5
Jun

Teething Tablets Recalled

teethingTeething 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.

 

8
Oct

Enterovirus D68 (EV-D68)

enterovirus - 2014-1008 -imageedit_7_9044717870What is Enterovirus D68?

Enterovirus is a non-polio virus that was first discovered in California in 1962. (http://1.usa.gov/1rVzPYU) It typically exists during the Summer and Fall, with frequency of the virus decreasing in late Fall.  

 

Where is Enterovirus D68 in the United States in 2014?

This year, Enterovirus D68 is documented with severe respiratory illness in the United States. Currently, the Centers for Disease control (CDC) or state labs have confirmed 628 people infected with this virus in 44 states and the District of Columbia.  Yesterday, the Florida Department of Health confirmed Florida's first Enterovirus D68 infection in a 10 year old girl from Polk county who was treated in Hillsborough County at Tampa General Hospital one (1) month ago for six (6) days. (http://on.wtsp.com/ZQzSw3)  The reality is that Enterovirus D68 is everywhere.

 

Enterovirus D68 Updates:

Update 10/8/14: Enterovirus D68 appears to be winding down.  Fewer severe respiratory illnesses reported last week.  Peak was three (3) weeks ago. (http://usat./1vUOJPz)

Update 10/16/14: CDC new rRT-PCR test for Enterovirus D68 allows more rapid test for the more than 1,000 remaining specimens from since mid-Sept. (http://bit.ly/ZC9JzW).  This will result in an increased number of positive results.  However, this will be for past infections, not recent ones.  Enterovirus D68 still appears to be winding down.  

 

What Are the Symptoms of Enterovirus D68?

Enterovirus is typically misdiagnosed as a common cold, rhinovirus, RSV, or the flu. Typical symptoms include those of cold symptoms, runny nose, cough, sneezing, and achiness.  In more severe cases, wheezing and difficulty breathing has occurred. There have been four (4) deaths associated with Enterovirus. (http://1.usa.gov/1yLuo52)  In addition, the Colorado Health Department reports that partial paralysis has occurred in 12 Colorado children infected with Enterovirus D68. (http://dpo.st/1CTtJgp)  The CDC is investigating the deaths and the potential paralysis link. 

 

Who's at Highest Risk for Contracting Enterovirus D68?

Infants, children, and teenagers are at highest risk for contracting the disease as they have not had sufficient exposure and therefore immunity against this virus.  Those who have asthma and reactive airway disease are at higher risk to have more severe symptoms and illness from the virus.

 

How Do I Prevent Enterovirus D68?

•Hand washing, hand washing, and hand washing! Hand sanitizers are not effective in prevention.  This virus spreads by cough, sneeze, or touching an infected surface.  

•Non-alcohol disinfectants are effective. However, hand washing is still the best.

•Keep your sick child home.  This is very important to prevent the spread of this virus. Remember, in some, this virus acts like the common cold.  However, if your child spreads it to someone else, the child may develop more severe symptoms.

•Cough and sneeze into your elbow.

•Clean commonly used surfaces (countertops, door knobs, toys, etc) with bleach water.

 

When Should I See a Doctor?

If you or your child have asthma or reactive airway disease, develop cold symptoms, fever, wheezing or shortness of breath, then go see a doctor.  

 

What is the Treatment for Enterovirus D68?

There is no cure for this virus.  There is supportive care.  The sooner you or your child receive supportive care, the better the outcome. That being said, it doesn't mean that the moment you or your child gets sick, you should run to the pediatrician.  However, if you or your child has asthma or reactive airway disease, become ill with fever, cold symptoms, is wheezing or short of breath, your pediatrician should examine your child.

Enterovirus D68 is most commonly a mild disease.  However, this year, it has become a scary one.  Knowing your child's health, closely observing them if they are ill, and follow-up care with your pediatrician will help in the treatment of Enteovirus D68, so it won't terrify you.

8
Aug

Drop Side Cribs: One Step Closer to a Ban

Photo by CPSC
Nationwide, manufacturers are recalling their drop-side cribs left and right. Recently, over two (2) million drop-side cribs have been recalled due to an increased number of injuries and deaths. This brings the total to over nine (9) million drop-side cribs that have been recalled in the last five (5) years. Some crib manufacturers affected include Pottery Barn Kids, Simmons, Bexco, LaJobi, Jardine, Evenflo, Delta, Child Craft (out of business), Graco, Simplicity, Generation 2, ChilDESIGNS, Stork Craft, Simplicity, PlayKids USA, and L.A. Baby. Sadly, the list does not end here. It goes on and on. To check to see if your crib has been recalled, go to the U.S. Consumer Product Safety Commission search at http://1.usa.gov/1ylfBdk
 
The injury or death can occur when the drop-side crib’s hardware comes loose, leaving a gap between the baby’s mattress and the rail, leading to suffocation or strangulation. Since 2000, these cribs have resulted in at least 32 deaths and 16 cases of entrapment in infants and toddlers, with another 14 deaths linked as well.

About two (2) weeks ago, the U.S. Consumer Product Safety Commission (CPSC) (http://www.cpsc.gov/) proposed a new crib standard that cribs manufactured for sale or resale must have four (4) fixed sides. If passed, it is predicted that as early as Summer 2011, drop-side cribs will be banned sale, re-sale or use in stores, hotels, and daycare centers.

What should you do if you have a drop-side crib? Stop using it. Contact the manufacturer of your crib or search their website. Many are offering kits that will immobilize the rail. If no such kit is available, please consider replacing your crib. Although the deaths have been few, your child could become one of the rare ones. It is not worth taking the chance.

You can also go to the CPSC’s Crib Information Center @ U.S. Consumer Product Safety Commission crib recall list.

If you have further questions, you can call the CPSC Recall Hotline at (800) 638-2772.

 
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