Will ear lidding in a newborn baby correct itself?

Ear Lidding in Newborns: Natural Resolution

Most cases of ear lidding in newborns will spontaneously resolve without any intervention within the first 6 weeks of life, and observation is the appropriate initial approach for less severe cases.

Natural History and Spontaneous Resolution

The most recent prospective data demonstrates that ear lidding has excellent potential for spontaneous correction in newborns:

• In a 2022 prospective observational study, 10 out of 10 consecutive newborns with ear lidding experienced complete spontaneous resolution within an average of 40 days (approximately 6 weeks) without any intervention 1
• This high rate of natural resolution suggests that immediate treatment may be unnecessary for many cases, particularly those that are less severe 1

When to Consider Intervention

While spontaneous resolution is common, early intervention with ear molding may be appropriate in certain circumstances:

• Ear molding is most effective when initiated within the first few weeks of life (ideally before 6 weeks), as neonatal cartilage remains malleable due to circulating maternal estrogen 2, 3
• The incidence of congenital ear deformities is documented as high as 58% of newborns, but the majority do not spontaneously self-correct, leaving some children with permanent deformities 3
• For more severe cases or those not showing improvement by 6 weeks, ear molding with devices like EarBuddies or EarWell systems can achieve permanent correction in 3 weeks when started early 2, 4

Clinical Approach Algorithm

Initial Assessment (Birth to 2 Weeks):

• Document the severity and specific characteristics of the lidding deformity 4
• Counsel parents that many cases resolve spontaneously within 40 days 1
• Initiate observation period for less severe cases 1

Follow-up at 4-6 Weeks:

• Reassess the ear deformity for signs of improvement or resolution 1
• If complete or near-complete resolution has occurred, continue observation 1
• If no improvement or worsening, refer for ear molding intervention, as effectiveness decreases significantly after 6 weeks of age 2, 3

Important Caveats

• Early detection is critical: The window for successful nonsurgical correction closes rapidly as maternal estrogen levels decline and cartilage becomes less malleable 2, 3
• Parents should be counseled that while observation is reasonable initially, delayed treatment beyond 6-8 weeks may necessitate surgical correction later in childhood 3
• The psychological impact of uncorrected ear deformities, including bullying and depression in older children, supports timely correction when spontaneous resolution does not occur 1
• Clinical screening for ear deformities should be performed immediately after birth to identify cases that may benefit from early intervention 2