven't had the benefit of education.

Cross contamination and training aside, the other problems with ear piercing devices is the method in which the piercing takes place and the limited size and style of the jewelry that can be used. An ear piercing starter stud is not even close to the sharpness of that of a piercing needle. This not only increases the amount of pain felt by the piercee but also cause more tissue damage. The force and dullness of the studs, cause the stud to tear or rip through the tissue unlike a surgical sharp needle that cuts through the tissue. In the case of thicker upper ear cartilage, the force can cause the cartilage to shatter instead of puncture or cut. The jewelry is one size fits all, which presents a problem with lobes that are thicker and doesn't allow additional space of swelling and inflammation. The other issue with the jewelry is that often it is plated or made of a substandard material that may lead to allergic reactions or a fungal infections. 

Another issue is that little or no information on aftercare is given after the piercing is done. Usually it will involve the device manufacture's instruction card and a bottle of disinfectant. The person that has done the piercing may have limited or no knowledge of what steps will need to be taken to insure a proper healing or what will need to be done to resolve problems that may come up during healing.

OK, No Cattle Tagging Device for My Kid but What About A Pro?

So, as a parent, I understand why you don't want to take your healthy child to the mall and turn them over to an inexperienced retail clerk armed with a improper device. However there is a lot more to consider even with a piercing done by a professional body piercer. I refuse to do those that I would consider pre-teen. There is no magic age for a child to get a piercing. There are a number of adults that I've refused to pierce for some of the same reasons that I won't pierce a young child. The thing with children unlike those that are older, a majority of the concerns. that I have with piercing them are more universal than they would be with those that are older.

Safety:

Children are a joy filled with energy, a need to explore and a huge imagination. It's some of the main reasons that they are endearing to us but they contribute negatively to the experience of getting pierced. You must consider what the piercing procedure will involve. Though the piercing is split second there is a period of set up involved and even after the piercing is done, the jewelry will still need to be inserted and closed. During the whole procedure the child must sit still or the piercing could be done incorrectly, the jewelry insertion won't go smoothly or a needle strike may occur. The biggest worry is that the child will move during or immediately after the piercing is done and cause the needle to puncture the piercers skin and causing a immediate exchange of blood or bodily fluids between the child and the piercer. Though the risks are reduced with an experienced piercer who is regularly tested, it is still the biggest fear of any piercer and the spread of a pathogen from a piercer who works in a high risk profession to your child should be high on your fear list. Consider what it would be like to try to handle a sharp object puncture through your child's ear when they are thrashing about and unwilling to calm down. 

Regardless of the age of the person getting pierced, part of the experience of getting a piercing is over coming one's fear of the unknown. The main source of this fear is our imagination. As adults, we learn to control or repress this imagination rationally.  However with a young child their imagination is a great deal stronger and intense. If you don't believe me, think of all the times you have checked under the bed for monsters or rocked them to sleep after a bad dream. Children view the world and their experiences with the world differently as we do as adults and often fears have no bases in reality but are completely under the full control of their imagination. So, consider them sitting in the chair and watching as I unwrap and set up sharp and strange objects. As parents we are driving to coach them on what is going to happen. Say things like, "Remember Junior, you have to sit still and you know it's going to hurt but you must sit still." Think back to your childhood and understand how the words, "Sit still" and "hurt" would have feed your imagination and fear of what was going to happen.

Let's say your little trooper makes it through the whole piercing. You watched with your chest out as they sat still through the thing without even a tear or a wiggle. Great, wonderful, what an exceptional child. However, the piercing is not healed. That will take up to three months or even more to happen and steps will need to be taken to insure that the piercing heals and doesn't become infected. This will involve sitting still and doing ten minute soaks or compresses twice a day and then cleaning the piercings under running water. Think about bath time. Are they going to be willing to submit to this twice a day?

Then you need to consider how your child interacts with their environment. Spend ten minutes watching them at play. Notice how they touch everything and when they are younger they taste everything. It is part of their natural development, it is normal and healthy. When presented with anything new, they need to touch it and often with infants and toddlers both must happen they are compelled to taste it.  Now consider these fresh piercings that are going to be open wounds and pathways into the body for the next couple of months. First off they are new and are going to be sensitive, so they must be touched and touched often. That is a problem in itself but when you consider everything else those little hands touch a much bigger problem comes into focus. This is compounded when you consider the environments that your child spends time in outside of the home and outside of your control. A playground or a school room are good examples. Hundreds of children touch, tasting and spreading pathogens on every surface within reach. No amount of good old fashion parental nagging will keep those little hands off those surfaces and away from those piercings.

One risk that isn't often consider is reactions to metals and other materials. Since the child has not often been exposed to a large amount of material is a reaction of metals isn't known. Also as we get older either through long term exposure or development allegoric reactions to materials can develop. With younger children often piercings are their first time exposure to the metals used in body piercing jewelry and there is no history to rely on to know if they are more prone to having a reaction to them. Thus they are at a much higher risk of having a reaction to metals.

The Effect of Growth on Piercings:

When you consider that the average height of a new born baby is 20 inches and the average height of an adult is 65 to 70 inches, the average human grows to three times its size within 13 to 16 years. Even with an ear lobe the size will triple in size from birth to adulthood. Often this growth is outward and alway from the body. Piercings are a fixed point on the body, so like in the case of an ear piercing, the piercing will stay at the same distance it was from the bottom of the lobe. As the body grows it produces more tissue above the piercing, causing the piercing to be placed at the bottom edge of the lobe by the time they reach adulthood. So even though the placement looks perfectly centered on a toddler, chances are it will not when they are 16 years of age and may need to be abandoned to avoid tearing and scarring.

Understand that this is risk not only in children that are pre-teen but even with teenagers. You may think that this isn't a problem because your ears have been pierced since childhood but you will find that if you consider the shape and size of your lobe, the placement is off. Of course the jewelry can be removed and the piercing will heal over but the scar of the piercing will never go away completely. Nature only gives us one set of lobes and if we alter them, they will not return to the way they were at birth.

Sports and Other Organized Activities:

A large part of childhood is playing sports and other completive hobbies like dance and gymnastics. Most of these activities are governed by a national organization and there is more than likely a uniformed dress code. In almost all cases piercings are limited or not allowed. Which will mean that the jewelry will need to be removed and often for long periods of time. The problem with this is that without the jewelry forcing the body to keep the hole open, it will begin to reattach the tissue and close the piercing. The more healthy the person is the more effective the body is to do this. If you marvel at how quickly your child's skinned knee heals by comparison to you, think about how quickly those lobe piercings will close on your ten year old soccer star. 

It is a completely misconception that ear lobe piercings stay open forever. The fact is the moment that the jewelry is removed, the body will begin repairing the hole and the longer the more it closes. Though on the outside the piercing may appear open, the reality is that the center of the piercing has shrink or been reconnected. Adding to this is the thickness of a majority of ear studs which are often very thin at 22 or 20 gauge. The thinner the jewelry the smaller the hole and the faster the body will close it. 

Forcing the jewelry through a closed or shrunk piercing will often cause the piercing tunnel to become torn or dislodged and thus jsut like the day it was pierced it is an open wound. Though it will usually take less time to heal then a fresh piercing the same amount of care is need to insure that it doesn't become infected. Activities that require removing the jewelry for long periods and then forcing the jewelry in, can create a situation where the piercing is in a continued state of healing. This can lead to a host of problems including infection, scarring, inflammation and other problems. The other issue is the jewelry itself and keeping it free of pathogens. Picture being back stage at your daughters dance recital and having to remove a set of studs before they go on in less then a minute and think about just what clean storage container will be handy. 

Peer Pressure, Responsibility, and Who's Body Is It Anyway?:

There are countless cases where piercings on small children have healed with no problem but often if you ask the child or the parent, you will find that it wasn't  without problems. There is a lot of cultural pressure for children to have their ears pierced.  This is especially the case with female toddlers. I would ask you if it is the drive to get this piercing is pressure from other children or other parents as a form to fit a norm. It seems over the last 30 years or so, ear lobe piercing has gone from a rite of passage from childhood into adulthood to marking the end of potty training. I think I would be misguiding you if I didn't bring up what your motivation is for your desire or willingness to have your child get the piercing.

It might be that they came home and told you they wanted because one of their classmates has them. I have to ask would you consider having your child tattooed because one of their classmate has a neck tattoo? That might seem extreme but if you consider that you are permanently altering your child's body it isn't that far of a stretch. Even if it was legal or you could find a tattooist willing to do it, would you even consider it? If the driving motivation is your Child's desire, do you think that they are capable of making that decision? 

Another point is that I'm increasingly getting requests to pierce children that are not even walking yet. This means that the parent is wanting the child to have this piercing. Whatever their motivation is, I think it is important that they should consider that this piercing is changing their child's body without their consent. I have almost equal issues with piercing an infant as I do with circumcision. It tends to be an act that has more to do with fitting into a cultural standard than considering the needs and health of the child. As parents are number one responsibility is to safe guard our children until they are developed enough to care for themselves. Consenting to a procedure that could put their health and well being in jeopardy should out way any fashion statement.

There is also this false idea that if you pierce them at a younger age they are not going to remember the pain. The reality is that a child may not remember the event at all when they are older but it can plant a seed of a unfounded fear. Children and even infants can develop related and sometimes unrelated impressions of events that can effect their prospective for the rest of their lives. 

Parents should also consider the amount of responsibility that is going to be needed for the child to heal the piercing. For the same reasons you wouldn't let your 7 year old play with knives, you should think that same child is responsible enough to care for a piercing. I've already brought up a number of issues on this subject but I have to ask, if you don't trust them to brush their teeth twice a day or wash their hands after using the restroom, why would you trust them to care for a piercing for over two months?

So If Not Now, Then When?

There is no clear answer to that. All children mature at different rates but the first thing to consider is responsibility. One way of judging this is if they can discuss the pros and cons of the piercing, have a clear understand of the risks and what it will involve to heal the piercing. I would suggest making them research the piercing before hand. Have them prepare a list or report on the piercing. Not only will this go a long way to proving that they clear understand the experience but will so that they process the skills to make a decision regarding getting the piercing.

There is no ideal age when a child stops growing but it should be after the major growth spurts of the pre-teen period. There will not be the drastic difference in the size of the lobe or most areas above the head like there is between the toddler years and the tween years. 

The next factor would be emotional growth and development and their ability to deal with stress and fear. How do they react in stressful situation? Do they panic or are they calm. Also, are they able to sit still and focus or are they antsy and easily distracted.  A good example is a parent brought their 16 year old in to get her navel pierced. I refused to do the piercing because she couldn't focus on the consultation and spent the whole time playing with her phone. With a piercing there is the stress and fear of the piercing but there is also the education on how to take care of the piercing. So, if your child isn't a good listen, waiting until they develop that skill is a better option.

Piercings in our culture and almost every culture on the planet are treated as a rite of passage from childhood to adulthood. It often over looked that a rite should be an earned privilege. Ideally allowing your child to get pierced should show your trust and mark their travel from child to adult. When you compare this idea with keeping up with fashion, the piercing takes on a completely and more meaningful experience.