We're Back in Washington State!

We've been having a great time all this week in Yakima and Spokane, Washington finishing a series of trainings for WIC staff and other community professionals. We'll be back next week with new posts. Have a great weekend!

 

Revisiting Teething: Part 3

Alternative medicines to relieve teething pain?

By Karolina Gonzalez, MAS

Note: We are not medical doctors. We are providing this information based on articles published in research journals. You should talk to your own doctor before you give any medications or remedies to your child.

As a mom, I totally understand parents have concerns when trying to help their children deal with teething discomfort. I’ve heard a lot of them telling others which of the alternative medicines available today are the best. But I’m sure many parents out there are wondering about how effective those options are. Do they really work? We want you to make an informed decision regarding the product you choose to relieve your child’s teething discomfort. So let’s take a look at what the scientific evidence tells us!

First of all, it is important to point out that even though many parents might think that “natural” options are safer than “drugs,” that is not true. There are, for example, highly toxic natural substances. You should also know that while the U.S. Food and Drug Administration (FDA) regulates "conventional" foods and drug products, it regulates dietary supplements under a different set of regulations, per the Dietary Supplement Health and Education Act of 1994. Manufacturers of dietary supplements, including herbal treatments, are not required to prove a product is safe and effective before it reaches the consumer. For example, there’s insufficient evidence to support the use of any herbal teething remedy as an effective method for treating teething discomfort (McIntyre & McIntyre, 2002). However, herbal compounds such as Chamomile (Matricaria Chamomilla) are still popular among certain communities to relieve infants’ teething pain.

Homeopathic teething tablets and gels, another type of alternative medicine, are also marketed to soothe pain, reduce inflammation and ease irritability associated with teething. Homeopaths treat disease using very low dose preparations administered according to the principle that “like should be cured with like.” The remedies are prepared by a series of dilutions and vigorous shaking. The more you dilute it, the greater is its strength (Vickers & Zollman, 1999).  

Homeopathic remedies are also regulated by the FDA. For example, Hyland’s Teething Tablets were voluntarily recalled by its manufacturer on 2010 to ensure all the lots of the product contained equal amounts of the ingredients. The product was re-introduced with a new formula in July 2011 when all concerns were addressed. According to the National Center for Complementary and Alternative Medicine (NCCAM) parents can safely use the tablets as well as the gel with young children. But there is currently insufficient evidence that homeopathy is clearly effective for any single clinical condition, including teething pain in infants (Ernst, 2010).

Amber teething necklaces are a traditional European remedy for relieving teething pain and widely available today. It is important to stress that these necklaces are designed to be worn, not chewed. They supposedly help to reduce teething pain due to an analgesic compound in the amber that is absorbed into the body through the skin. But according to research, there is currently no scientific evidence suggesting that such necklaces are effective for treating teething discomfort (Markman, 2009).

From my own experience, I can tell you that an extra dose of loving care and attention has been the most effective method for “treating” my now 11 month-old teething baby. But no matter which method you choose, remember to talk with your doctor before giving your child any medication. And feel free to tell us about your experience!

References:

FDA. Dietary Supplements. Available at: http://www.fda.gov/food/dietarysupplements/default.htm

McIntyre GT & McIntyre GM. Teething troubles? British Dental Journal. 2002;192: 251-255.

Vickers A, Zollman C. ABC of complementary medicine: Homeopathy. BMJ. 1999 October 23; 319(7217): 1115–1118.

National Center for Complementary and Alternative Medicine. Homeopathy. Available at: http://nccam.nih.gov/health/homeopathy#sideeffects

Ernst E. Homeopathy: What does the “best” evidence tell us? Med J Aust. 2010;192(8):458–460.

Markman L. Teething: facts and fiction. Pediatr Rev. 2009;30:e59-64.

 

 

Revisiting Teething! Part 2.

By Karolina Gonzalez, MAS
Some time ago we shared information about common ways parents may "treat" their teething infants. We discussed the pros and cons about the use of teething toys, pain medications and mouth gels. New information is available about the latter two, so we decided to share it with you today!

We want to remind you we are not medical doctors and we are not recommending the use of any medication, pharmaceutical or natural. We are just reporting what research tells us about those options, to help you to decide which of these methods, if any, to use with your own infant. Please consult your doctor before giving your child ANY medication.

Common Teething Medications
Acetaminophen: Pediatricians often recommend acetaminophen products, such as Tylenol, for infant and toddler teething discomfort. Until quite recently, there were two suspension strengths: one for infants (80 mg/0.8 mL) and one for children (160 mg/5 mL), which resulted in the potential for confusion, as well as the potential for an accidental overdose. In response to recommendations from an FDA Advisory Committee Meeting, since 2011, some manufacturers have changed the amount of acetaminophen in these medicines to one standard amount to help reduce dosing errors that can lead to accidental overdoses (Krenzelok, 2009). Infant drops, which contain 3 times more medicine than the children’s liquid, are being phased out and will no longer be available. You need to be aware that the dosing amounts are different depending on the concentration they are using. And please remember, even though teething pain might affect some children on-and-off for several months, acetaminophen is not appropriate for long-term pain-management.
Mouth gels: Even though teething gels have been popular, on April 2011, the FDA warned the public that the use of benzocaine, the main ingredient in over-the-counter (OTC) gels and liquids applied to the gums or mouth to reduce pain, is associated with a rare, but serious condition. This condition is called methemoglobinemia and results in the amount of oxygen carried through the blood stream being greatly reduced. In the most severe cases, this condition can result in death. Analysis of the incidence of adverse reactions to benzocaine and dose required to produce an adverse reaction revealed 132 cases of methemoglobinemia between November 1997 and March 2002. Only 69 of the reported events specified the dose used, but of those, 37 indicated use consistent with package directions (i.e. appropriate dosing) (Moore et al, 2004). As of today, the FDA recommends that benzocaine-containing gels and sprays not be used on children younger than 2.

References:

Krenzelok. The FDA Acetaminophen Advisory Committee Meeting – What is the future of acetaminophen in the United States? The perspective of a committee member. Clin Toxicol (Phila). 2009 Sep;47(8):784-9.

U.S. Food and Drug Administration. FDA Drug Safety Communication: Reports of a rare, but serious and potentially fatal adverse effect with the use of over-the-counter (OTC) benzocaine gels and liquids applied to the gums or mouth. Available at: http://www.fda.gov/Drugs/DrugSafety/ucm250024.htm Accessed on May 27, 2013.

Moore et al. Reported Adverse Event Cases of Methemoglobinemia Associated With Benzocaine Products. Arch Intern Med. 2004 Jun 14;164(11):1192-6.

Additional resource:

American Academy of Pediatrics. Fever and Pain Medicine: How Much To Give Your Child. Available at: http://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Fever-and-Pain-Medicines-How-Much-to-Give.aspx  Accessed on May 26, 2013

Happy Fathers Day!

Happy Fathers Day to all of our dad-readers! We hope you get breakfast in bed, to skip the yard work, to enjoy some time outdoors and the remote control all to yourself. Have a great day.

Revisiting Teething! Part 1

By Karolina Gonzalez, MAS

 

Is your little one too fussy? Always consider the “big picture” before blaming those tiny pearly whites

As a new mom I’ve already been there! When my baby starts getting fussy and irritable in the grocery store, there appears that helpful advice from an empathetic woman: “He must be teething! Have you tried this? And what about that?” Everywhere you go and your baby starts showing any disengagement cue, together with the excessive drooling and the desire to chew on something hard, someone shares with you a popular treatment to help him soothe his tender gums, right?

Parents and caregivers attribute a wide variety of signs and symptoms in young children to teething. Excessive drooling, runny nose, diarrhea, fever, and sleep problems are just a few examples. A few days ago I even heard a mom saying she was sure her baby gets constipated when teething.

Such parental beliefs are consistent worldwide, across all education levels, and for both first-time and experienced parents (Markman L, 2009). We’ve already mentioned in previous posts though, that results from research studies indicate that no symptoms are linked consistently with tooth eruption in all children. However, those popular beliefs might lead parents to try possible solutions that will not always help and in some cases, may even pose a risk for their children’s health.

Remember that young children are exposed to a wide variety of environments, illnesses and situations that may cause episodes of congestion, diarrhea or fever; and that local symptoms may occur, but systemic (whole body) symptoms are not caused by teething. This perspective will help you avoid using the “teething diagnosis” to explain either normal baby behavior or a serious illness that should be treated right away.

My baby’s first two lower teeth appeared when he was 7 months old. And even though we noticed one of his upper teeth coming in a few weeks ago, we can’t say more teeth have appeared yet at almost 10 months. I must say, though, as first-time parents, learning everything from scratch and getting to know our baby day by day, we’ve considered teething pain as the cause for him being pretty irritable at times!

Next time, we’ll continue with this series about teething, sharing an update regarding common over-the-counter medications used to treat teething pain in infants. Stay tuned!

References:

Markman L. Teething: facts and fiction. Pediatr Rev. 2009;30:e59-64.