Teething signs parents should not ignore
When a baby is born between four to six months, teething signs begin to occur. While most parents see it as a condition that needs to be treated, it is just a developmental phase in a baby’s life, so proper care should be taken just as it is important to care for a baby.
According to a paediatrician at Healing Strips, Lagos, Dr. Osueni Gold, teething is a normal physiologic self-limiting process in humans and usually starts from about the fourth month of infancy. It is not an illness and as such, does not require specific “anti-teething” treatment.
With teething, the initial phases involve eruption of the teeth (usually the ones on the lower jaw) through the gums and this is sometimes associated with some redness and mild swelling of the gums as well as some discomfort. The teething process actually continues well into childhood with eruption of all the primary or milk teeth and subsequent eruption of the permanent teeth. Other things that might be noted during the teething process are excessive drooling of saliva and a slight reduction in the appetite of a few children.
There have been reports of fever, but all research points to the fact that any fever higher than 38.3 degrees Celsius or 101 Fahrenheit is very unlikely to be because of teething and, as such, another cause of the fever must be sought.
There have also been claims of loose stools or a slight change in the colour of the stools during this period. Studies have actually shown that teething and stooling are not usually associated. However it must be noted that any diarrhoea that involves copious watery stools or the presence of blood is not as a result of teething.
Dr. Osueni also noted that it is important for parents to understand that the period of teething coincides with the prevalence of upper respiratory tract infections as well as common viral infections in children. As such, the symptoms of these illnesses are commonly mistaken for teething. A prospective study done in Scotland to evaluate 50 children aged 3-30 months who presented to their doctors with complaints of teething showed that 48 of these children had several types of infections including upper respiratory tract infection, bronchitis e.t.c and one even had meningitis.
She said that according to the National Institute for Clinical Excellence (NICE guidelines) and the American Association of Paediatrics (AAP), the following are acceptable measures.
. Gentle rubbing of the gums with clean fingers to help soothe the gums. It also helps make it easier for the teeth to erupt through the gums.
. A child can bite of a clean cool object which could include a clean teething ring (preferably one that is intact and bumpy) or a clean cool wash cloth or children who have begun weaning (less than 6months old) can be given chilled fruit or vegetables like a piece of banana or cucumber. These items should be cooled in the fridge, not freezer, and kept clean. If fruits are to be used, the parent should hold it and use things that don’t easily break up into pieces so as to prevent choking hazards. What these measures do is to produce a counter pressure against the swollen gums and this in addition to the cold sensation soothes and anaesthetizes the area, causing relief.
. In a few cases when there is a fever, syrup paracetamol or ibruprofen can be given at the appropriate doses only to children greater than 3 months of age. Remember, if this fever is high or prolonged, it is very unlikely to be as a result of teething and as such, a paediatrician should be sought immediately.
So what should NOT be used for teething?
Essentially everything else apart from the above recommendations has no basis or good evidence. These include:
. Teething powders and mixtures- there isn’t reliable evidence that any of these formulations are actually helpful and some have been downright lethal. In 2008, about 84 children died in Nigeria following the use of My Pikin Baby Teething Mixture, which was tainted with diethylene glycol, which is a cheap industrial solvent used as a sweetener instead of glycerin. The makers of this product were prosecuted and convicted in 2013.
. Use of topical anaesthetic agents and gels are generally unnecessary and unadvisable and, depending on the contents, can result in Reyes syndrome or even convulsions.
. Some cultures practice lancing or cutting the gums to hasten the eruption of the teeth and this amongst other things can cause disfigurement and infections of the gums and teeth.
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