The eruption of primary teeth in babies usually begins between three to six months of age. Many parents describe these months as a difficult period of crying and sleepless nights. During this time, many parents look for solutions to alleviate their child’s distress, from frozen teethers to various medications. Marketers take advantage of this situation, offering magical solutions that promise to solve the problem, but often lack a solid scientific basis. This is the case with amber teething necklaces, whose manufacturers often claim that these can alleviate babies’ teething pain and protect them from harm.
The pain that babies experience is not due to the eruption of the teeth through the gums, but rather due to the swelling of the gums three to five days prior to the eruption. Studies have found a connection between teething and symptoms such as fever, increased drooling and diarrhea, among other things, which pass almost immediately upon tooth eruption. Other studies, however, have determined that tooth eruption causes no systemic symptoms such as fever or diarrhea, but rather strictly local effects such as redness, swelling and excessive drooling.
In the Middle Ages, when infant mortality was extremely high, with the highest mortality rates observed around the age at which tooth eruption occurred, teething was defined as a life-threatening illness. In fact, up until the 19th century, teething was still considered a process that disturbs the nervous system, thereby bringing on disease.
Many strange methods were tried on children during those days, from honey and minerals to toxic metals such as mercury. It was even not unheard of to cut the gums in order to expose the erupting teeth. Between the 16th and 19th centuries, it was estimated that about 50 percent of child mortality in France was due to teething. It is difficult to determine how many of the tragic cases were indeed related to teething, and how many were caused by the toxic and dangerous treatments. Thankfully, most of the methods have long since been discontinued, due to the realization that they were unhelpful. However, some existing cultures preserve some of these methods to this day.
The use of herbal necklaces began in the 16th century at the latest. In 1597 it was first documented that necklaces made of peony roots were used to treat teething pain. In a 1633 article from England, an author by the name of Galen writes that the extremely high infant mortality rates during his time brought on the development of a market of miracle solutions for almost any real or imagined mortality factor, including teething.
The target audience for the healing necklaces was diverse and included mothers who had just given birth, infants of teething age, and anyone who suffered from a disease that originated in the head. Necklace sellers purported to heal any ailment: diarrhea, fever, cuts, and even tick-borne Ehrlichiosis disease. Galen added that the herbal necklaces were relatively expensive, and were worn by children from affluent families. Their survival rates were indeed higher, but Galen attributed this to the fact that children from well-off families lived in a cleaner environment, rather than to the herbal necklaces.
Similarly, an amber necklace supposedly represented a natural and magical relief for teething pain. Amber is a fossilized pine tree resin that has undergone mineralization deep underground. Trees secrete resin as a means of self-healing for situations in which the wood tissue is damaged by breakage or insects. The hardening resin seals the wood and protects the tree from diseases and contamination.
Amber was used for decoration as far back as 13 thousand years ago. During the 18th century, it was utilized, among other things, as a fragrance oil used as an aphrodisiac and as a controversial treatment against “hysteria” and female fertility problems. Baltic amber, which is the raw material used to make most modern amber necklaces, comprises up to 3-8 percent succinic acid, oils and alcohol.
A Therapeutic Resin?
In recent years the use of amber necklaces for alleviation of babies’ teething pains has become trendy again. Those who support it declare that the necklace was specially designed for teething babies. The common belief is that the baby’s own body heat warms the amber, causing it to secrete oils containing succinic acid, which is absorbed in the baby’s body and soothes the pain.
Is this scientifically valid? Highly doubtful. Firstly, amber melts at high temperatures of 200-375 degrees Celsius - substantially higher than the baby’s body heat, which naturally is around 37 degrees Celsius. It is therefore doubtful that the amber will secrete any substance at a temperature so much lower than its melting point.
Secondly, we need to understand what succinic acid is. It is a weak acid, first isolated in 1546 from amber. In 1937, the Hungarian researcher Albert Szent-Györgyi discovered that it plays an important role in cellular respiration, and even received a Nobel prize for this discovery. This substance is widely used in the food and plastic industries, as well as in the manufacturing process of many medications.
This acid also occurs naturally in all our body tissues and is involved in the cellular energy production process, as well as in many metabolic processes. Succinic acid levels were found to increase during inflammation, and it was found to contribute to immune system activation. Studies have demonstrated its involvement in many different physiological processes.
Although it is a relatively weak acid, any skin contact with it at a high concentration necessitated immediate washing of the affected area and a consultation with a doctor, since succinic acid can cause burns. Therefore, if amber did secrete this acid onto the baby’s skin, such a treatment could be not only non-beneficial but could also be harmful in certain circumstances.
However, research has shown that succinic acid has therapeutic potential for diseases related to problems with cellular respiration, under laboratory conditions. In practice, it is not used on its own as a medication for pain relief and is present in medication only as a non-active ingredient that regulates the acidity level of the medication.
Even if parents decide to don their baby with an amber necklace, there are still many questions about it. Firstly, the necklace distributors market them as a “natural cure” but there is no reference regarding dosage relative to the child’s age or weight. For example, it seems there is no difference between a necklace for a two-month-old and a necklace for a two-and-a-half-year-old. In addition, there is no mention of possible side effects or sensitivities, as is the practice for real medicine. It is important to remember that even a “natural” substance can still be dangerous.
Another danger has to do with putting a necklace on infants, especially while sleeping. The necklace designers claim that it was designed to tear as a result of the weakest pull, to prevent strangulation. They also warn that the necklace should not be worn while sleeping, and recommend supervising the baby carefully during the day as well.
Suffocation is the leading cause of death during the first year of life and is responsible for a third of deaths in Israel that are due to unintentional injury in this age group. In a letter by child safety organization, “Beterem”, regarding amber necklaces, they state that the danger of suffocation exceeds the possible benefits. The World Health Organization declared that 23 percent of child deaths worldwide in 2008 was due to suffocation, snakebites or hypothermia.
Babies and infants are naturally inquisitive and explore the world through their mouths. Many warnings were issued calling for keeping strings and beads away from the reach of children due to risk of suffocation, as well as warning against the use of necklaces on babies, following documented deaths due to self-hanging of the baby, when his body weight is pressed against an object pressing on his windpipe. The FDA recently issued a warning against using amber necklaces for teething pain in babies, or for creating sensory stimulation with special needs children. The warning stated that these necklaces can cause suffocation due to pressure on the neck, suffocation due to swallowing small parts if the necklace breaks, as well as mouth lesions and infections.
We know today that teething is not a disease, and it is, therefore, safe to say that there is no need to take any special measures to deal with it. It is obvious that the risks due to placing necklaces on the necks of small babies far exceed the benefit of supposed pain relief ambers are alleged to possess, a property which is debatable at best.