Teething tablets carry real safety concerns that health agencies have flagged

Teething tablets marketed for infant pain relief have been the subject of warnings from the U.S. Food and Drug Administration (FDA) and poison control centers. The main concern is that these tablets often contain belladonna alkaloids, plant compounds that can cause serious side effects in infants, including rapid heart rate, constipation, fever, and in severe cases, seizures. The FDA has stated that the safety and effectiveness of these products have not been established, and the agency has taken action against manufacturers making unproven claims.

The problem is compounded by inconsistent dosing and labeling. Tablets may dissolve unevenly, meaning one dose could contain far more of the active ingredient than another. Parents also cannot always tell how much of the ingredient their infant is actually receiving, which increases the risk of accidental overdose.

Key Takeaways

  • The FDA has warned against teething tablets containing belladonna alkaloids because their safety in infants has not been proven and serious side effects have been reported.
  • Poison control centers have received calls about infants experiencing rapid heartbeat, constipation, fever, and other symptoms after teething tablet use.
  • Tablets do not dissolve uniformly, so the amount of active ingredient per dose is unpredictable and can lead to overdose.
  • Safer alternatives for teething discomfort include cold (not frozen) teething rings, gentle gum massage, and pain relievers like acetaminophen or ibuprofen at doses recommended by your pediatrician.

What the FDA and poison control have documented

Between 2010 and 2015, the FDA received reports of adverse events linked to homeopathic teething tablets and gels, including seizures, difficulty breathing, and constipation. Poison control centers across the United States have fielded calls from parents whose infants experienced symptoms after using these products. The FDA issued a warning in 2016 stating that it was not aware of any proven, safe, or effective teething tablet product on the market.

In 2017, the FDA took enforcement action against Hyland's, a major manufacturer of homeopathic teething tablets, for making unsubstantiated claims about the products' safety and effectiveness. The agency emphasized that belladonna alkaloids are toxic to infants and that the amount in each tablet cannot be reliably controlled during manufacturing.

Why belladonna alkaloids are dangerous for infants

Belladonna alkaloids are compounds derived from the deadly nightshade plant. Even in small amounts, they can affect an infant's nervous system and heart function. Infants metabolize drugs differently than older children and adults, meaning their bodies cannot clear these substances as quickly. A dose that might cause mild symptoms in an older child can cause serious harm in a baby under two years old.

Reported symptoms of belladonna toxicity in infants include increased heart rate, flushed skin, dry mouth, constipation, fever, and difficulty urinating. In more severe cases, infants have experienced seizures and loss of consciousness. Because teething tablets are not regulated the same way prescription medications are, manufacturers are not required to prove the dose is safe before selling them.

How teething tablets are regulated differently from medicines

Teething tablets sold as homeopathic products are regulated under a different set of rules than conventional over-the-counter medicines. The FDA allows homeopathic products to be marketed with less rigorous safety testing, which means manufacturers do not have to prove their products work or that they are safe for infants. This regulatory gap is where the risk lies.

Conventional pain relievers like acetaminophen and ibuprofen, by contrast, must undergo clinical testing and carry clear dosing instructions based on an infant's weight and age. The FDA has reviewed these products and determined safe doses for infants. Homeopathic teething tablets do not meet this standard of evidence.

Safer ways to soothe teething discomfort

Cold (not frozen) teething rings can numb sore gums and provide relief without medication. Refrigerate the ring for 15 to 20 minutes before giving it to your infant—frozen rings can damage tender gum tissue. Gently rubbing your infant's gums with a clean finger can also help, and many parents find this straightforward approach effective.

If your infant is in significant pain, your pediatrician can recommend a dose of acetaminophen or ibuprofen based on your baby's age and weight. These medications have been studied in infants and carry clear safety guidelines. Your pediatrician can also rule out other causes of discomfort, such as ear infection, which can mimic teething pain.

What to do if your infant has taken a teething tablet

If your infant has taken a teething tablet and you are concerned about symptoms, contact Poison Control when ready at 1-800-222-1222 (available 24 hours, seven days a week in the United States). Have the product container nearby so you can tell them the exact ingredients and how much your infant took. Poison Control can advise you on whether your infant needs medical attention.

Do not wait for symptoms to appear before calling. Even if your infant seems fine, Poison Control can assess the risk based on the product and the amount ingested. If your infant is experiencing difficulty breathing, seizures, or loss of consciousness, call 911 or go to the emergency room when ready.

Reading labels on teething products

If you are considering any teething product, read the label carefully. Look for the words "homeopathic" or the letters "HPUS" (Homeopathic Pharmacopoeia of the United States). Check the ingredient list for belladonna, deadly nightshade, or any plant-derived alkaloid. If you see these terms, the product carries the risks described above.

Products labeled as conventional medicines will list their active ingredients clearly and will have dosing instructions based on age or weight. These products have undergone FDA review. If you are unsure whether a product is safe, ask your pediatrician or pharmacist before using it.

Frequently Asked Questions

Are all teething tablets unsafe?

Teething tablets containing belladonna alkaloids carry documented safety risks. Conventional pain relievers like acetaminophen or ibuprofen, when dosed correctly by a pediatrician, are considered safe. Homeopathic teething tablets are not regulated the same way and have not been proven safe for infants.

What should I do if my pediatrician recommends a teething product?

Ask your pediatrician specifically what product they recommend and why. If they recommend a conventional medicine like acetaminophen or ibuprofen, they will provide a dose based on your infant's weight and age. If they mention any homeopathic product, ask them about the ingredients and whether it contains belladonna alkaloids.

Can teething tablets cause long-term harm?

Most infants who take teething tablets do not experience serious harm, but serious side effects including seizures have been reported. The risk is that you cannot predict the dose or how your individual infant will react. Long-term effects are not well documented because these products are not studied in the way conventional medicines are.

Is there a safe age to use teething tablets?

The FDA has not identified a safe age for teething tablets containing belladonna alkaloids. The agency's position is that these products should not be used in infants at all. If your infant is in pain, talk to your pediatrician about alternatives that have been tested and proven safe for your infant's age.