There is much discussion online as to whether amber teething necklaces work, and whether they pose a risk to your child.
These questions seem to be intertwined, as those who think amber teething necklaces are too risky often believe they don’t work, while those who use them despite any risks usually swear by their teething pain nullifying ability.
Adding fuel to the fire is the FDA’s warning in December, 2018 against the use of teething necklaces, bracelets, or any other jewelry designed for teething pain relief.
In this post we’ll discuss the actual risks, and also how to use these teething necklaces safely.
What are amber teething necklaces? Do they work?
An amber teething necklace is a small necklace made out of natural amber. Amber is fossilized tree resin and is millions of years old. There’s not much scientific data available to support or refute the claim that amber teething necklaces work, but many parents swear by them.
Succinic acid, which is in Baltic amber at up to 8% concentration, is thought to act as an analgesic when absorbed through baby’s skin. There’s no evidence that succinic acid does, indeed, pass into the body in this way, but there is some information that succinic acid may have a soothing effect.
Succinic acid is actually the precursor to aspirin, so it makes sense that it could have soothing effects. One study found that succinic acid helped reduce stress induced hyperthermia (a rise in temperature) in mice.
When babies are teething, they feel pain and may have a slight temperature increase associated with this pain and stress. It is conceivable that succinic acid may help reduce this discomfort.
Is succinic acid safe?
Succinic acid is a naturally occurring compound present in many animals, plants, and microorganisms. Succinic acid has been tested and deemed safe by the U.S. Food and Drug Administration (FDA) as a food additive. They state:
‘There is no evidence in the available information on succinic acid that demonstrates, or suggests reasonable ground to suspect, a hazard to the public when it is used at levels that are now current or that might reasonably be expected in the future.”
What makes amber teething necklaces dangerous?
There are several risks associated with teething necklaces, and they have nothing to do with the naturally occurring succinic acid.
Risk #1: Strangulation
The obvious danger with anything that goes around a small child’s neck is strangulation. Tragically, one child, Deacon Morin died from strangulation while wearing an amber teething necklace during a nap at daycare. Whether the necklace was the cause of strangulation is still up for debate, as the child’s mother, Dani Elaine, stated on Facebook:
[The daycare is] trying to hide their lack of supervision by stating that Deacon choked on his Amber necklace. This is not the case, and his medical examinations have shown another story… Whether or not his beads were involved is still under investigation.
Another child, Ellie, was injured when she got her arm through the necklace and twisted it into a figure eight during her nap.
These incidents both occurred during naptime, a time which the teething necklaces are not intended to be used. Children wearing amber teething necklaces should never be left unattended and should never wear the jewelry while sleeping or napping. This is a critical safety measure that many parents don’t follow.
A possible reason why many parents allow teething necklaces to stay on 24/7 is that many babies are fussiest at sleep times. Understandably, parents want to provide natural teething pain relief at those times if possible. Some parents remove the necklace from the child’s neck and wrap it around a wrist or ankle to lessen the risk of strangulation while still providing some pain relief.
Our strong recommendation is to remove amber teething necklaces completely while the child is sleeping or is unsupervised, even if that’s only for a very short period of time. Better safe than sorry.
Risk #2: Break away feature not working
Teething necklaces are supposedly designed to break away easily as a safeguard from strangulation. But one Canadian study showed that almost 50% of the necklaces tested didn’t breakaway with 15 pounds of pressure (the standard amount of pressure used to test children’s jewelry).
The other possible danger of teething necklaces is that when they do break, baby may ingest or inhale the beads. Most teething necklaces are made with a knot between each bead so that, if the necklace breaks, the beads don’t scatter. Instead, just one bead will fall off of the necklace, lessening the choking risk.
Risk #3: Length
When we look back at the story of Ellie, who got an arm through her necklace while it was still around her neck, the necklace that she wore was likely too long for her.
It’s important to buy a well fitting amber teething necklace for this reason. You should be able to fit two fingers between the necklace and your child’s neck while your child is wearing it, but the necklace should not be long enough for the child to bring the beads up to his or her mouth.
A good, standard length for an amber teething necklace is 32 centimeters, or approximately 12.6 inches. This fit isn’t too tight to cause discomfort, but also not too long where baby is more inclined to bite, play, or get tangled in it.
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Amber teething necklace safety and alternatives
Ireland’s Health Service Executive (HSE) warns very strongly against the use of amber teething necklaces. The reasons are the same as the potential risks we’ve talked about here.
What’s interesting to note is that on the same page, the HSE recommends numbing gels with a local anaesthetic instead. The FDA has has warned that one of these anaesthetics, benzocaine, can cause a rare but dangerous condition called methemoglobinemia, in which the oxygen in the blood stream becomes dangerously low. Symptoms include pale skin and lips, fatigue, confusion, headache and elevated heart rate. This study documents at least 2 cases of this happening.
The American Academy of pediatrics (AAP) doesn’t recommend using Benzocaine, but they do recommend using acetaminophen (Tylenol), which the AAP themselves have found to be potentially dangerous, especially for children. Acetaminophen is the number one cause of acute liver failure in children.
So what’s a mama to do?
Of course other teething remedies like rubber teething rings and frozen washcloths are always an option.
Amber teething necklaces are not inherently dangerous (at least not more so than benzocaine or acetaminophen); it’s user-error that can cause a potentially dangerous and tragic situation.
If you choose to use these necklaces for your teething infant or toddler, always adhere to these safety measures as the AAP advises:
- Never leave your child unattended while wearing jewelry.
- Never allow your child to sleep while wearing a necklace around his or her neck.
- Choose a necklace that is knotted between each bead to avoid scattering beads.
Bottom line on amber teething necklace safety
Accidents do happen, and can cause unthinkable tragedy for families. According to the Center for Disease Control (CDC), more than 700 children die each year from accidental drownings not related to boating.
In comparison, we only know of one death that may possibly be linked to a teething necklace, and the safety precautions weren’t being followed.
None of these tragic deaths are taken lightly, and even one death is too many, but we do need to take the relative risk into consideration.
Some parents feel that the risk, no matter how small, isn’t worth testing, especially if they don’t feel confident they can follow the safety guidelines every time (like taking the necklace off at bedtime).
Other parents may, instead, see that the risks are directly related to not following safety precautions, like leaving baby unattended or allowing baby to sleep while wearing the necklace; these parents may feel confident that they can follow those precautions every time.
If you do choose to use a teething necklace, be sure to follow the safety guidelines provided by the AAP and our team here at Mama Natural.
How about you?
Have you used amber teething necklaces? What steps do you take to ensure your child’s safety while wearing one? Share with us in the comments below.