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Your Baby

High Lead Levels in Baby Bracelet

2:00

After an infant girl in Connecticut developed lead poisoning, the cause was found to be a bracelet made with lead beads. Doctors discovered that the 9-month-old had abnormally high blood lead levels during a routine checkup.

Her blood lead level was 41 micrograms per deciliter (ug/dL); anything over 5 ug/dL is considered abnormal, according to a recent report by the Centers for Disease Control and Prevention (CDC).

Health investigators visited the infant’s home to try and determine where the lead originated. They found lead based paint on windows in the home; however, the child would not have been able to reach the windows. There were also 3 siblings in the house between 3-5 years old whose lead levels tests came back normal.

Investigators also found a homemade bracelet that the infant was given to chew on to relieve teething pain. The beads on the bracelet contained extremely high levels of lead; 17,000 parts per million (ppm). The amount of lead that's considered safe for children's products is 90 ppm or 100 ppm, depending on the type of product, according to the U.S. Consumer Product Safety Commission (CPSC).

Investigators were unable to track down the manufacturer of the beads in the Connecticut case or the bracelet maker, according to the report.

In 2003 and 2006, there were several cases of severe lead poisoning and death linked to lead-containing jewelry and charms marketed to children, the report said. After these instances, the CPSC set limits on the amount of lead allowed in products marketed to kids, and each year, there are recalls of children's jewelry that exceed those limits. However, the limits do not apply to products that aren't intended for use by children, the report noted.

There's no safe amount of lead exposure for children, according to the CDC, and the toxic heavy metal can affect nearly every part of the body. In many cases, lead exposure can occur with no obvious symptoms. Symptoms of severe lead poisoning can include confusion, seizures, coma and death.

Lead in the body is distributed to the brain, liver, kidney and bones. It is stored in the teeth and bones, where it accumulates over time.

For severe cases of lead poisonings, doctors will sometimes recommend Chelation therapy or EDTA chelation therapy.

There are safe non-toxic ways to treat teething pain in infants. The American Academy of Pediatrics (AAP) suggests using a chilled teething ring or “gently rubbing or massaging the gums with one of your fingers.”[3] However, there are safety concerns about plastic teething rings.  A 2015 study found chemicals that can affect the child’s hormones (also called endocrine-disrupting chemicals, or EDCs) in several types of plastic baby “teethers..”For this reason, parents may want to avoid using teethers made of any kind of plastic. While there are several non-plastic alternatives on the market which claim to be safe, some of these products may not have been adequately tested. In addition, some teething products could break or leak, presenting other safety concerns.

Safe ways to help your infant through the teething period include gum massage, a chilled spoon from the refrigerator (not the freezer!) to suck on, a chilled wet washcloth dipped in water, breast milk or chamomile tea to chew on, or chilled foods such as applesauce or yogurt to soothe pain.

Talk to your pediatrician first before applying any over-the-counter products for teething. Never put Lidocaine on your child’s gums.

In 2016, the FDA urged parents to avoid homeopathic teething rings that contain Belladonna. Belladonna comes from the deadly nightshade plant and can be poisonous.

The bottom line on easing teething pain in infants is to talk with your pediatrician about ways to help your little one can get through this sometimes challenging time.

Story sources: Sara G. Miller, https://www.livescience.com/60287-teething-bracelet-causes-lead-poisoning.html

 

 

 

Daily Dose

Teething Pain & Recalled OTC Products

Do OTC teething products really work? Which ones have been recalled? WHat parents need to know.I am getting a lot of questions from patients related to teething, pain, and the recall of over the counter teething products that contain benzocaine.

The FDA recently issued a warning to parents who use OTC products like Oragel and Anbesol on their infant’s gums for relief of teething pain. These products come as both liquids and gels, and benzocaine is the active pain reducing ingredient. It has now been found that excessive amounts of benzocaine may lead to a very rare, condition called methemoglobinemia. (Hemoglobin is the molecule in the red blood cell that carries oxygen). With methemoglobinemia there is a reduced amount of oxygen that is carried in the bloodstream which may lead to a bluish gray discoloration to the skin, shortness of breath, a rapid heart rate and fatigue and lethargy. Although the FDA did not withdraw these products from the market, they did recommend that they not be used in children under two, and then should be used “sparingly”. Unfortunately, the benzocaine containing products do not yet contain warning labels. I have never recommended using these products in the first place. I always wondered if they really helped a baby who was teething, as I am not sure you can tell when a baby is teething in the first place. If you watch any infant over the age of 4 months, their hands are always in their mouths, and they are constantly drooling!  Does that mean they are getting teeth? Unlikely, as most babies don’t even cut their first tooth until about 6 months, so they have been drooling and putting anything they can in their mouths for months prior. The drooling and “gnawing” on their hands (and sometimes feet too) is rather a developmental milestone and not always a sign of teething. My theory is let the baby chew on a teething ring, a frozen piece of a bagel (cut into quarters, good for gnawing and can throw out when used), or rub their gums with a cold washcloth if you think your child has discomfort. Babies will get teeth for many years to come and once the first several have broken the skin we don’t seem to pay as much attention anyway, right?  I mean, who is going to worry about a child cutting their 2 year old molars, there are way too many other issues to deal with (tantrums, climbing, throwing food) than if their molars are erupting. So, save your money and don’t buy teething products. Now the FDA even agrees! What do you think? I look forward to your feedback.

Daily Dose

Teething Questions Never End

I saw a lot of nine to 15-month-old babies yesterday and there were many questions related to teething.  Your child may get their first tooth as early as three to four months of age on up to 18-20 months of age.

The average age for a baby to cut their first tooth is usually around six months of age, and typically the lower central incisors are the first teeth to erupt. There have been many articles written on teething, but the longer I practice the less I believe that parents, or doctors for that matter, can tell if there is a lot of pain associated with teething. It seems if any baby or toddler is fussy, whiny, clingy or not sleeping, it is often attributed to teething. But children will cut 20 teeth in the first two to three years of life and the majority of the time they do so without a lot of fuss or even suspicion until a tooth is suddenly there. If they have pain related to teething it is probably only for a day or two prior to the actual eruption of the tooth. It is certainly not days and nights on end. As parents we want to be able to blame these difficult your-baby moods on something so why not teeth as a new one is always somewhere in the gums. Children will also lose all of these baby teeth beginning around 5 years of age and here we go again with new teeth erupting. But, no one is blaming poor grades at school, or inappropriate manners, or fighting with your sibling on teething pain! It just doesn't make sense that it hurts when younger than older, a tooth is a tooth. So...that being said, I am not a big fan of oral topical analgesics for teething. They just make the mouth numb and the tongue too as the child spreads the "goop" all over their mouth. I do think you can give an infant a dose of Tylenol if you see a tooth erupting, but only for a day or two. Many of the mothers and dads I talked to today had been giving daily and nightly doses of medication as they thought their child's awakening must be teeth. I am afraid it is probably more a habit of awakening and that needs to be addressed but not with nightly Tylenol or Advil. Wish I could ask the tooth fairy for a comment. That's your daily dose, we'll chat again tomorrow. Send your question to Dr. Sue!

Your Baby

Teething May Make Your Baby Fussy, But Not Sick

2:00

Parents sometimes have trouble distinguishing between whether their cranky baby is actually ill or is just getting his or her first teeth. Because a baby’s gums may be tender and swollen as their teeth come in, a slight rise in temperature can occur.  Other changes may happen as well such as fussiness and increased drooling. All- in –all, babies can be pretty miserable till those first teeth break through.

That said, teething does not cause a full-fledged fever above 100.4 degrees Fahrenheit or any other signs of illness according to a new review led by Dr. Michele Bolan, of the Federal University of Santa Catarina, Brazil.

Certain symptoms can be confusing for parents says Dr. Minu George, interim chief of general pediatrics at Cohen Children's Medical Center, in New Hyde Park, N.Y.

"I get questions about this on a daily basis," said George, who was not involved in the study.

When a baby’s temperature reaches 100.4 degrees F or higher, it becomes an actual fever, not just a slight increase in temperature.

"Fevers are not a bad thing," she pointed out. "They're part of the body's response to infection." But, George added, parents should be aware that a fever is likely related to an illness.

Of course, new parents are going to be somewhat edgy when it comes to caring for their infant. It’s a new world of responsibility that can seem overwhelming at times. 

Pediatricians and family doctors regularly answer questions about this topic with an explanation of how a typical teething experience presents.

Over the ages, other symptoms have been linked to teething that should never apply. They include sores or blisters around the mouth, appetite loss and diarrhea that does not go away quickly. Any of these symptoms warrant a call to your pediatrician.

Babies differ in age as to when their teeth begin to come in.  Typically, the fist tooth begins to erupt around 6 months of age. It can also be as early as 3 months and as late as 1 year of age. There really isn’t a set age for teething to begin, just an average.

Baby’s teeth usually erupt through the gums in a certain order:

·      The two bottom front teeth (central incisors)

·      The four upper front teeth (central and lateral incisors)

·      The two lower lateral incisors

·      The first molars

·      The four canines (located on either side next to the upper and lower lateral incisors)

·      The remaining molars on either side of the existing line of teeth

By age 3, most children have all 20 of their primary teeth.

As for helping babies get through the misery of teething, George advised against medication, including topical gels and products that are labeled "natural" or "homeopathic."

Instead, she said, babies can find relief by chewing on a cooled teething ring or wet washcloth, or eating cool foods.

The analysis was published in the February online edition of the journal Pediatrics.

Sources: Amy Norton, http://www.webmd.com/parenting/baby/news/20160218/teething-makes-babies-cranky-but-not-sick-review

http://www.webmd.com/parenting/baby/tc/teething-topic-overview

Your Baby

FDA Warning: No Homeopathic Teething Tablets or Gels

1:45

Some babies have little to no symptoms during teething, while others experience quite a bit of pain for months. When teething pain occurs, infants may cry and be irritable until they find relief.

Homeopathic tablets and gels aimed at helping soothe babies’ pain may be dangerous for infants and toddlers, the Food and Drug Administration (FDA) recently announced in a statement. 

The FDA is investigating reports of seizures in infants and small children who were given homeopathic teething products, which may contain "natural" compounds but are not regulated as drugs by the FDA.

In addition, the FDA said in the statement that "consumers should seek medical care immediately if their child experiences seizures, difficulty breathing, lethargy, excessive sleepiness, muscle weakness, skin flushing, constipation, difficulty urinating or agitation" after using homeopathic teething tablets and gels.

According to the National Center for Complimentary and Integrated Health, homeopathy relies on two theories: “like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy people; and “law of minimum dose”—the notion that the lower the dose of the medication, the greater its effectiveness.

The FDA said in the statement that the agency is not aware of any proven health benefit of using homeopathic teething tablets and gels.

In 2010, the FDA issued a safety alert about a homeopathic teething tablet that contained belladonna. Belladonna — also called deadly nightshade — is a poisonous plant that contains a chemical called atropine. At high levels, atropine can be deadly. In homeopathy, it is used to treat redness and inflammation.

At the time, the FDA found that the teething tablets contained inconsistent amounts of belladonna. The company that made the tablets, Hyland, subsequently recalled the product.

Hyland issued a statement and video in response to the current FDA warning against the use of homeopathic teething remedies.

"As you may have seen, on September 30, 2016, the Food and Drug Administration issued a surprise statement recommending that consumers discontinue use of homeopathic teething tablets and gels because they may pose a risk," Hyland's stated. "We are fully cooperating with FDA’s inquiry and we’re providing them with all the data we have. We also hope to learn from FDA what facts, if any, the Agency has based its action on."

Hyland also noted “The safety and effectiveness of Hyland’s natural homeopathic medicines is our top priority. That’s why we work with regulators to ensure that our products meet the highest standards. If we ever had reason to be concerned of that safety, we would act immediately."

"Teething can be managed without prescription or over-the-counter remedies," Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said in the FDA statement. 

The American Academy of Pediatrics (AAP) recommends teething rings or hard, unsweetened teething crackers. Do not use frozen teething toys because they can cause more discomfort by injuring a baby's mouth, the AAP advises.

Be sure and check with your pediatrician about teething pain relief if your little one is having a hard time getting through the teething process.

Story sources: Sara G. Miller, http://www.livescience.com/56352-fda-warning-homeopathic-teething-tablets.html

Michael Johnsen, http://www.drugstorenews.com/article/hylands-responds-fda-teething-tablet-warning

 

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