Monday, December 5, 2016

Safe Help for Teething in Infants and Toddlers

     Most infants get their first teeth at 5-9 months of age. For months before this, you may not see much happening at the gums (not puffy or swollen). But leading up to the teeth breaking through, many infants drool more than ever and chew more for comfort. Although some infants and toddlers cruise through teething without much pain and discomfort, other little ones are intermittently uncomfortable. The pain and the teeth actually breaking through do not always correlate well. In other words, your infant might be having a great week when a tooth actually breaks through, but the previous week was filled with fussiness. You may be wondering how to safely help with teething discomfort.
     Teething toys are a good option for teething discomfort. Teething rings, wet washcloths kept in the freezer for 10 minutes or so (we want them cold but not frozen), a favorite blanket or toy, and your fingers (can be a big ouch!) are all good options. The liquid filled teethers are thought to be unsafe as they can break open - so avoid those.
     Another treatment option for teething pain that you may have heard about is Amber Teething NecklacesHere is a link to more information about these necklaces. We do not recommend them, as we feel they may not be safe and there is no scientifically sound information to show that they work.
     We have recommended the Baby Orajel and Ambesol for many years. These products contain benzocaine, a topical numbing agent. Recently recommendations have changed and the Federal Drug Administration no longer recommends the routine use of benzocaine because of the risk of methemoglobinemia, a rare but serious condition when the blood cannot carry the oxygen properly. In addition to possible safety issues with the benzocaine, anything massaged on to the gums washes away very quickly because of all the drool.
     We are asked about the use of acetaminophen (Tylenol) and ibuprofen (Motrin and Advil) for teething discomfort. The truth is we think these are safe to use on occasion for discomfort, but we do not think it safe to dose many times in a week. A safe guideline might be to "save it" for the 2-3 times a week when things are at their worst and nothing else seems to help. Daily doses of Tylenol or Motrin for teething given on a regular doses may not be safe for your liver or kidneys.
     I love referencing the Healthy Children website. They have so many good articles about so many issues in kid's health. Their page about teething found here has lots of good information. Ask your doctor at an appointment if you have questions or call during regular office hours. Good luck!

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