Where did you buy your amber teething necklace Baby Club Forum

Being a new parent and a sceptic I have been on guard regarding unconvinced advice and practices. Parents, especially new parents like myself, are a vulnerable group. We tend to be full of anxiety that we are doing the "right thing" by our children. Where-ever you find a vulnerable group like this you also tend to find those who prey on such fears. I have really been pleasantly surprised, despite my vigilance I have not yet been subjected to any unconvinced advice (that I've noticed). But early last week I was confronted by a practice from a fellow new parent that I found a modest disturbing. I'm taking about using necklaces of amber beads to reduce the pain of teething for babies.

Teething can be an especially worrying time for parents and children, the child may be experiencing pain as the new teeth break through the gums. This means an irritable child and frazzled parents. Anything that promises to relieve or preclude this harrowing time is gratefully embraced.

On to the amber beads. This practice disturbs me for several reasons. First is safety, the necklace if left on the baby for long periods may pose a strangling hazard of it becomes caught on something. Most advertise that they are made to break easily to preclude this and that the beads are individually knotted onto the necklace to preclude scattering on breakage. But this still seems to leave a broken string of beads in reach of a baby, as as most people know – anything a baby can get it's hands on goes straight into the mouth. So choking is also a concern[1&17].

Now, I'm not one to be a worry wart over each modest potential hazard, used correctly under parental supervision I suspect that the likelihood of a tragedy of this kind is low. But not zero[15&16]. This coupled with the low possibility that the necklace really does anything is what worries me. The following disturbing thing is that parents are accepting this via word of mouth and apparently not consulting their doctors before subjecting their child to an intervention of unknown safety and efficacy.

I have three main points I want to cover with regard to these amber beads that parents should consider before tiresome these beads (in addition to the physical safety higher than). The first relates to basic plausibility.

Before we get to that though it depends on which mechanism of action for the beads you subscribe to. There are several explanations regarding how the beads are supposed to work floating around the intertubes, many are of the tinfoil hat brigade variety, these will be unseen (but look here and here for a bit of a chuckle). Only one description I have found makes biological sense so that's the one I'll be focusing on.

That description is Succinic acid, baltic amber is known to contain between 3-8% succinic acid. According to proponents this is released from the beads and into your baby. The succinic acid then allegedly has an analgesic effect and so reduces the pain of teething. Here is where my first top regarding plausibility comes in:

Amber is tough, really tough. This is a material that has persisted for thousands and in some cases millions of years unchanged. Suffering through heating and cooling of innumerable climatic changes through the years. Yet this same tough unchanging material with happily give up it's chemical components upon the gentle heating it receives on being placed next to your baby's skin? Colour me unconvinced[1&2]. Related to this top amber has a hardness on the Mohs scale of between 1 and 3 [3], baltic amber which is usually touted as the therapeutic variety (because of the high succinic acid content) is at the high end of this scale 2 – 2.5. To place this in perspective, Tin has a hardness of about 1.5 and Gold is 2.5-3 [4]. But forget about this top, I don't need it. Lets say for argument sake that clinically noteworthy amounts of succinic acid are released by the amber and absorbed by your baby's skin.

My following top then, relates directly to the claims made for succinic acid. Succinic acid is made in the body (and in plants) as part of the citric acid cycle (aka krebs cylce)[5]. It is also use in the food and beverage industry as a food acid (additive #363 to be strict)[6]. Fascinatingly in this capacity there are recommendations from some quarters to avoid the substance[7]. Even so, apart from it's early use as a topical treatment for rheumatic pain[8] there is no evidence that I may maybe find (searching Pubmed at least, where I would expect a decent study to be referenced) that it is effective as either an anti-inflammatory or general analgesic. Let me be clear on that, I don't mean low quality evidence, I don't mean tiny poorly designed trials with equivocal effects, I mean nothing. Zip. Nada. In fact if anyone knows of any let me know because I find this complete lack quite surprising, I'm open to the thought that I was looking in the incorrect place or was using incorrect search stipulations. So, except there is late breaking news, it fails on that count as well. Meh, what do we care about evidence of efficacy anyway? Throw this top out too. Lets go on to my final argument, uh, I mean top to consider.

Lets say that a. the beads do indeed relief succinic acid into your baby and b. this succinic acid has an analgesic effect once it enters your baby's body. Doesn't the very fact that an unknown amount of a drug[9] is being place into your baby's body bother you? What is that I hear? It's natural? Oh, well, that's ok then. No wait, no it's not. I don't care what the origin of a compound is, the question is what are it's effects on the body and do the benefits out weigh the risks. Ok, lets replace succinic acid with some other naturally occurring substance, salicylic acid. This is a compound with known anti-inflammatory properties[10]. Would you be pleased with a product that introduced unknown levels of this compound into your baby? What if I said that overdoses with this compound may maybe lead to a 1% chance of death?[11] It's natural, it's also the precursor to acetylsalicylic acid, otherwise known as Aspirin[12].

Now, lest I be accused of excessive dread mongering and drawing fake comparisons I want to admit that at present there is no evidence to suggest that succinic acid is hazardous, nor even that it is potentially hazardous[5]. This does not detract from my main top but, the top isn't whether this particular compound is safe or not but that the reasoning[13] around it's use is faulty and cannot be used as a substitute for evidence.

Based on the complete lack of plausibility on any level of efficacy any potential for harm, but tiny, must tip the balance of this equation away from the use of this product. Don't trust me though, talk to your doctor, I suspect though that given the complete lack of reliable information on this topic they will be left to rely on their own philosophy of harm vs benefit. In the final analysis, there are not always clear answers[14], but developing excellent critical thinking skills will at least provide you with a tiny set alight in the darkness.

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