Steven Novella recently wrote a post discussing an FDA warning against the use of homeopathic teething products over safety concerns related to the possibility of toxic amounts of belladonna. He goes into the hypocrisy of the FDA regulation of homeopathic products, a topic covered numerous times here on Science-Based Medicine, as well as the misleading initial response from Hyland’s, producers of the most popular homeopathic teething remedies in the United States and Canada. There have been some updates over the past two weeks that I’ll cover in this post. (more…)
The FDA recently put out a consumer warning about homeopathic teething gels and pills. The warning states:
The FDA recommends that consumers stop using these products and dispose of any in their possession.
The warning is not because all homeopathic products are inherently useless. As we have discussed here often, the basic principles of homeopathy are pure pseudoscience. The practice of diluting substances so that almost no or no active ingredient remains means that most homeopathic products are just sugar pills. Further, clinical studies show that homeopathic products don’t work. There isn’t a single homeopathic product that has been shown to be effective for a single condition with rigorous clinical trials.
The FDA acknowledges this, writing in their warning:
Homeopathic teething tablets and gels have not been evaluated or approved by the FDA for safety or efficacy. The agency is also not aware of any proven health benefit of the products, which are labeled to relieve teething symptoms in children.
As a pediatrician I have an opportunity to observe a wide variety of unusual and sometimes alarming parental efforts meant to help children through illness or keep them well. I have recently noticed one particular intervention that seems to be becoming more prevalent, at least in my practice. I’ve begun to see more and more infants sporting Baltic amber teething necklaces. These consist of multiple small beads of amber on a string that is worn around a baby’s neck, and are supposed to relieve the discomfort of teething. Before I had any idea what these necklaces were for or how they were supposed to work, my first reaction was to inform these parents of the dangers of necklaces or anything placed around an infant’s or young child’s neck. Strangulation is a known cause of accidental injury and death in children, and pediatricians are trained to discuss this as part of the routine anticipatory guidance we give to parents. In addition, we strongly advise against giving infants or young children any small items that could be accidentally aspirated, such as the beads found in a necklace of this sort. But I was equally surprised to learn that these necklaces are not intended for babies to chew or gum. Instead, they are supposed to ease a baby’s teething discomfort simply by lying against the skin.
I will not discuss teething here, or the many myths that surround it; that was well covered in a previous post. I will reiterate that there is little-to-no evidence that the majority of concerns parents have about teething are actually due to teething, including fever and diarrhea. The irritability associated with teething also tends to wax and wane for only several days before and after the emergence of a tooth. But let’s assume for the moment that these necklaces actually work to ease the discomfort of teething, and whatever other problems parents tend to associate with the long period of time during which infants and young children develop their teeth. Assuming these necklaces work as recounted in the glowing testimonials on countless websites and parent blogs, how do they produce their dramatic results?
Your baby’s goobery, soon-to-be-chompy mouth, with a tooth breaking through in the middle
Teething is one of the most common sources of parental concern in the world of pediatric medicine. All children go through it, typically starting at about 6 months of age, and the current list of signs and symptoms attributed to the eruption of teeth in infants is long and varied, with most if not all of them inaccurate if not highly suspect. And although teething as a concept may seem rather commonplace, it is an entity with an interesting history and a frequent impetus for exposing young children to ineffective and even risky treatments.
What is teething?
Simply put, teething occurs when a tooth nears completion of its journey into the oral cavity, a journey which begins early in fetal development. The tooth erupts though the gum, often preceded by a small lump. Occasionally there can be a larger eruption cyst, and the area may appear somewhat bluish and swollen from bleeding into the tissue, but this is uncommon. The most widely accepted duration of a bout of teething is a roughly 8 day period, with tooth emergence generally felt to occur on day 5. The whole process usually takes about two years, with an average of one tooth emerging each month until the full complement of 20 baby teeth are present. (more…)