Knowing the signs of teething in babies can help react correctly - Tribune Online

IT is the middle of the night and Kenny's mother is worrying why he has been crying inconsolably. Kenny usually sleeps well. Suddenly, he won't sleep or feed. He still played with his daddy before sleeping off in his crib. The father is suggesting that he is grumpy and probably sick or maybe teething. Can Kenny's sudden acting outside his normal routine or behaviour be a red flag that there is something unsettling him?

What Mrs Kemi Ayoola noticed in her 6-month-old daughter was increased drooling. She also starts to pull and poke her left ear, to the point where she has cut the inside a few times.  Also, before the lower tooth breaks through, even six hours after a meal she can vomit it up.

Well, grandmas, great-aunts, neighbours and almost everyone else love to blame teething in young children for all these. In a cross-sectional survey involving 60 mothers present at a Children's clinic in the Enugu metropolis, many also attributed such a variety of symptoms in their babies as fever (71.7%), loose stools (58.3%) and vomiting (35%) to teething.  It was in the journal, BMC Research Notes.

In fact, more than 90% of the mothers thought that a variety of symptoms of childhood illnesses are a result of teething even though there is little evidence to support these beliefs. As a result, teething symptoms is often overlooked.

Some of the acclaimed symptoms of teething such as drooling of saliva, gnawing and itching gum are trivial, nevertheless significant to the child and parents. But others such as fever, diarrhoea and cough may connote underlying serious medical conditions in the child.

Now, teething, Dr Folasade Fadare, a public health physician and Medical Director of General Hospital, Igbeju-Lekki, Lagos said It's a normal developmental stage and involves the process of teeth growing and then breaking through the gums.

Teeth begin to develop while a baby is in the womb, with tooth buds forming in the gums. Once developed, they break through the gums. Babies usually cut their first tooth around four to six months, and they continue until age two or three.

Dr Fadare said that teething is not synonymous with sickness, adding, "It bleeds my heart when I see a mother say I thought that it is teething. They do not bring the child to the hospital until the situation is bad. It is just like a woman saying what worries her is pregnancy and will not go to the hospital, even though she is bleeding or vomiting in a stupor."

According to her, when a child is found passing out watery stool, vomiting, not eating well or running a fever, irrespective of age, the best bet is to take such to the hospital even while continuing to breastfeed.

Dr Fadare said there is a difference between a child that is teething and that which is sick.

"If a child is teething, he may just have a mild body temperature; he may just be off food for a meal and by the second meal, he is eating and playing again. But if it is now extending to a day, the child must be taken to the hospital for care. It could be that the child is sick."

While teething is a process that all children go through, Dr Taiwo Soyinka, a family physician at the University College Hospital (UCH), Ibadan, said some children when teething do not experience any symptoms contrary to opinion of many mothers.

However, she said that the toll of teething also tends to be much on babies with reduced immunity because they are more susceptible to infections.

"The child may be harbouring the malaria parasite and then the mother is thinking of teething and giving teething powder and paracetamol.  Meanwhile, the parasite continues to multiply in the body, leading to the child to convulse or develop cerebral malaria, a severe form of the disease.

"So, whatever the symptom the child may have, mothers should not assume that it is due to teething. They should seek medical advice, even for a slightly raised body temperature."

Howbeit, in another prospective study, increased biting, drooling, gum-rubbing, sucking, irritability, wakefulness, ear-rubbing, facial rash, decreased appetite for solid foods, and mild temperature elevation researchers said were all statistically associated with teething.

But congestion, sleep disturbance, stool looseness, increased stool number, decreased appetite for liquids, cough, rashes other than facial rashes, fever over 39°C, and vomiting were not significantly associated with tooth emergence. All these are all symptoms of many illnesses.

Dr Kemi Tongo, a consultant paediatrician at the UCH, Ibadan, said teething does not cause colds, diarrhoea, or high fever, but it can make a baby uncomfortable.

According to her, babies only become sick around the same time of teeth eruption because the period coincides with the time many children tend to catch disease-causing germs from things they pick from the floor and put in their mouth and when they lose the immunity they received from their mothers.

And as such, they tend to fall sick more often when care is not taken to protect them from being infected and ensured to be well breastfed.

No doubt, a variety of symptoms may occur contemporaneously with teething and there is no pattern of symptoms manifesting that can reliably distinguish teething from any other potential cause of the symptoms. So, it is important therefore that mothers are counselled about symptoms of common childhood illnesses and to react correctly.

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