Teething

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Q: My poor baby seems to be in serious pain now that her teeth are starting to come in. Teething has turned my sweet girl into a tiny terror! What can I do to help her (and me!)?

A: As a mother of a toddler whose teeth came in a little late (and are still coming in), I can tell you firsthand that teething is no fun for mama or baby! Once teething begins, your precious little one no longer wants to sleep at night and may be irritable and cranky, drool excessively, and chew on anything she can get her hands on. I hope I can provide some helpful tips to ease teething symptoms, because a happy baby means a happy mommy.

Did you know that a child’s teeth begin developing in the second month of pregnancy?  Teething is caused by the tooth coming up through the gum. A baby’s first tooth usually comes in at around six months, but all babies are different, and teeth can arrive earlier or later. In my case, my baby did not get her first teeth until she was close to one year old.

In the past, teething gels containing benzocaine (i.e. Orajel Baby) were recommended for discomfort, but the American Academy of Pediatrics has issued a warning against their use, due to their potential for toxicity in babies. The same holds true for some homeopathic medications. On September 30, 2016, the Food and Drug Administration (FDA) released a Consumer Product Safety Alert warning against the use of homeopathic teething tablets and gels. Many homeopathic products were found to contain belladonna, a substance that can cause seizures and possibly death if over-ingested. For the most part, relieving the pain from teething is non-pharmacologic, with the exception of infant’s acetaminophen, which I will discuss below.

So, how can you alleviate teething discomfort?

  • If possible, with a clean hand, massage the gum around the erupting tooth to provide relief.

  • Give the baby a cold teething ring to chew on. Teething rings need to be one piece to prevent choking and should be chilled in the refrigerator and not frozen. Frozen teething toys can cause damage to the baby’s gums. It may also be helpful to refrigerate your baby’s pacifier. I have heard some mothers recommend having the baby suck on a cold food, such as a frozen bagel or toast, but this is not a good idea, since pieces of the food can break off after sucking and pose a choking hazard.

  • If the pain is too much and the baby is still irritable, it may be acceptable to use infant acetaminophen (i.e. Tylenol) to take the edge off, but only after a recommendation from your child’s pediatrician. According to the American Academy of Pediatrics, teething may increase body temperature, but does NOT cause fever. A rectal temperature that is greater than 100.4 degrees Fahrenheit is not a normal symptom of teething and needs to be further evaluated by a physician. Never give a baby aspirin or rub it on their gums! Aspirin should not be used in children under 17 years old, because it can cause Reye’s syndrome.

If your child is experiencing severe symptoms or has fever, diarrhea, or is pulling her ear, do not automatically attribute it to teething, and have the child evaluated by her physician.

*Disclaimer* This article is not intended to be used as a substitute for medical advice from a healthcare provider!

References:

Tighe M, Roe MF, Does a teething child need serious illness excluding? Arch Dis Child. 2007;92(3):266.

American Association of Pediatrics. “Teething and Dental Hygiene.” HealthyChildren.org, May 11, 2013.

References:

Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis. Massignan C, Cardoso M, Porporatti AL, Aydinoz S, Canto Gde L, Mezzomo LA, Bolan M, Pediatrics 2016;137(3):e20153501

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Miriam Mason is a community pharmacist at New Utrecht Pharmacy in Brooklyn, NY. She is also a health coach and certified Whole30 coach who specializes in clean eating and helping women who struggle with their sugar addiction. If you have any questions or topics that you would like to discuss, you can contact Miriam at miriammason89@gmail.com or on Instagram.