Dr. António Salgado 

Pediatrician

Myths and truths in Pediatrics

HPA Magazine 21 // 2024

In pediatric consultations, we often encounter questions and some beliefs from parents that may not have scientific basis. 
I dedicate this article to exploring some of these issues, highlighting what the literature says about them

What symptoms and signs occur during teething?
A meta-analysis published in Pediatrics in 2018, which analyzed 1179 articles, addressed this topic.
It is important to note that primary dentition eruption usually occurs after 6 months and coincides with oral exploration of the environment and frequent introduction of objects and hands into the mouth, leading to the transmission of infections (such as nasopharyngitis, gastroenteritis…). Thus, out of eleven symptoms that parents associated with teething, it was found that only irritability, nighttime awakenings, decreased interest in solids, and subfebrile temperature (below the fever threshold) could be attributed to it.
Therefore, teeth do not cause fever, loose stools, or colds or ear infections.

Are amber necklaces beneficial for teething?
Around 2011, amber necklaces emerged in the global market as a "natural" therapy for relieving teething discomfort. It was presumed that they would have benefits due to the release of succinic acid through contact and heat. In 2022, a meta-analysis published in the Revista Brasileira de Pediatria concluded that amber necklaces can be colonized by bacteria and pose a risk of infection. Additionally, there is a risk of strangulation, as children cannot easily open them. There is no evidence that the supposed active ingredient (succinic acid) has anti-inflammatory properties or can be absorbed by the skin.
Therefore, their use is not recommended.
Are honey and carrots useful for cough?
There seems to be some evidence that honey may help, especially with dry cough, compared to placebo or medication, although more robust studies are needed. However, it should be avoided in the first 12 months of life due to the risk of botulism and sugar content. As for carrots, the influence of some of their constituents on the immune response to viruses has been identified.
Thus, they can be used with the awareness that their benefit may be limited.

Can cold weather make my child sick?
It is known that respiratory viruses, such as Influenza and Rhinovirus, thrive better in cold environments, hence their increase in colder months. 
However, any infection is transmitted through contact with infected people (through the air or droplets) or fomites (infected objects and surfaces). 
Due to exposure to colder air, there may be a normal response of nasal passages to produce mucus to warm the breathed air, but it is short-lived and not infectious.
Therefore, children can and should play outdoors in colder months, provided they are properly dressed, without an increased risk of infection (ear infections, pneumonia...), and it is even better than being in warmer, less ventilated indoor spaces.

Should a mother avoid certain foods while breastfeeding because they "cause" colic in the baby?
Current recommendations advocate for mothers to have a varied diet when breastfeeding, giving preference to fresh products. Breast milk is "dynamic", meaning its taste varies according to the mother's diet (through volatile amino acids). Therefore, it is contradictory to advocate for a monotonous and unvaried maternal diet. 
Foods like beans and green vegetables, due to the presence of non-absorbable fibers and gas release during digestion, are generally associated with abdominal distension and some discomfort for the person consuming them, without any influence on the baby. However, the intake of stimulating foods containing caffeine, theophylline, or cocoa is discouraged.

Should water be boiled before preparing formula?
The purpose of boiling water is to sterilize it. 
If it comes from wells, it should be boiled because it does not undergo regular microbiological verification. 
In the first months of a baby's life, it should be bottled and not from the public supply, as it may contain some products, including endocrine disruptors, which may be present in the disinfection process of the latter.

With this, I conclude this article, hoping it has been helpful to you, aware that there are many more myths to address.