Posted tagged ‘teething’

Be wary of infant jewelry and lead poisoning

September 5, 2017

The Pediatric Insider

© 2017 Roy Benaroch, MD

A recent story reported by the CDC reminds us of a few important lessons about teething, lead, and the kind of jewelry you buy at craft shows. A mom had purchased a handmade “homeopathic magnetic hematite healing bracelet” from an artisan at a local craft show. Her 9 month old daughter wore it on her wrist, reportedly to help with teething symptoms, and occasionally chewed on it (as babies are known to do.) She was found on routine screening to have a blood lead level about 10 times the safe upper limit of safety.

Lessons to learn:

Babies really shouldn’t wear jewelry at all (they look good without it!) Some bling is probably OK (like small earrings), but you have to be sure they’re not made with lead. That’s because anything on a baby or near a baby will end up in the baby’s mouth. Seriously, everything.

This particular bracelet was triple-dangerous. Looking at the photo, it was made of little beads strung together, which apart from their poisonous lead content were a potential choking hazard. And: magnets are a very bad thing for kids to swallow, because they can glom onto each other in clusters, or even while pinching a piece of intestine. Magnets are less likely to make their own way out without causing big-time tissue damage. No lead, no beads, no magnets!

Babies should especially never wear any kind of jewelry around their necks. Even a small tug on a necklace can close off the airway and kill a baby. That includes those trendy amber teething necklaces, which are both a choking and strangulation hazard. There are media reports of deaths from those things. Look out for long cords or straps on pacifiers, or cords on window blinds or binoculars or anything else thin and round and shaped in a loop. Anything that could wrap around a neck can strangle a baby and needs to be cut to pieces or kept very far away.

And: teething. Most babies experience teething with no symptoms whatsoever – the only way you know, with most babies, is that you see teeth poking out. An occasional baby might have some fussiness with teething, and you can treat them with love and cuddling, maybe a teething ring, or some acetaminophen if needed. There is no great plague of terrible symptoms of teething that need constant treatment, especially not with dangerous things. Teething is just another thing most parents do not have to worry about.

Other dangerous teething “cures” have included “homeopathic teething tablets” which contained poison, and benzocaine-containing teething gels (now mostly off the market) that caused a potentially fatal blood disorder. The sad thing here is that none of these were ever really needed – they’re marketed based on fear of a normal, harmless condition. Don’t waste your money, or endanger your child’s health, on jewelry or potions to treat teething.

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Homeopathic teething pills: Still poisonous

October 4, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

In 2010, I wrote about the FDA’s recall of Hyland’s Teething Tablets. It turned out that the tiny little pills, sold to allegedly help babies with teething symptoms, had measurable and potentially toxic amounts of a poisonous plant extract, belladonna. See, they were supposed to not actually have any of that, because homeopathic products aren’t supposed to have any of anything.

One principle of homeopathy works like this: by ultra-super diluting a poison, you get a cure for the poison, or at least relief of the symptoms that the poison would have caused if you ingested it. Which, of course, you shouldn’t do (ingesting the actual poison is discouraged, until it’s ultra-super diluted and isn’t there anymore. That’s what you’re paying for.) Those Hyland’s Tablets turned out to contain the poison that wasn’t supposed to be in there. Oops.

By the way, it’s called “belladonna” from the Italian roots for “beautiful woman”. Belladonna comes from the nightshade plant, and this “natural” chemical will make your pupils dilate (that’s the beautiful part.) It can also cause excessive sleepiness, muscle weakness, difficulty breathing, agitation, and seizures. Those parts are less beautiful.

Last week, on September 30, the FDA updated their 2010 release, warning consumers against using any homeopathic teething tablets or gels. This includes not just Hyland’s products, but those sold at CVS and other retail and online stores.

The bottom line: if they’re manufactured correctly, homeopathic products don’t contain any active ingredients at all. There is nothing in there that could possibly help with teething or any other condition. Oh, sure, there may be other things added to homeopathic products to make you drunk, but that’s not the point. Homeopathic products should be as safe as drinking a little water or swallowing a tiny little sugar pill—because that’s exactly what they’re supposed to be, a little vial of water or a tiny little placebo pill.

That’s if they’re made the way they’re supposed to be made. But homeopathic products, like all of the other alt-med goodies sold next to the real medications, aren’t regulated. There’s no guarantee of purity, and no guarantee that what’s on the label is on the bottle. You’re paying for what you hope is a bottle of literally nothing, but you might accidentally get something that can hurt you.

Funny world, isn’t it? Can you imagine someone complaining to the manufacturer that their placebo was contaminated with a biologically active substance that might actually have an effect on their body? Hey, I paid good money for absolutely nothing, and that’s exactly what I wanted!

Anyway: if your baby seems to be having teething symptoms, try hugs and love or a dose or two of acetaminophen. If that doesn’t help, go see your doctor (it may not be teething at all—those little babies can’t talk yet, and it’s hard to know exactly what’s on their minds. Maybe they got a glimpse of that presidential debate, and they’re understandably worried about the future.) “Homeopathic Teething Tablets” certainly aren’t going to help, and might just make your baby sick.

belladonna

Gas drops, teething tablets, and pinkie straighteners

February 6, 2012

The Pediatric Insider

© 2012 Roy Benaroch, MD

A carnival. A white-toothed, perfectly-haired Huckster stands on a platform in front of a crowd of parents.

The Huckster: “Step right up! I’ve got what every parent needs! A fix to one of The Most Serious problems your child has—right now!”

Boscoe’s mom: “There’s nothing wrong with my Boscoe! He’s the very picture of health!”

The Huckster: (looking down with concern at Boscoe, aged 2) “Hmmmm… yes, yes, I can see why you’d say that, Ma’am. But I can tell he’s headed for trouble! Just look at that pinkie!”

The Huckster reaches down, and picks up Boscoe, who continues to eat his cotton candy. His mouth is blue and sticky (the child, I mean.) The Huckster holds up Boscoe’s pinky finger to the crowd.

The Huckster: “Look!”

The crowd gasps, and inches forward.

 Boscoe’s mom looks apprehensive, but confused. She turns her head sideways.

Boscoe’s mom: “That’s his pinky. I don’t see anything wrong with it.”

The Huckster: “It looks ok now, sure, but if you look at it from the side— Behold! It isn’t straight!”

Pandemonium ensues. The crowd erupts in fearful chatter. A woman faints. Sirens can be heard in the distance, and strobe lights from the nearby Tilt-a-whirl along with inexplicable gusts of smoke add to the mayhem. The Huckster seems to have grown taller, looming over the crowd.

 Boscoe continues to eat his cotton candy.

Boscoe’s mom, joined by several other onlookers, wails: “What can we do?”

The Huckster: “I have just the thing you need!”

From the depths of his topcoat The Huckster draws out a handful of devices, each of which looks like two pencils held together by rubber bands. The crowd pushes fistfuls of money at him, buying each for $19.95.

There is a sneaky and pervasive influence on health expectations, and I’ll bet most of us have fallen for it. Companies—The Hucksters—are trying to sell you things. And often, to sell them, they’ll first convince you that your child has a problem. Then, surprise, they’ll turn out to have the perfect thing to fix it.

Take “gas drops.” Usually made of simethecone (sold in common brands like Mylicon, and many others), these products “cure” your child of “gas.” But it’s just The Huckster at work. The truth is, farts do not hurt. Sure, newborns might be surprised and alarmed at the weird, unexpected feelings of stuff moving around in their little tummies, but that’s not pain, and it’s not anything that needs medicine. What it needs is love and support and reassurance, so babies learn that they don’t have to worry about these normal sensations. Gas and farts are a normal part of life. They are not a medical condition that needs a cure.

No medical study has ever shown that any gas remedy (including simethecone, but also gripe water and anything else you can find) actually helps alleviate any symptoms. It helps The Hucksters, but they certainly won’t help you or your child. If you’re using them, and they seem to work, it’s because symptoms we call “gas” always come and go. You give the gas drops when there are symptoms, and the symptoms improve—because they always improve. Go ahead and give the gas drops when there aren’t symptoms, and you’ll likely see that soon enough symptoms will start up again. Because they come and go, no matter what “medicine” you’re giving.

Another example: teething tablets. Study after study has shown that teething children have no consistent symptoms. The only thing teething causes is teeth. Sure, infants often have fussy times, or loose stools, or feel warmish—but they do that whether they’re getting teeth or not. It’s not the teeth, it’s the child. Teething is not a medical problem, but there sure are a lot of Hucksters who will tell you otherwise. And they’ll sell you something, too!

The vast majority of these nonsense cures are perfectly safe, and they’re actually not very expensive. So what’s the harm? The biggest problem I see is that parents get convinced that their children have many problems, and that every problem needs a cure. Most kids are very healthy, and few kids actually need any kind of medicine at all. That may sound weird, coming from a doctor, but honestly I will tell you that 90% of the “cures” given to our children (whether prescription, non-prescription, alternative medicine, voodoo magic beans, or stuff purchased at a carnival) are completely unnecessary and do nothing to help your child.

Don’t fall for The Huckster. Save your money, hug your child, and stay away from the drug store. If you do go to the carnival, take the rides, but don’t be taken for a ride. Tell The Huckster your child’s pinky is straight enough, and go get yourself a hot dog instead.

Teething, Grandma, and John Locke

April 26, 2009

Magan asked “Is it a myth that children run a fever with teething?”

A good rule for pediatricians is: Don’t pick a fight with Grandma. But here at the Pediatric Insider, we don’t shy away from controversy—especially since Grandma isn’t reading the blog.

Teething had been thought for centuries to cause all kinds of ill effects, from fevers to seizures to death. John Locke (1632-1704), English philosopher and physician, wrote that “Convulsion fits before tootheing are from gripeings in the belly”, and recommended a form of opium, almond oil, and therapeutic bleeding to prevent fevers and “height of blood” from this scourge. Times were rough for babies then, and the doctors didn’t make life any easier.

A few recent studies (summaries here and here) have tried to pin down an association between teething and symptoms. Both of these had some important drawbacks: they’re not very big, and teething and symptoms were reported by parents who could easily figure out what the study was for. The data sets were incomplete, too—leading the authors to point out that parents were more likely to fill out logs when their children did have symptoms, rather than turn in reports of healthy days. Though both studies did find weak and inconsistent associations with a number of minor symptoms, reports of low fevers were inconsistent and didn’t reliably fit with days of teething. High fevers (> 102 F) definitely did not occur with teething.

Though it’s possible that minor symptoms or low grade fevers could occur with teething, it’s clear that significant symptoms and fevers do not. If your baby has a fever > 102 or any serious symptoms, don’t blame it on teething—or from “gripeings in the belly.” And don’t tell grandma I told you that!