The Teething Period
It’s the moment in their “career” that many mothers dread a lot. It is the period between the fifth and seventh month of life of their infants. It is the period they visit hospitals and clinics most, coming out of a relatively “peaceful” first four months after birth. Aside the physical stress, parents are also worried stiff and spend a lot of money purchasing medications, of all forms and formulations. They call it the “teething period”.
Features of the Teething Period
What happens during “teething”? Infants tend to be generally ill; this “illness” has no definite pattern of symptoms. It can cause illnesses ranging from fever (high body temperature), through vomiting, catarrh and cough, poor feeding, frequent stooling to skin rash, ear discharges and multiple boils. Obviously, the kind of illness that can masquerade a lot like this deserves all attention.
The Drug Shelf
To feed the parental anxiety that goes on with “teething”, many products are on the drug shelves known under various names but generally regarded as “teething powder” or “teething mixture”. So, to the manufacturers of such products, which are available over the counter and requires no prescription, the treatment of “teething” is a multi-million naira business. These products generally contain different mixtures of drug which controls fever, drugs which decongest nose and throat and some ridiculously low doses of antimalarial drugs of the quinine family (either chloroquine or quinine itself). The decongestant almost always causes sleepiness as well. Therefore, these mixtures control the body temperature, dries up cattarh, reduces cough and puts the infants to sleep. At least, the mothers can have momentary relief. We will revisit the danger inherent in this temporary relief in due course.
What is “Teething”
So, what exactly is teething and why is it so troublesome, a disease? Why is it so difficult to treat or cure that many mothers get several sleepless nights and mega anxieties from it? Teething is a misnomer. There is no disease or illness known in medicine, as “teething”. It is rather an illness conjured in the mind of care givers and used to explain every illness a young infant has at about the time of cutting the teeth. Unfortunately it is passed down across generations of mothers as an illness that every infant must encounter and that comes with a lot of parental anxiety.
Tooth Eruption
The process of tooth eruption is a natural mechanism reflecting normal development in a growing child. Since it is natural, science does not expect it to cause an illness. The tooth, the nails and hair all originate from the same tissue types in the human body. When children grow finger nails or hairs on their scalp, do they have fever, vomiting, cattarh, cough, stooling, skin rash and boils? Obviously not! So, it is attractive to ask why only tooth eruption causes all those illnesses. What about tooth eruption?
There is No Illness called “Teething”
Message number one is: there is no illness known to medicine as “teething”. What generations of mothers tag “teething” is a product of misconception.
Tooth Eruption Does not Cause Fever
Message number two is: apart from very mildly increased intra-oral temperature (the mouth gets warmer) and itching of the gums, tooth eruption does not cause any illness.
Children Are more Vulnerable to Illness from 6months upwards
Message number three comes as a question: Why do children take ill severally between the fifth and the seventh months of life?
That is the period infants, for the first time ever, are vulnerable to infections. Prior to that time and indeed, from the moment of birth, infants are protected by “protective properties” (called antibodies, which help in fighting infections).
These antibodies are acquired from their mothers; mainly through the placenta before birth and some through breastfeeding.
Therefore, the infants are well protected against these common infections (malaria, stooling, catarrh and cough, boils).
Unfortunately, the amount of these antibodies in the infants’ bodies dwindle from about the sixth month and that leaves the infants vulnerable to germs they were previously protected against.
Secondly, from the age of six months, infants begin to feed on other kinds of food apart from breastmilk and that reduces the amount of protective properties they acquire from breast milk.
It is important to stress here that other foods must be introduced from six months because, the nutritive value of breast milk is no longer enough to support the rapid growth of infants from the age of six months hence the need for complementary feeding.
Thirdly, the infant is exposed to more germs from that age: the manual preparation of foods allows contamination of the meals, however, minute and the infant being more mobile, begins to pick up objects and put such straight into the mouth or crawls on the floor and put objects and the dirty hands into the mouth.
Let us imagine, an infant losing immunity and yet getting more exposed to germs. Shall we not expect infections and illnesses?
Unfortunately all these events happen at about the time tooth eruption begins from the fifth and sixth months of life. So, it is just happenstance that these illnesses are attributed to “teething”.
Take your Child for Treatment when he/she is Sick
Therefore, when a child develops fever, vomiting, poor feeding, ear discharges, frequent stooling or boils, that child has an infection and that infection should be appropriately treated.
Rather than keep the child at home, assuming it is “teething” and flooding the child’s body with powders and mixtures which would only provide temporary relief, the child deserves to see a doctor who will make a diagnosis and give the appropriate treatment.
Danger of Delaying Treatment
Of course, the danger in investing time on “teething” while more sinister illnesses are going on, is that the infection gets worse, spreads and become life-threatening.
Let’s take malaria which is the commonest and most notorious of childhood illnesses, as an example.
The damage malaria does is destruction of blood cells which circulates oxygen in the body. Giving teething mixture to a child who has malaria is deceptive. The body temperature may momentarily reduce but the germ causing malaria is untouched and it keeps destroying the blood cells until the infant develops severe anaemia (severe shortage of blood).
The brain and the heart are the most vulnerable when the blood can no longer distribute good quantities of oxygen. Many children end up requiring blood transfusion while many childhood deaths have also occurred on this path.
This is preventable if only mothers will stop making wrong diagnoses for their ill children while sitting at home and timely seek appropriate care.
The Good News
The good news is that every child gradually builds up his or her own immunity over the first five years of life but the frequency of the illnesses generally decline, with good nutrition and good hygiene. Teething is a natural process, not an illness. A child who is ill deserves to see a doctor not “teething powder”
Prof. Tinuade A. Ogunlesi is an Associate Professor of Paediatrics, Olabisi Onabanjo University, Sagamu, Nigeria.
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