How could homeopathic teething tablets possibly work?
April 13, 2015 8:02 AM   Subscribe

Many parents I know recommend Hyland's Baby Teething Tablets, a homeopathic remedy. But how could they possibly have an effect?

Let's be clear. Homeopathy is woo. I give my baby acetaminophen if he has having teething pain.

However, I've met a number of people who heartily recommend Hyland's Teething Tablets. They say it just calms a fussy teething baby right to sleep.
I am sure that they are not imagining this result, but what could possibly cause it? Babies don't respond to the placebo effect, right? And wouldn't the lactose tablet amp up a baby instead of calming him down?

The link above goes to the product page, which lists the following ingredients:
Active Ingredients: Calcarea Phosphorica (6X HPUS); Chamomilla (6X HPUS); Coffea Cruda (6X HPUS); Belladonna (12X HPUS). Inactive ingredients: Acacia Gum; Lactose N.F.
Hyland's had a recall a few years ago after infants overdosed on belladonna in the tablets, but the product is back on the shelves, and that product page goes to great lengths in defense of the product and the almost complete lack of belladonna in it.

To be clear, some of the friends recommending these are pretty pro-vaccine and pro-science and do not otherwise trip my woo sensors. It seems like baby teething just allows for a little creep of woo around the edges, between these tablets and the amber teething choke hazard necklaces. I don't get it.
posted by aabbbiee to Science & Nature (29 answers total) 3 users marked this as a favorite
 
Sugar can have a pretty strong effect on babies. I'd guess it was just the lactose and maybe the "inactive ingredients"
posted by mercredi at 8:13 AM on April 13, 2015 [3 favorites]


They are literally just sugar pellets -- lactose; there isn't usually any of the "active" ingredients left -- and sugar makes babies cry a bit less. Kids like candy...
posted by kmennie at 8:15 AM on April 13, 2015 [3 favorites]


We used another homeopathic teething thing -- the Camilla liquid. I do not believe in homeopathy. It did seem to make things a bit better.

Now, the mechanism: Firstly, a lot of "homeopathic" medicines actually contain certain natural or "inactive" ingredients in higher-than-homeopathic (i.e. measurable) concentrations. It is conceivable that these ingredients could have some effect. Secondly, I do think that some placebo-like effect is involved -- the baby likely gets cuddled or comforted while getting the drops or tablets, and for the most part likely associates things given by a parent with comfort or relief (of hunger, thirst, and maybe pain as well).

And the rationale: Sleep-deprived parents are a prime target for woo. If I've been up for several nights and someone tells me that burning ten goat skulls in my front yard will calm down the child, then I will laugh, but the next night I will probably call up some farms just in case.
posted by Behemoth at 8:15 AM on April 13, 2015 [16 favorites]


I don't get it either. A possibility might be that the placebo effect is on the parents: calmer parents who are convinced baby will feel better and fall asleep = higher likelihood that baby will pick up on the calming vibe of the parents and feel better and fall asleep. Maybe.
posted by lydhre at 8:17 AM on April 13, 2015 [4 favorites]


I've given my babies Hylands teething tablets and I firmly believe that they "work" because they are a sweet and a distraction, and the kid forgets to cry. If I think they're in real pain they get pain medicine first.
posted by annathea at 8:19 AM on April 13, 2015


It seems like baby teething just allows for a little creep of woo around the edges, between these tablets and the amber teething choke hazard necklaces. I don't get it.
That matches my own experience. After a few sleepless nights you're willing to try pretty much anything. If someone assures you that something will cost you $10 or $15 and worked every time for their kid, you'll give it a shot even if you know there's no way it can work. Being desperate puts you in a very suggestible state of mind.

The other factor is random reinforcement. Say you use an amber necklace and the baby doesn't happen to teethe that night. From then on you'll feel like the necklace is helping somehow. It's really hard to break out of that kind of thinking since a peaceful night is such a huge reward.
posted by pocams at 8:33 AM on April 13, 2015 [2 favorites]


Well, the baby is essentially a prop in this story. The one giving the medicine in anticipation of an effect is the parent, and the one reporting the effect is the parent. So I'm not convinced that a placebo effect isn't going on in the sense that the parents seem to perceive the baby as being less upset than before.
posted by Naberius at 8:36 AM on April 13, 2015 [3 favorites]


The parents are only remembering the times the baby went to sleep after having the tablets. It's easy to forget the times the baby didn't, especially if you want to believe the pills helped.

And by the way, the teething necklaces are NOT meant to be chewed on; they should be short enough that they don't reach the baby's mouth and are therefore not a choking hazard. If, y'know, you're into that kind of thing.
posted by Specklet at 8:37 AM on April 13, 2015


Response by poster: Re: amber necklace
I know; the baby is supposed to absorb the magical anti-inflammatory properties through the skin. But babies can grab and pull on them, and the necklace strands can break, and then the loose beads go everywhere, to be easily picked up and put into mouths.

The amount of worrying I've done about SIDS, but I'm going to tie a string of beads around his neck?
posted by aabbbiee at 8:50 AM on April 13, 2015 [4 favorites]


The tablets work because it makes the parents feel like they are doing something, a relaxed parent is a more relaxed baby.
posted by wwax at 8:55 AM on April 13, 2015 [2 favorites]


It's been a long time, but I vaguely remember trying one of the teething tablets myself (with a similar curiosity), and noticing they had a slight tingly or bubbly feeling on my tongue and lips, almost like a tiny mild alka seltzer. I always assumed that's what had an impact-- the surprising sensation distracting the baby.
posted by instamatic at 9:11 AM on April 13, 2015 [2 favorites]


Also, I know you're not talking about using them yourself, but later I learned that Hyland's was having some quality control issues with the amount of belladonna In the tablets. That's a pretty scary thing to mess around with.
posted by instamatic at 9:15 AM on April 13, 2015


Confirmation bias.
posted by JackBurden at 9:17 AM on April 13, 2015


Yeah, both this and amber teething necklaces are placebo on parents. Further, many scientists and dentists believe that teething itself causes no pain at all. Good luck convincing most parents of that, though. I'm not entirely certain I believe it myself!
posted by PhoBWanKenobi at 9:37 AM on April 13, 2015 [2 favorites]


The chammomile and the belladonna are what jumped out at me; chammomile does have chill-you-out effects.

And an interesting thought about what PhoBWanKenobi says about "scientists don't think teething is painful" - I can actually vaguely remember what it felt like as an older child and had my adult teeth erupting. It wasn't profoundly painful, but there was some sort of slightly uncomfortable sensation.

However, I'd been exposed to other kinds of pain by that point, so I was working with a more complete understanding of "what is pain and what happens on a sensory level", whereas a baby, experiencing that sensation for the first time, is probably all "oh my god what is happening i don't like this AAAAAAAAAUUUUUGGGGH". So I wonder if the chammomile, combined with the extra reassuring attention from parents, is what is calming down the baby - yeah, your teeth feel funky, but your mom and dad aren't freaking out about it, instead they're soothing you and telling you it's gonna be okay and maybe they're right about that so hang in there.
posted by EmpressCallipygos at 9:50 AM on April 13, 2015


My take on these (and they worked on both of my kids) is that the sugar distracts the baby long enough that they can be settled down by other means.

I have no explanation for why the very similar (hell, maybe identical! Who knows?) arnica pills work on my back.
posted by padraigin at 10:09 AM on April 13, 2015


A sweet taste does help distract babies from pain -- there have been studies with giving a baby a pacifier dipped in sugar-water right before and/or after immunizations, and sucking on something sweet does seem to help calm them. (Perhaps just because it's a pleasant and somewhat novel sensation for a baby that helps distract from the painful sensations.)

Hyland's has poor quality control and the teething tablets contain "inconsistent amounts of belladonna" that has resulted in reports of belladonna toxicity in teething babies. That will, in fact, chill you right the hell out and work as a very effective painkiller, on the way to belladonna poisoning.

So, basically, if it's actually working for a kid, the sugar pill is helping and a pacifier dipped in sugar solution you whipped up at home would do the same with less risk, OR you're busy poisoning your child with one of the most toxic plants in the world, courtesy of a company that sells unregulated sugar pills with inconsistent amounts of belladonna, who have refused to pull the product despite multiple reports to the FDA of children poisoned by it. They still don't even bother with a child-proof cap. Yay Hyland's!
posted by Eyebrows McGee at 10:45 AM on April 13, 2015 [3 favorites]


PS, best teething treatment in the world for between Tylenol doses -- buy a pint of blueberries, shove them in the freezer (you don't have to bother spreading them on sheets or anything, just put them in in the supermarket container), and pop four or five of them at a time in a mesh feeder. Cold like a teething ring, sweet like a sugar pill, and an interesting flavor that kept my kids interested in gnawing on it MUCH longer than teething rings.

It's hella messy and will ruin your carpets. We just stripped the baby to a diaper and plopped him on a designated blueberry-stain towel and let him go to town, YMMV. (It's also kinda hard to clean the blueberry skins from the mesh, but the teething relief was worth the hassle.)
posted by Eyebrows McGee at 10:52 AM on April 13, 2015 [2 favorites]


Response by poster: I do want to point out that there WAS a recall of this product in 2010, and the product is back on the shelves now, reformulated, with a child-resistant cap. Snopes has a summary.
posted by aabbbiee at 11:12 AM on April 13, 2015


Also, I believe that the FDA has said that Tylenol is ineffective for infant and toddler pain relief. (Link to actual FDA statement hidden in that article.) Also, our pediatricians have strongly discouraged dosing our kids with Tylenol in the last year or two, because it is really easy to give them too much, and the consequences for liver health in case of overdose are dire. But obviously, MPINYP (my pediatrician is not your pediatrician), and you should ask your own.
posted by instamatic at 11:21 AM on April 13, 2015


Everyone I know who the homeopathic drops uses them "most of the time" and Tylenol/Advil when it's really bad (ie when the baby is actually teething).

If it makes the parents feel better, giving sugar water can't hurt too much, I guess?

Don't get me started on the amber necklaces.
posted by betsybetsy at 11:38 AM on April 13, 2015


Oh and as an aside, I got my wisdom teeth as an adult and it absolutely 100% hurts!
posted by betsybetsy at 11:46 AM on April 13, 2015


And an interesting thought about what PhoBWanKenobi says about "scientists don't think teething is painful" - I can actually vaguely remember what it felt like as an older child and had my adult teeth erupting. It wasn't profoundly painful, but there was some sort of slightly uncomfortable sensation.

+1

On preview: +2
posted by JimN2TAW at 3:30 PM on April 13, 2015


I can actually vaguely remember what it felt like as an older child and had my adult teeth erupting. It wasn't profoundly painful, but there was some sort of slightly uncomfortable sensation.

But those were teeth coming into a space where there had already been a tooth. I'm with Betsybetsy! I had a wisdom tooth came in when I was about 30... it HURT. Sometimes it was just weird achey pressure sensations, sometimes my jaw ached, sometimes the gum area in front of the tooth *hurt*. Regardless, I can't imagine it's pleasant. My 7mo old's been teething and he bites/knaws on cold hard things and just... yells. It's sad.

We haven't tried the tablets, but I can only imagine it'd be as effective as chamomile tea (if that!). I can't find them now, but there's been studies showing that sugar intake decreases pain, though I think it's an awful lot of sugar. More anecdata? We've tried all the teething gels, and the Curash one seems to kinda help and Hylands does jacksh*t. Even then, I think of the gel as a temp/placebo thing to distract him while I pull out the Panadol! (I can tell you, with the wisdom tooth coming in I took Tylenol. I did not go have a cuppa!)

(OMG I KNOW... re: Amber necklaces and SIDS! wtf, right?!)
posted by jrobin276 at 7:44 PM on April 13, 2015


It cannot, in any rational universe. Please await scientific validation before you use this as a solution.

1000 hugs and best of good luck...
posted by FauxScot at 8:18 PM on April 13, 2015


Here is a similar AskMe thread about homeopathy and gas pain in babies. I think some of the answers could apply just as well here.
posted by SLC Mom at 8:59 PM on April 13, 2015


"I am a baby, something is not right and I am sad about this. My only real yardstick for the rightness of the word (about which I know nothing) is the facial expression of my parents. They are all -powerful. My mouth hurts, so I cry. The tall and almighty god-carers around me look sad and tired. I am worried and my mouth hurts. The god-carers put something in my mouth. Normally they put food in my mouth. I like food. This thing is not food. It's unusual. It fizzes slightly and tastes sweet. Sweet things are good! What is this thing? The all-powerful carer god has heeded my cries. They look at me, hopeful. This thing I have been given must be a good thing, they look happy about having given it to me. My mouth hurts a bit, but the god-carer has done something that will help. The god-carer is all powerful (and very tall). "

-Second-order placebo effect receiver. (aged 8 months)
posted by Just this guy, y'know at 3:12 AM on April 14, 2015 [3 favorites]


there isn't usually any of the "active" ingredients left

The standard anti-homeopathy line that there is literally nothing left of the original active ingredients is really only applicable to the homeopathically "stronger" dilutions like 12C: a C dilution is one part in a hundred, and 12C means that this has been repeated successively 12 times. After dilution to one part in 1024 you really would be reaching to find even one molecule of the diluted substance in a typical tablet.

Calcarea Phosphorica (6X HPUS); Chamomilla (6X HPUS); Coffea Cruda (6X HPUS); Belladonna (12X HPUS)

An X dilution is to one part in ten, so these tablets are alleged to contain one part per million calcium phosphate, one part per million chamomile, one part per million coffee, and one part per US trillion belladonna. In other words, you would actually expect traces of the active ingredients to remain detectable in these tablets though you'd need some bloody good equipment to track down the belladonna.

Even so, one part per million of a small tablet is not going to constitute a pharmacologically active dose of pretty much anything (with the possible exception of LSD). So if they work at all, they're doing that via the the direct effects of their bulk ingredients (lactose and binders) and/or placebo effect (self-fulfilling expectation). As others have pointed out, expectation is a slippery thing and quite capable of jumping from person to person.

The really cool thing about homeopathic preparations is that you never need to buy them more than once! Get yourself a pill press and a supply of lactose and gum, powder up your original tablets, combine 1 part of that powder with 9 parts lactose, pill them up again, and you now have ten times as many tablets as you started with and they're ten times as potent each! Talk about economy!
posted by flabdablet at 5:44 AM on April 14, 2015 [1 favorite]


Response by poster: I am most satisfied with the answers that point to the link between sugar and pain relief in babies. I think that seems to make the most sense of the results that my parent friends are seeing. I get the confirmation bias part of this, for sure, but *something* seems to be comforting these babies, and I don't think it's placebo (particularly in the middle of the night).
At the same time, it's kind of bizarre that parents who shy away from acetaminophen are fine with fizzy sugar tablets.

I don't understand how the placebo effect could work on a baby. Those suggesting it are working on the assumption of awake baby in the middle of the day, and a baby of a particular age. If there are studies on nighttime placebo use in infants under age 1, please share.
When my baby cries in the night because of discomfort, his eyes aren't open. I barely wake as I attempt the list of things that usually get him (and me) back to sleep. If these fail, and I give him pain relief (placebo or not), he is not aware of my facial expression. I was already in a state of complete relaxation when he woke me, so I am not giving him a cue with my body tension. If anything, my body tension is increasing because I am waking more and more to fix the problem. He is either relieved from the discomfort so that he can sleep, or he is not relieved and continues to fuss, and then I try the next thing on the list.
posted by aabbbiee at 7:08 AM on April 14, 2015


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