Dr.Silva: Tots, Tweens & Teens™

Lead Poisoning

A 9 month old infant girl from Connecticut was found to have lead poisoning.  Doctors discovered that the young infant had a high lead level during her routine physical exam.

CDC Report

According to a report (http://bit.ly/2wBf8LJ) by the Centers for Disease Control & Prevention (CDC) on August 31, 2017, her blood lead level of 41 micrograms per deciliter of lead was much higher than  acceptable.  According to CDC, an acceptable blood level is up to 5 micrograms per deciliter.

Home Investigation

Investigators reviewed the home in detail.  Although there was lead paint on two of the windows in the home, the infant girl was not able to reach those windows, so she couldn't have contracted lead poisoning from them.  In addition, the her 3-year-old and 5-year-old siblings didn't have lead poisoning, so the windows were not the source of the lead.  

Teething Bracelet

The baby girl's parents bought her a homeopathic magnetic bracelet to help with teething pain.  She had used the bracelet for teething relief, chewing on it, causing her to ingest the lead.  The homeopathic community believes magnets help with healing.  Tests on the beads of the bracelet revealed that it contained 17,000 parts per million (ppm). According to the U.S. Consumer Product Safety Commission (CPSC), for the most part, products containing 90 to 100 ppm are considered safe.

Chewing & Lead Poisoning

Please be careful with items that your child may chew on.  Sadly, each year, there are recalls on children's jewelry due to high levels of lead and cadmium poisoning (https://drsilvatotstweensandteens.com/2010/02/cadmium-jewelry-poisoning.html).  Infants and toddlers place objects in their mouths as part of their development and natural curiosity.  They learn about their world orally, in this fashion.  Depending upon the lead level in a child's body, lead poisoning has long-term consequences including, but not limited to lower IQ, speech delay, behavior problems, seizures, and death.  Treatment does not necessarily reverse the negative effects of lead on the brain and body.

Routine Physical Exam & Lead Testing

Please remember to follow-up with your pediatrician for your child's physical exam, as so much is done at these visits, including lead level testing, if recommended.  Consider buying a lead surface test kit for your children's toys or objects they may place in their mouths, as lead poisoning is a nightmare for any family to handle whether from teething bracelet or toys.

Teething Tablets Not Recommended

On April 20, 2017, the FDA recalled Hyland's homeopathic teething tablets.  This article was update on 9/16/19.

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 used to 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."

However, since the FDA warned consumers to stop using and discard Hyland's Teething Tablets, Hyland recalled and no longer manufactures Hyland's Teething Tablets, so the above information is no longer available online.  This was updated as of 9/16/19.

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 recalled products are:

Photo by CPSC

About two (2) weeks ago, the U.S. Consumer Product Safety Commission (CPSC) (http://www.cpsc.gov/) proposed a new 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 one? Stop using it. Contact the manufacturer 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 @ https://www.cpsc.gov/Safety-Education/Safety-Education-Centers/cribs.

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