Teething Tablets Not Recommended
On April 20, 2017, the FDA recalled Hyland's homeopathic teething tablets.
For many years now, many parents have asked me if I recommend teething tablets and if they even work.
I always told them that didn't recommend them because the ingredient concentrations are not known or clear. Hyland's website (http://www.hylands.com/products/hyland%E2%80%99s-baby-nighttime-teething-tablets) lists the ingredients and their benefits as follows:
"Calcarea Phosphorica 6X HPUS
Chamomilla 6X HPUS
Coffea Cruda 6X HPUS
Belladonna 12X HPUS (0.0000000000003% Alkaloids)
HPUS indicates the active ingredients are in the official Homeopathic Pharmacopia of the United States."
Belladonna is listed as 12X HPUS. How much is this? Is it really safe for our babies? In addition, in 2010, the FDA has also advised against these tablets due to inconsistent dosing of Belladonna alkaloids from bottle to bottle (http://www.cnn.com/2016/10/12/health/hylands-teething-tablets-discontinued-fda-warning/). If I didn't know what I was really giving to my baby, I wouldn't give it to my baby. Therefore, if I couldn't give it to my baby, I couldn't recommend it as a pediatrician.
In addition, I used to tell parents that based on parents' feedback, it seemed that these tablets worked about 50% of the time. Given that it wasn't consistently helpful, I didn't recommend them.
Hyland's Teething Tablets Recalled
Now, I say even more. I say absolutely not. There have been ten (10) deaths linked to Hyland's teething tablets. "The FDA concluded that the products have mislabeled the amounts of belladonna alkaloids they contain." (http://www.cnn.com/2017/04/14/health/hylands-teething-tablet-fda-recall-bn/) There have also been seizures linked to them as well. There are of course other homeopathic teething tablets. However, the same problem exists. How much of each ingredient is in each tablet? Unknown. So, the bottom line is, I don't recommend teething tablets.
What To Do For Teething Pain Relief
So the question remains, what to do to help relieve the pain? There are several recommendations:
(1) Use a cold wet wash cloth (kept in the fridge) that your baby can chew on.
(2) Have your child chew on a frozen bagel.
(3) Have your child chew on a frozen banana.
(4) Have your child chew on an ice cube.
Be careful with any of these items that your child can chew on. Always supervise your baby in order to prevent your child choking. In addition, chewing on a frozen item needs to be for a limited time to prevent physical injury due to prolonged cold. I recommend using a fresh food feeder. This is essentially a small mesh bag that your infant can chew on without choking. As always supervise that as well.
Teething is a painful time in infants' lives. However, teething tablets or bells that contain belladonna and/or benzocaine are not recommended.
The Blue Whale game is a social media suicide game that has been linked to over 150 children suicides. To date over 130 children suicides in Russia have been linked to the Blue Whale game. The game has made its way to Europe. It has been linked to suicides in Portugal, Spain, England, and Ireland as recent as April and May of 2017. (www.crimeonline.com/2017/05/22/parents-please-read-dads-warning-after-son-found-dead-after-playing-blue-whale-suicide-game)
The Blue Whale Game is an online interactive challenge game that starts with an assignment of tasks for the player. A series of tasks occur over a 50 day period to complete. Some tasks may be as simple as watching a horror movie. Gradually, the tasks are increasingly more severe involving self inflicted injuries. As each task is completed, the player posts a picture of the task on Instagram. Although this game has typically been played on Instagram, other social media platforms have been used as well. Some posts include pictures and videos of self inflicted wounds include a whale carving on an arm, balancing on a roof, or a pool of blood. The player wins at the end of the game, when they complete the final task of suicide. In some cases, this has involved posting "End" with a picture of a blue whale.
Instagram has begun to post a warning regarding the Blue Whale game when a search is done for the term "blue whale."
The game's creator, Phillip Budeikin, from Russia, is imprisoned. He started the game in 2013. He has stated that he was cleansing society of certain people that were biological waste. Even though he is imprisoned, other "death groups" have continued with the Blue Whale game. In addition, the creator receives love letters in prison.
Please discuss the Blue Whale game, its dangers, and its links to suicide with your children and their friends, especially if you have my concerns regarding depression or suicide in your children or notice my change in their behavior.
Zika Virus | International Public Health Emergency
Zika Virus is a global health scare, especially for pregnant women. Due to the October 2015 cluster of 524 cases of newborns in Brazil diagnosed with microcephaly and other neurological disorders reported in Brazil, World Health Organization (WHO) has stated that it is as a Public Health Emergency of International Concern. (bit.ly/1PYrRKs)
What are the symptoms of the Zika Virus?
When humans become infected, they may develop symptoms which include fever, itchy rash, headache, red eyes, joint pain, muscle pain, and temporary paralysis. Typically, symptoms last for 2 to 7 days. Incubation period is unknown, but ranges from a few days to a week (1.usa.gov/1MMg1Qi).
There has also been an increase in incidence of Guillain-Barré syndrome that has coincided with increased incidence of Zika Virus. (bit.ly/22Tg8mx)
Pregnant women infected with the virus have had newborns with microcephaly and brain damage. It is believed that the virus has spread from the infected mother to baby in utero and during delivery. Zika virus has been found in the brain tissue of these infected babies.
Where Did Zika Virus Start?
According to WHO, it was originally detected in a rhesus monkey in Zika Forest, Uganda in 1947 and in humans in Nigeria in 1954 (bit.ly/1QeAEcO). Before 2015, the virus was found in Africa, Southeast Asia, and the Pacific Islands. Currently, there are many countries around the world with local mosquito-borne Zika virus disease cases as noted on the CDC website at 1.usa.gov/1Mv4zhb Currently, countries affected by local transmission include Aruba, Barbados, Bolivia, Bonaire, Brazil, Colombia, Puerto Rico, Costa Rica, Cuba, Curacao, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Saint Martin, Saint Vincent and the Grenadines, Sint Maarten, Suriname, Trinidad & Tobago, U.S. Virgin Islands, and Venezuela).
Is Zika Virus in the United States?
Yes. However, only travel associated cases have been reported in the United States. However, "local mosquito-borne transmission of Zika virus has been reported in the Commonwealth of Puerto Rico, the US Virgin Islands, and America Samoa." (1.usa.gov/1RvWNAq) As of March 28, there have been 273 travel associated cases have been found in the U.S., including in Hawaii. There have been 258 locally acquired cases in Puerto Rico, 10 in the U.S. Virgin Islands & 14 cases in the American Samoas.
How is Zika Virus Transmitted?
It is most commonly transmitted by a mosquito bite. It can also be sexually transmitted and via blood transfusion. It is unknown how common sexual or blood transmission is among humans.
Can Zika Virus Be Sexually Transmitted?
Yes. The CDC recently reported on February 2, that this virus was sexually transmitted in Texas, USA (cnn.it/1WSuiRd). In addition, Florida confirmed on March 9 & California confirmed on March 25, that they too have had their first case of sexually transmitted Zika Virus. As a result of confirmed sexual transmission of the virus, the CDC now recommends that if you are a pregnant women whose "male sexual partner has traveled to or lives in an area with active Zika virus transmission, you should abstain from sex or use condoms the right way every time you have vaginal, anal, and oral sex for the duration of the pregnancy." The case in Texas did not involve pregnancy. However, keep in mind that this illness can infect anyone.
Other countries, confirmed that they too have had their first case of sexually transmitted Zika Virus. France confirmed this occurred on February 27. Chile confirmed firmed this on March 27. Be aware that more cases and countries are confirming sexual transmission of the virus.
What Can I Do to Prevent Zika Virus?
Use insect repellent, especially when outdoors. Avoid travel to areas with active Zika Virus transmission. If you cannot avoid travel to an area with active transmission, then practice abstinence or use birth control while traveling in that area. Abstain from sex if your partner has traveled to an area with active transmission.
What Insect Repellent is Best to Zika Virus Infection?
The CDC recommends the use of insect repellents with active ingredients registered with the U.S. Environmental Protection Agency (EPA) for use to be applied to skin and clothing. EPA registered insect repellents contain DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol. Insect repellents with these active ingredients products offer longer-lasting protection. Insect repellents containing oil of lemon eucalyptus should not to be used on children under the age of three years. Insect repellents can be used by pregnant and nursing women. The CDC has many details about use, efficacy, and safety of insect repellents available at 1.usa.gov/25rRxr1.
I'm Worried Myself or My Child Might Have Zika Virus. What Should I Do?
First, know the symptoms. Typically, at a minimum, an infected person may have a low grade fever which is frequently accompanied by and a rash. Next, contact your doctor. If your doctor is concerned that you or your child might be infected with Zika Virus, they will advise you to schedule an appointment for a more detailed evaluation. Lastly, if your doctor thinks that you may need to be tested for Zika Virus, then your doctor will refer you to your local health department. Currently, only local health departments have testing for the Zika Virus.
Is There a Travel Advisory Due to Zika Virus?
Yes. There is a Alert Level 2, Practice Enhanced Precautions in areas with active transmission (1.usa.gov/1MMaER1). There is not yet a Warning Level 3, Avoid Nonessential Travel for areas with active transmission.
I'm Not Pregnant & Plan to Travel to an Area with Zika Virus. Is There Anything I Should Do?
It is advised to not travel to areas with the Zika Virus. However, if you do travel to an area where Zika Virus is present, then use insect repellent at all times, especially when outdoors. It is also recommended that if you are a women that is not currently pregnant, that you take birth control as it is estimated that 50% of all pregnancies are estimated to be unplanned.
I'm Pregnant and I've Traveled to an Area with Zika Virus. What Should I Do?
Talk to your OB/GYN doctor before any travel, especially if you are traveling to an area with active Zika Virus transmission. Follow up with a phone call with your doctor immediately upon return. Depending upon your experience or exposure, they may have additional recommendations for you and your unborn baby.
Is a Vaccine for Zika Virus Available?
Not yet. However, there is work on a vaccine. As of February, the National Institutes for Health (NIH) has stated that Zika Virus Vaccine trials will begin this summer (wapo.st/1pTCPZO). They have built upon research on similar viruses, Dengue and West Nile. They are likely to be able to do a small scale trial of about 20 to 30 people in Summer 2016 with large scale trials likely to occur in 2017. Until a Zika Virus Vaccine is available, use insect repellent, travel with caution, if pregnant prevent exposure in your travel and with your sexual partner.