Dr. Leonard Mbamara is the Chief Medical Director of Albina Mejeel Specialist Hospital in Lagos. He is a former USSR trained medical practitioner with over 30 years in active practice spanning from Lagos University Teaching Hospital LUTH, Idi-Araba, Falomo Police Hospital, Lagos, Bonny Camp Medical Centre and others before delving into private practice. His vast experience in general practice armed with a doctorate degree in orthopaedic medics and obstetrics positioned him in a state to allay the challenges parents go through during their children’s’ teething period.
By Chris Onuoha
WHY is teething in children a challenge especially to young parents?
When a tooth wants to come out from the gum, it comes with a lot of pains. Anyone who has developed wisdom teeth as an adult will attest to this.
For children, there are equally pains that are connected to growing of teeth.Since children cannot talk, the only means of communicating is by crying. Confusion might set in among parents because of the child’s inability to explain what’s wrong with him or her.
Some parents will begin to imagine many things. At that point, the over- the -counter (O/C) drugs from a chemist shop might come handy which is not bad though. I mean such drugs that contain paracetamol that is meant to reduce pains in children and make them sleep.
How can such challenges be managed especially by first time mothers?
Every child has his or her own way of reacting to such situations. Some will have mild reaction while to some, intensively pains. Some children will not react or take any drug before the pain disappears.
Every child reacts differently. In most cases, women are always anxious. Anxiety is what drives most mothers to administer wrong medication to a child. This rush for any available drug might degenerate into other case. Some of them will come to me complaining that they have done all they can, and the baby is still not getting better.
Obviously, they cannot get it better on their own because some of the sympthoms can be superimposed on malaria. It is because when you treat the teething pains and it persists, then, you check the baby for malaria and other things. That is why we advise that when you use the O/C drugs for two days and the pain persists, then go and see a doctor for proper check.
Are there really medical complications in teething that parents do not know?
There is no serious complication or illness that will happen within teething period because this is something that should be and must be passed through by any normal child. Some children will develop temperature while to some, it might be only the teething pains. During the treatment of such cases, you will realise that they are all associated with the teething.
People should not be too anxious about it, running from one place to another. It is nothing too serious to worry about. All you need to do when a child cries because of the pains is handle him or her with care, pacify or lull with something that will make him or her sleep. When a child sleeps, the nerves, the brain and pains will subside, so that she wakes up with newness and less pains.
How helpful is sleep to a child in such a situation?
Sleep is very important even to an adult. Pains can be excruciating while a child is awake, but when she sleeps, the nerves are soothed and the child gets better after a good rest. As children sleeps, their brain will cool down and they will respond to healthy growth. Sleep for them has a far reaching effect to their growth. Every mother should endeavor to make a child sleep very well. Besides, gestures , playing and talking to children also has an effective means of relieving their pains. Even though, they cannot talk, they hear and understand, and you will be surprise how they respond in their own way when you do those things to them.
Most parents believe that crying is good for children even when they should be attended to. Does it apply in this teething period when they cry a lot as a result of the pains?
Crying normally is good for a child. If the child did not cry during child birth, we would not have lifted him or her from the womb. Crying helps them to develop their lungs and opens their systems. When children take a very big breath and shout, they develop their lungs. But continuous crying is not pleasurable. Some parents will allow a child to cry until he or she stops crying. If it becomes a habit, such child might not grow happy or psychologically balanced. This type of attitude is not good for a growing brain. The brain of a child is very tender and does not need harshness. Parents should talk to them, play with them and not allow prolonged cry which is not good.
Is watery stooling associated to teething?
Teething is not stooling related. But there are lot things that will happen to a child during this time, like feeding. Any mistake in feeding will result to vomiting and stooling. This should not be seen as an outcome of teething. However, one can superimpose on the other. Coincidentally, these might occur at the same time. When you treat the pain, you can also handle the stooling aspect which can come as a result of infections.
The plates, spoons or anything you give the child food with can harbour germs and cause the stooling. Even without teething, children can have watery stooling. Such a child must not be left stooling for too long in the name of teething. Parents should beware.
How can parents handle this?
In most cases stooling and vomiting are joined together as result of infections by germs. We call it gastroenteritis. Mothers must always keep children’s feeding materials very clean. People that live and maintain very clean environment do not suffer this problem much. Dirty environment causes most of these problems. Toddlers crawl and move around their surroundings much.
In that case, they pick everything that comes their way straight into their mouth. Some of the children who suck their fingers are vulnerable. We usually advise mothers to discourage children from sucking rather replace such habit with gadgets meant for such. Unlike in the western world, that has child products called sucker which replaces hand sucking that will minimise germs getting into their body.
Unsual stooling can be handled by allowing a childs stomach to be quiet. By this, I mean not allowing much food in it. Apart from the medicine we give, stomach has its own environmental sanitation. Without medicine, a child can still get better when the stomach is empty. Even animals in the bush survive without medicine. However, we also substitute this with drips. The stooling and vomiting is way of eliminating unwanted organisms in the stomach. So, when a child is doing it, it is normal but you must observe that the stomach needs sanitation.
Can overly clean environment have effect to a child’s immune system?
Yes. Too much of cleanliness has its own side effect. There should be a little bit of it to balance the immune system. A child will always develop immunity when he or she comes in contact with infection from an environment. You can observe that most of the things we suffer in the city, people in the rural areas do not suffer them. There is a controversy over this understanding, but I think as an experienced medical practitioner, allowing a little germ to balance the system is good.
When children get sick, you treat them. If they don’t get sick, you worry. It is through these germs that they build their immune system. But it must be done with caution. A child who is here can survive anywhere in Nigeria, but a child from outside the country might not be able to cope unless he redevelops immune system within the new environment. In this case, parents that practice extreme cleanliness should carry on, but will also remember that movement from one place to another within the climatic region can cause the child to get sick. Without infection, there will be no immunity. The two work hand in hand.
What is your general advice to parents against teething challenges?
Generally they should be able to go through it with only paracetemol to relieve pain and fever. There should be not too much drugs. When my children were young in London UK, I was not exempted from such fear even as a medical doctor, but I was adviced to buy certain toddlers’ biscuit produced to soften the gum while biting it.