Q&A: pain relievers for teething

Amy writes:

"You mention in your supplements for pregnancy post that you are not much of a pill-popper, and in fact have been working on the same bottle of ibuprofen for 5 years (I paraphrase). So I respect your reluctance to overmedicate and with that in mind I pose this question:

What are your feelings on Tylenol and Motrin (or acetaminophen and ibuprofen)? Here's the true-life scenario playing out at our house this weekend: Baby, almost 7 months old, has her first  I-don't-know-what. Cold? Some congestion, some wet-sounding coughing, some fussiness. Last night her normally stellar sleep habits were all out of whack and we had to drive her around in the toasty car to get her to sleep. (Usually she's down at 7 easily and sleeps until about 5 or 6. We are lucky in that regard.) She doesn't have a fever, but she is cutting teeth. Knowing how much longer than usual it took to get her to sleep last night, I went ahead and gave her a dose of Tylenol before putting her down tonight. She cried in a lackluster way for about 10-15 minutes, and then went to sleep.

The other day I mentioned having given her Tylenol for teething pain to an acquaintance (yes, we use Hyland's gel too). He smiled knowingly and said "Ah, liquid sleep!" I try not to feel defensive about parenting stuff, but I confess I felt a twinge of guilt when he said that, and he wasn't even saying it in a disapproving way. It's just that I suddenly wondered if I am too quick on the trigger, or dropper rather. Your thoughts?"

I have this thing about informed constent. I just don't think I have the right to do something painful or permanent to a person without their informed consent unless there's a clear, definite reason for doing it. This is why I'm anti-circumcision for my own boys--there was no way they could consent, and they certainly couldn't be informed. (They can do what they want to when they're old enough to understand and consent, and it won't be my business.)

Pain relief falls under that same idea for me. I don't take anything for my own pain very often, but I don't think it's fair to deny pain relief to someone who can't ask for it in any way except by crying. If there was overwhelming evidence that the dangers of Tylenol and Motrin were huge I'd reconsider, but they're both generally safe in the small, infrequent doses that a baby gets during teething. So I definitely use them when my kids are having a particularly rough time.

I do try other things, though, first. I use a lot of homeopathic remedies (my kids' pediatrician is an MD and also a homeopath) and usually try either Humphreys #3 pellets (in a sugar base; you can get them OTC for around $5 from a pharmacist, who can special-order them for you and they should come in within a day or two) or Hylands Teething Tablets (in a milk base; you can get them for around $5 at a natural foods store). I'm not a fan of the Hylands Gel, which has been worthless for my kids. The homeopathic remedies are great at easing the crankiness and restlessness of teething, but they don't do much for the really painful nights.

Our pediatrician told us to try to avoid Baby Anbesol and Oragel, because even the baby formulations can be too strong and can kind of burn the gums (like a frostbite kind of burn).

I'm really not crazy about baby Tylenol because I don't want to give an infant the artificial flavors and colors. Plus it's hard to measure out in the middle of the night, and they always end up spitting out half the dose. So I was thrilled to discover acetaminophen suppositories. No artificial colors or flavors, no measuring, and they get the full dose. Just remember to keep them in the refrigerator so they don't melt all over.

I wish I could find ibuprofen suppositories, because the ibuprofen works so much better, and I hate the fake bubble gum (for babies?!) flavor.

So that's what I do for teething.

It sounds to me like all her problems are symptoms of the teething. Some common symptoms of teething are:

* biting hands or anything that comes near their mouths
* crying out in yelps of pain
* drooling
* runny nose or congestion from drooling
* "smokers' cough" from the drool going down the back of the throat
* spitting or throwing up from drool going into the stomach
* "drool stool," which is shards of drool in the poop (I know, and it's truly stunning when you see it)
* rash around the mouth
* rash around the anus
* acidic poop (sometimes you can even smell the difference) and a burned monkey-butt look after pooping
* tugging or pulling at the ears
* not wanting to nurse
* biting while nursing
* flash fevers (fevers that come out of nowhere and are gone in 30 minutes to an hour)

Are there any I'm forgetting? Some kids never have any of these symptoms, some have a few, and some lucky children (like mine) have all of them. The congestion and cough sound like they could be from the drool. I hope her teeth come out quickly and she (and you!) gets some peace and sleep, and that the poor little thing stops crying "in a lackluster way" (which gave me a mental image of Simon Cowell telling her she has a beautiful voice but he just didn't believe the crying, and she needs to work on "connecting" to the crying more for next time).