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updated: 4/21/2011 3:54 PM

What you need to know before you say yes to a piercing

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Rachel Baruch Yackley

Your daughter is begging you to let her get her ears pierced. She just has to get her ears pierced. Everyone else has her ears pierced. You are skeptical and need more information.

Or it may be a tradition in your family to pierce babies' ears, as soon as possible, and you're wondering where to go.

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Two viable options are available: commercial business, which offers ear piercing services, or pediatricians who pierce ears in the office.

Dr. Tanya Altmann is a pediatrician who pierces even the tiniest ears in her office in Southern California.

A leading medical authority, and a designated spokeswoman for the American Academy of Pediatrics, Altmann (drtanya.com) has also authored three books: "Mommy Calls," "The Wonder Years," and "Caring for Your Baby and Young Child, Birth to Age 5."

"I've been a practicing pediatrician for 10 years. During the first few years, moms would ask me where to take their children to get their ears pierced. They wanted a doctor. I thought, 'What a great idea,'" Altmann said.

"Toddlers are the most difficult to pierce, so I recommend piercing at 4 to 12 months old, or older elementary-age children," she said. "I once had a 4-year-old; I did one side and she refused to let me do the other side. She left with one ear pierced and then came back several months later for the other one. I have had some 3- or 4-year-old girls who wanted to do it and sat still, but that's not typical. I also prefer to wait until a child is old enough to take care of her own ears."

Piercing babies' ears is very common practice in certain ethnic cultures. In Altmann's practice, where she has many Latino and East Indian patients, she pierces a lot of babies' ears, often in preparation for a big ceremony, like a christening.

Parents who ask for Altmann's advice are encouraged to wait until their children are old enough to really want their ears pierced, as this helps the child experience less pain and stress.

If your baby or toddler is especially wiggly, the doctor cannot hold her down, but sometimes will have a nurse help hold her head still, if possible.

There are also cosmetic reasons for waiting until your child is older before she gets her ears pierced. Altmann pointed out that "as you grow, your ears grow, and your earlobes may change shape. You have a better cosmetic result (over time) if you wait."

During the actual piercing, Altmann employs a few different strategies to also help reduce the stress of the child.

"I say I'm going to say '1, 2, 3, squeeze,' and I have them blow out or squeeze someone's hand," she said.

There is certainly a risk of infection, when getting your ears pierced, but Altmann believes it is safe for children, "as long as the (location) is clean and the ears are pierced in a sterile fashion."

And she emphasized the cardinal rule: wash your hands. Wash them before you touch your children's ears; make sure children wash their hands before they touch their own ears and earrings.

"I've pierced hundreds of ears and have only had two problems: one was a girl who sat in class and twisted her earrings all day long; the second was a mom who got sunscreen on her child's ears."

In cases of severe infection, the doctor recommends letting the site close and waiting six months before re-piercing.

Some problems may arise due to sensitivity to certain metals. Because of her own jewelry allergies, Altmann learned of a practical solution, which she utilizes in her office: piercing with Blomdahl medical plastic earrings.

"If you pierce with a metal, especially one that has a bit of nickel, that's what people can develop an allergy to, " she said.

Another benefit to plastic earrings is the stud is slightly larger, making it easier to get future earrings in and out. In addition, the plastic backings used by Altmann fit tightly onto the stud, ensuring that babies and young children will not be able to pull off their earrings and turn them into a choking hazard.

Piercing businesses as well as doctors typically use a piercing gun, instead of a needle.

"I like the quick, fast procedure," said Altmann. "It's just 1, 2, 3, click. The hardest part is getting the dots in the same spots, equal on both ears. I'll often bring a nurse into the room and ask her if it looks right (before the actual piercing)."

Because she treats patients up to age 21, Altmann does receive requests to do other types of body piercings, but she only pierces earlobes. If someone does want a nose, eyebrow, or other body part pierced, Altmann strongly suggests going to a professional who works in a sterile environment.

"Infection can spread very quickly," she said. "If this happens, go see a doctor right away. Any skin infection is serious."

After any piercing, keep an eye out for signs of infection at the piercing site: pain, redness, warmth, swelling, pus and especially if your child spikes a fever or develops flu-like symptoms.

Among the businesses who pierce ears is Piercing Pagoda. With 39 years of piercing experience, Piercing Pagoda has ear piercing down pat.

"We've been in business since 1972," said Jennifer Antons, district manager of 13 stores in Illinois and one in Indiana. "We started on the East Coast, and now have store in 48 states and in Puerto Rico."

Children who are brought in for ear piercing need to be at least 2 months old, and have had their DPT (diphtheria, tetanus, and pertussis) vaccine. Parents need to provide identification, and those 18 or over need to provide their own ID.

Like Altmann, Piercing Pagoda uses ear-piercing guns, and ensures a sterile process by using earrings that come in disposable cassettes.

"We use a one-step process," said Vicki Boyer, manager of two Piercing Pagoda kiosks at Spring Hill Mall in West Dundee.

Both parents and children are taken through the piercing process and the care instructions before the piercing is done.

"When we go through the process, we tell them to check for redness (or other changes), and to wash hands before cleaning. They can always stop in for a four-week follow-up visit, and we'll see how they're doing," Boyer said.

Piercing Pagoda pierces ears and also the ear cartilage. Although they sell jewelry for body piercings, they do not offer any body piercing services.

Either white gold or surgical steel earrings are typically used, but gold plated and titanium earrings are also available. These earrings come in their own sterile cassette packages, ready for use with the piercing gun.

Special attention is given to the youngest customers, who are often the wiggliest, too. It's for these customers that "Earful," a stuffed dog, comes in handy.

For all piercing customers, Piercing Pagoda works to make their experience fun and special.

"I think it's the way we approach it that helps the kids relax," Antons said. "The kids get a goody bag with a certificate, a sucker, stickers, pencils, and an 'I got my ears pierced at Piercing Pagoda' sticker to wear."

All of the Piercing Pagoda staff are specially trained by the business's Piercing Pagoda University, and all staff are recertified every year.

To find a location near you, visit pagoda.com.

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