Whether it’s pain relievers, cough medicine, or gas drops, there are shelves and shelves of over-the-counter medications marketed for the very young. When your baby is uncomfortable, whether it’s colic or teething or a very stuffy nose, it’s natural to want to do something. But there are very few times when it’s appropriate to give any kind of over-the-counter medication to a child, especially one under 2 years old. For most of the usual baby troubles, it’s best to leave the drugs on the shelf.
Because babies’ teeth come in gradually, the “teething” period can last over a year. For some babies, it’s a quick and unremarkable process, but some babies endure months of misery as their teeth erupt through the gums. Or do they?
It’s common for parents to ascribe a baby’s distress to teething when there’s no other obvious solution. Bad sleep? Fever? Red cheeks and diaper rash? It must be teething! But studies on teething babies have shown that aside from more saliva and a slight increase in loose stools, there really isn’t such a thing as a “teething syndrome.” One study in particular found an association between teething and fever, but notes:
…coincidentally, primary tooth eruption begins when infants lose maternal antibody protection against bacteria and viruses; making the baby more vulnerable to general threatening conditions as the newly pierced gingiva around an erupting tooth offers a convenient viral infection site.
That’s the most important thing to remember about teething – sometimes, what’s brushed off as teething might actually be a viral or bacterial infection that needs to be treated by a doctor.
Even if it really is teething, the medications available to treat it come with some serious risks.
Topical Gels and Creams
Several different brands of benzocaine gels are available to numb the soft tissues of the mouth for a short period. Many parents use them just before bedtime, hoping to allow the baby to fall asleep.
Unfortunately, that numbing magic can come with tragic side effects for some infants – children can develop methemoglobinemia from benzocaine exposure. The rare condition reduces the amount of oxygen that the blood carries, leading to shortness of breath, high heart rate, and in the most severe cases, death. The FDA strongly recommends against the use of benzocaine products in children under 2, because that age group is most likely to develop symptoms.
Infant acetaminophen – known by it’s most common brand name Tylenol – reduces fevers, but the jury is out on how well they work as pain relief for children under 2. That doesn’t mean you can’t use it, but use it with caution: Acetaminophen overdose is, sadly, very common in infants.
Different concentrations are available for purchase, and the kitchen spoons so often used as delivery systems are very inaccurate. In fact, after meeting with the FDA to discuss the issue in 2011, the pharmaceutical industry agreed to standardize the drug’s concentration in their formulations, and sell the bottles with measured dosing devices (i.e., those little measuring caps that come on infant medicines).
The other common infant pain remedy, ibuprofen (sold under Motrin and other brand names), isn’t FDA approved for use in infants under 6 months of age. Once it’s allowed, though, it has the same issue as acetaminophen: no clear proof of its use in relieving teething pain. Overdose is less likely, but continued use can cause stomach upset and in very rare cases gastrointestinal bleeding.
If you do decide to give your child pain medications, do so carefully, sparingly, and only after consulting your child’s pediatrician.
Natural or Homeopathic Remedies
Parents frightened by the dangerous side effects mentioned above sometimes turn to the “natural” area of the store to find more palatable options. Essential oils are sold online as super cures for teething pain, but they’re not proven to work. They are sold as very concentrated solutions, and if not diluted properly they can burn the gums.
Homeopathic teething tablets are incredibly popular, but at their safest they’re placebos, and at their worst they’re toxic. The FDA stepped in and forced a recall of one brand of teething tablets in 2010 after receiving reports of infants experiencing lethargy, difficulty breathing, and seizures.
In September 2017 the FDA once again urged parents not to use teething tablets made by homeopathic manufacturers. Some tablets marketed and sold by CVS and Hyland’s Inc. have been tested and found to contain belladonna alkaloids (atropine and scopolamine) and caffeine. In some cases, the amount of these ingredients far exceeded the specifications on the product label, and there is absolutely no federal oversight of “natural” remedies and supplements.
In short, be careful when you’re attributing your baby’s symptoms to teething. If there’s a high fever or prolonged crying, check in with a doctor. If it really is teething, there are some safer and effective ways to relieve your child’s discomfort.
Safe and Effective Teething Remedies
Pressure and cold are the best and safest ways to help your baby through the rough weeks (or months) of teething. Hundreds of different nontoxic, BPA-free teething toys are available for purchase, each with their own shape and texture.
Some have a gel inside and keep cold for a long time after they’re cooled in a fridge. It’s important to never freeze them, though, as that could cause tissue damage to the gums. If you’re using the gel-filled kind, check it often for leaks, and consider retiring it when the baby has a tooth or two, since there will be more risk of a puncture.
A wet washcloth, a chilled spoon, even a parent’s finger gently massaging baby’s gums can generate a little relief from throbbing and inflammation. Almost anything will do as long as they can safely chomp down on it – just remember to supervise your little one as they’re gumming the washcloth or teething ring you’ve given them.