Numbing Gels for Teething Babies and Infants - the FDA Says No

I’ve known for twenty years that the use of numbing gels (Oragel, Anbesol. Baby Oragel and others) can be associated with a potentially life threatening complication in infants and toddlers if used in excess. I have always cautioned parents not to use them more than four or five times per day. The FDA now has data that even occasional use can be series in some infants. They just issued issued a recommendation that they not be used in children under age two at all.

The problem is that when absorbed, the benzocaine (the numbing agent in these medicines) can interact with the hemoglobin in your blood and change it into a form that cannot carry oxygen called methemoglobin. If you can’t carry oxygen normally, you will turn grey then blue, then pass out and, if untreated, eventually die. I have encountered this before a couple of times, but in children whose parents were applying it 10 to twenty times per day. Symptoms can develop within minutes to one to two hours after administration. The problem is that medical personnel may not think of methemoglobimemia right away if the child winds up in the emergency room leading to a delay in treatment as it is not something seen commonly.

There have been nearly four hundred reported cases in the U.S. including at least three deaths from methemoglobinemia. So, I have to agree with the FDA on this one. It is safer not to use these medicines in children under age two. However, that doesn’t mean there aren’t plenty of other ways you can help your teething child. Teething rings, water filled teething rings chilled in the refrigerator (never in the freezer as, if to cold, the gums can get frostbitten), a damp, chilled washcloth to chew on or the occasional Tylenol or ibuprofen can all be used to comfort your child. If you have questions or these techniques aren’t helping, talk to your child’s doctor.

Teething is a normal part of growing up. It can be uncomfortable at times, but usually simple measures (teething rings) for example are usually all it takes to sooth a teething child. So, the lesson is, don’t use medicines if you don’t really need to, and talk to your doctor before using over the counter medicines in any young child.

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