Many parents question when children are old enough to wear jewelry, especially earrings. Patrick Mularoni, M.D., from Johns Hopkins All Children’s Hospital gives parents some helpful tips.

Is there a right time to get a child’s ears pierced and are there risks?

The right time to get a child’s ears pierced is a personal family decision. There are many cultures who pierce children’s ears when they are babies and many other families choose to wait until children are past the toddler stage so they can help make the decision as to when and whether they want their ears pierced. The most important thing for parents to remember is that earrings should be checked daily. I say this because we often see girls coming into the Emergency Center who have had an earring backing get too tight and then migrate into the ear lobe. This usually starts as a small amount of inflammation and when the skin breaks, the backing will migrate into the lobe and the earlobe can heal over top of the backing making it very difficult to remove without the help of a doctor. I personally have noticed that this happens most often with the backings that are shaped like the nipple on a baby bottle so you should probably avoid that type of backing and opt for a backing with a wider base that has more surface touching the back of the earlobe.

Should children be wearing rings?

This is also a personal family decision, but they do pose some risks for children. We see children coming in with rings stuck on their fingers quite frequently because the child has either put on a ring that is too tight or they have been wearing a ring for too long and the finger has grown to the point where the ring will not come off. We actually stock specialized ring cutter tools in the Emergency Center that are just for this purpose because the ring actually needs to be cut in order to get it off the finger. The second risk for children wearing rings is of the ring catching on something and then injuring the finger. This is especially a problem in the “tween” group with children putting on rings that are actually too big for their finger, which allows more space for them to get caught on things leading to an injury to the finger.

Many children now wear amber necklaces that are supposed to help with teething. Does that work and are they safe?

Advertisers who sell these necklaces promote them as a naturopathic way to decrease pain associated with teething. The claims range from the idea that “amber releases succinic acid that is absorbed through the skin, which decrease pain and inflammation,” to effects on the thyroid that somehow “decrease drooling.” Unfortunately there is no scientific evidence to support these claims and the American Academy of Pediatrics has released a statement cautioning parents against their use. I feel that there are two risks associated with use of these necklaces that cannot be looked past. The first is a strangulation risk in toddlers who are often wearing these necklaces day and night. To decrease the risk of strangulation, some manufacturers have designed the necklaces to break off easily, which leads to another risk for toddlers who could choke on broken parts of the necklace. There are many other options that range from frozen chew toys to topical medicines that are more likely to decrease the discomfort of teething that do not create risks such as strangulation and choking.