Abstract
BACKGROUND: Necklaces and bracelets made of amber or hazelwood beads are currently marketed to parents as teething pain remedies for their infants and toddlers. There is no scientific evidence to support the effectiveness of these necklaces and bracelets in relieving pain; moreover, they pose a significant safety risk. There have been case reports of children dying or experiencing serious suffocation accidents as a result of wearing teething necklaces. Both the Canadian Paediatric Society (CPS) and the American Academy of Pediatrics discourage parents from the use of such products. The Canadian Paediatric Surveillance Program (CPSP) issued a one-time survey designed to capture paediatricians’ knowledge and experience with teething necklaces or bracelets in infants and young children in Canada. OBJECTIVES: The survey’s primary objective was to collect information from paediatricians on adverse events related to the use of teething necklaces and bracelets in infants and young children across Canada. The survey also collected information on paediatricians’ knowledge and attitudes regarding these products. DESIGN/METHODS: This study was funded and issued by the CPSP. It was designed as a one-time survey that was distributed to eligible paediatricians (N=2845) across Canada. The survey asked paediatricians if they had encountered any adverse events related to the use of teething necklaces and bracelets and details about these events. Information was also collected on paediatricians’ awareness and approaches to counselling around the use of teething necklaces and bracelets. RESULTS: The survey response rate was 36% (1020 responses of 2845 eligible paediatricians). Paediatricians across Canada identified 10 cases of adverse events related to the use of teething necklaces and bracelets over the past 12 months. Duplicates were excluded based on the first three digits of the postal code. Adverse events included swallowing the clasp magnet, strangulation by the necklace, choking on the beads, and contact dermatitis. These events resulted in hospitalization and medical procedures in some cases. None of these cases resulted in disability or death. Seventy-seven % of responders were aware of teething necklaces or bracelets and 91% were aware of risks associated with teething necklaces, such as choking or strangulation. Sixty-nine % of responders reported having seen an infant or a toddler in their practice wearing a teething necklace or bracelet over the past 12 months. Only 13% of responders had been approached by families with questions regarding the use of teething necklaces and bracelets. Fifty-nine % percent of responders reported discussing the risks associated with teething necklaces and bracelets with families who were using the product. Only 8% of paediatricians discussed these products with all families. CONCLUSION: Paediatricians and other healthcare workers looking after infants and young children should advise families of the dangers associated with teething necklaces and bracelets as a component of anticipatory guidance during routine health visits in infancy. Providing parents with alternative ideas such as those recommended by the CPS for helping their child with teething may help parents refrain from using unsafe (and unproven) teething products.