Being a new parent and a sceptic I have been on guard regarding dubious 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 actually been pleasantly surprised, despite my vigilance I have not yet been subjected to any dubious advice (that I’ve noticed). But early last week I was confronted by a practice from a fellow new parent that I found a little disturbing. I’m taking about using necklaces of amber beads to reduce the pain of teething for babies.
Teething can be an especially stressful 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 prevent 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 prevent this and that the beads are individually knotted onto the necklace to prevent scattering on breakage. However 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 every little 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 actually does anything is what worries me. The second 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 trying these beads (in addition to the physical safety above). 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 ignored (but look here and here for a bit of a chuckle). Only one explanation I have found makes biological sense so that’s the one I’ll be focusing on.
That explanation 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 point 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 point 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 put this in perspective, Tin has a hardness of about 1.5 and Gold is 2.5-3 [4]. But forget about this point, I don’t need it. Lets say for argument sake that clinically relevant amounts of succinic acid are released by the amber and absorbed by your baby’s skin.
My second point 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 precise)[6]. Interestingly 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 could 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 small 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 idea that I was looking in the wrong place or was using incorrect search terms. So, unless there is late breaking news, it fails on that count as well. Meh, what do we care about evidence of efficacy anyway? Throw this point out too. Lets move on to my final argument, uh, I mean point to consider.
Lets say that a. the beads do indeed release 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 put 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 happy with a product that introduced unknown levels of this compound into your baby? What if I said that overdoses with this compound could 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 unnecessary fear mongering and drawing false comparisons I would like 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 point however, the point 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, however small, 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 good critical thinking skills will at least provide you with a small light in the darkness.
Footnotes:
1. http://www.3news.co.nz/Teething-necklaces-dangerous—sceptics/tabid/423/articleID/160820/Default.aspx
2. I found this paper that analysed the volatile out gassing of amber, succinic acid was not mentioned as an identified component. http://www.springerlink.com/content/865ku15055np3x78/
3. http://www.emporia.edu/earthsci/amber/physic.htm
4. http://en.wikipedia.org/wiki/Mohs_scale_of_mineral_hardness
5. http://www.accessdata.fda.gov/scripts/fcn/fcnDetailNavigation.cfm?rpt=scogsListing&id=339
6. http://en.wikipedia.org/wiki/List_of_food_additives,_Codex_Alimentarius
7. http://www.foodreactions.org/allergy/additives/300.html
8. http://en.wikipedia.org/wiki/Succinic_acid#History
9. If it has biologic activity that can be used in a therapeutic fashion, it’s a drug, no quibbling on that point please.
10. http://en.wikipedia.org/wiki/Salicylic_acid#Medicinal_and_cosmetic_uses
11. http://en.wikipedia.org/wiki/Salicylic_acid#Safety
12. http://en.wikipedia.org/wiki/Aspirin
13. ie “It’s got to be good, it’s natural.”. Don’t make me barf.
14. Who am I kidding, there are almost never clear answers. Who wants certainty anyway?
15. http://safekidspiercecounty.health.officelive.com/Documents/Choking%20and%20Suffocation%20Fact%20Sheet.pdf This is an american document but I don’t think necklaces become safer just because we’re in NZ.
16. http://www.nzchildren.co.nz/infant_mortality.php NZ infant mortality statistics.
17. http://www.bpac.org.nz/magazine/2010/april/docs/bpj_27_oral_pages_30-41.pdf See page 33.
Related articles
- Death by “alternative” medicine: Who’s to blame? (Revisited) (sciencebasedmedicine.org)
- Herbal medicines (scepticon.wordpress.com)
- What is the Harm of Alternative Medicine? (scepticon.wordpress.com)
- Complexity and Health – A Rant (scepticon.wordpress.com)
72 Comments
Hm, quick question, do you prefer comments here or on SciBlogs?
sciblogs would probably be better I think. Better atmosphere for discussion. Cheers.
A Jewellery related comment was removed for looking spammy. If you think this is in error please re-comment and attempt to not be suspicious.
Hallelujah – someone talking common sense – and science – on teething necklaces! I’m really alarmed by the number of people who will quite happily use them for their children. Admittedly they’re pretty. And they probably don’t do any harm. But the way people lap up the cod ‘science’ behind them, or even worse, believe in the purely anecdotal evidence, doesn’t bode well for scientific rationality.
Yep, the number of people who dismiss my arguments based on anecdote or personal experience is overwhelming. This, unfortunately, isn’t surprising. We are not natural scientific or logical thinkers, we also do not believe things for rational reasons. But, I am ever hopeful that we can learn.
Thanks for the comment.
Has anyone used them and had success? Have twins teething at the moment and would like a natural way of dealing with the pain. I am weary of putting a necklace around Jacks neck as he will surly find a way to get it off or get it caught in something. He is a messer.
That’s part of the problem ciara, the use of anecdotal evidence when making this decision.
Lot’s of people say they work, but lot’s of people also say other things like Power Balance bands or homeopathy work too. The issue is that this sort of testimony is not reliable. Looking at the objective evidence (such as it is) there is no good reason to think they work and small but real risks.
You also seem to have fallen into the trap of thinking natural = good. My advice is to look at the evidence of efficacy and risk and let that be your guide, not artificial distinctions of natural or unnatural.
my twins were soothed by them. when i took them off it was noticeable. i never left them unsupervised – buy the right length and watch them…..
Each positive anecdote has a negative anecdote. The science that everyone seems to want to dismiss is how we decide.
and vice versa – as you’ve hinted at below, evidence based research is about making an informed risk assessment.
‘……..“Better the Devil you know”…..’
i don’t think people are outright dismissing scientific evidence.
it seems to me (and i may be mistaken) that you mainly have a campaign against/ irritation with people blindly following, but there are many parents who research, find that there is no evidence of harm, try an option out and then find it works – what is the problem with that, even if they do end up with personal anecdotes???
at the end of the day, (or in the middle of the night), if one baby is more comfortable, one family is sleeping better, then it is worth that parent having decide to do something for their own family, against the commonly accepted advice in drs surgeries.
i just had surgery a week ago, and knew that every step of the way the anaesthetic, surgery and pain relief have side effects (some of the non-life threatening ones which i have and continue to sadly have) but i made an informed choice and put myself through the cost of it (financially and physically) in the hope that the 80% positive outcome might work out in my favour. if it doesn’t it will have been all for nothing, but it was worth the risk to me try and imrpove my quality of life. if there had been a 1% chance of improvement i may also have taken the risk, because my condition affects me daily.
i made another decision 2 years ago to try amber on my twins (which cost a lot less and didn’t require a loan!) as well as using ibuprofen on occasion, despite knowing the risks for that in my babies. i didn’t use amber or ibuprofen with my older children (i used calpol) and that was my risk assessment at *that* time.
our risk assessments are constantly changing, as does evidence based medicine if we’re honest – many conventional therapies have eventually been thrown out for the side effects that trials missed. many new therapies/ drugs/ protocols are being ignored in hospitals because drs and nurses are stuck in their ways, it costs too much per patient or drug compamnies won’t make money from the new proven way forward. i work in health and see it.
i personally feel that your interest in educatiing parents and pointing out there is no evidence for using amber in teething could be better put to use in debunking some of the more harmful interventions in life.
but this is your blog and your platform, so peace!
I hope your medicals issues resolve well.
I’m am not trying to make the case that scientific evidence is infallible or unchanging. That is an untenable position. But there is a big difference between imperfect evidence and no evidence. Sorry if my inability to trust anecdotes is an impediment in your eyes.
I’m well aware that there are those who try to make an informed decision about these things but having read a number of replies and visited a number of boards discussing this topic, those people appear to be in the minority, by far.
Finally, yes, this is my blog and but one post. Given that it is rapidly becoming my most popular post I think it is time well spent. Perhaps you feel that attempting to give people resources and shake them out of believing everything they hear (often without realising it) it a waste of time, you could be right. But it’s my time to waste.
My self and countless other Mommy friends have had surprising success with the teething necklace, noting a distinct difference between teething with it on and off.
But I do notice if left on the necklace usually leaves a rash, if it’s from the necklace or improper use I’m not sure. My daughter has never had a rash with it on.
She’s also the type to play/pull on anything and has never gotten it off or broken it. Never gotten it caught on anything either.
I wish you luck with that. So long as you understand anecdote =/= good evidence.
Luck with what?
I didn’t see the entire thread of comments just the original asking if anyone had personal experience.
Not trying to start anything or disprove anything but I do find if you can recreate positive anecdotal evidence then that’s usually a good sign. Enjoyed reading your post and found it informative so thank you!
You’ve spent a considerable amount of time researching, reviewing and studying a topic that would have been far simpler (and faster) to just tryout. Put a necklace on your kid and see what happens when you take it off after about three days (obviously, don’t have him/her sleep with it or take a bath with it). It’s not a big investment and the result is obvious. I am not one for “crunchy” cures, but it works for my son. He’s a drooling mess and constantly has his fingers in his mouth if he doesn’t have one on (he’s 18 months now and his molars are coming in)
yep, the easy way would be to use it and have my investment colour my evaluation. Unfortunately I’m actually interested in the evidence not what my single biased experience would tell me.
llama, funny as always.
[edit] I cover the “try it yourself” line of argument in the second half of this post
@tsinn because they cause autism. That’s why.
An immensely interesting argument and one that has swayed my decision on buying these ‘teething aids’. Your acuity and articulate argument leave many questions to be asked. Ultimately though you have made other ‘naive’ / new parents question what we are giving our beloved children. Well done, and thank you.
I don’t know much about the scientific side of amber use for relief of teething, but when a mum sees her baby in pain she will try anything to help her little one! That’s how I ended up buying a necklace from [redacted as spam] a few months ago. I was very skeptical, but my baby was visibly calmer and less irritable after wearing the necklace for a couple of days. So I guess it’s worth a try, it’s cheap and won’t cause any harm, you cannot say the same for over-the-counter medication…
A couple of things:
1. Any necklace would have done the same job.
2. You don’t know how or why it works and that you don’t care is disturbing.
3. Unless you know what it does, it’s NOT worth a try.
4. HOW do you know it won’t cause any harm, especially since you have no idea how it works.
5. Over the counter medication comes with clinical trials, contra indications and common sense.
6. What are you going to do when you find out the beads cause autism? They do you know.
The Furious one has a point, we Think they don’t cause harm, we have no good evidence they cause direct harm (beyond a coking hazard) but we have no good evidence about them at all.
I’ve seen a number of replies like this lately (on parenting boards) that say, “I don’t know how they work, or if they work, or if I’m fooling myself – but I’m going to keep using them anyway”. That’s your prerogative.
The advantage of over the counter medicines is we DO know how they work, we DO know if they work and we DO know the risks. The phrase “Better the Devil you know” exists for a reason. If you have the information you can make an informed choice and take the risks into account. If you are working in ignorance then that option is taken away.
Like I said, it’s your prerogative, but I don’t appreciate you essentially advertising a product on my website. Especially if I don’t get a share.
We also THINK a lot of things are safe that aren’t, necessarily. How many drugs have been recalled because they turn out to cause more harm than good?
I used an amber teething necklace with my youngest son. It seemed to work. When he developed tooth decay because of a genetic enamel deficiency, at around a year old, I looped the necklace around his foot like an anklet while I nursed him, and it did seem to help. (FTR: I asked our pediatrician about this and she was of the opinion that it wouldn’t release any of any of the succinic acid whatsoever, but could be a choking hazard, which is why he wore it on his ankle and only while nursing so that he would be completely, 100% supervised.)
To be perfectly honest, I think they work because mom (or dad) THINKS they will work, and the child can sense the calmness in the parent, so they settle down. I think any object that you think is going to work, is probably going to work to some degree due to the placebo effect.
Thanks for the comment Rose,
You’ve made a couple of good points. The first is discovering drugs (and therapies) that when we take an overview of the evidence do not provide a satisfactory risk/benefit ratio. The important thing to remember about this is we need the evidence to make such a determination. There is none for the teething beads.
The second is about the placebo effect, this is something that is widely misunderstood and can confuse the issue. But I note that you make a very good observation that it is the parent that is contributing most to the placebo effect here. That may be true.
Beyond that we get down to what level of evidence we are comfortable before trying something. For some things I need a reasonable amount of reliable (ie not anecdotal) evidence before deciding that something is worth it. Others have a different threshold.
Thanks again.
Salicylic acid containing items are a big no-no for pregnant women, too – it can cause birth defects.
Also, I also think Hyland’s Teething Tablets are also a crock. They are homeopathic and don’t do anything (my wife bought some.) Furthermore, they suggest using more of them for a higher dose – which is contra to what homeopathy is all about, isn’t it? It ought to be “one tablet as needed. If baby is still fussy, crush tablet, and put a single grain under the baby’s tongue’ or something.
Finally: You should check out youtube for “That Mitchell And Webb Look: Homeopathic A&E” . It’s great.
Thanks for the comment. Just looked up the teething tablets, the company has a press release on their website announcing a product recall. Appears to be from last year, seem to be having internet issues at the moment so I’m not sure of the details but the FDA was involved and that in “working with the FDA, has identified manufacturing processes of Teething Tablets that can be improved to ensure uniformity in dosage”.
A bit more digging shows that these products do actually have active ingredient (albeit small). The Zicam debacle a while ago showed people that homeopathic medicines are not all diluted into harmlessness. This reveals the ridiculousness of allowing homeopathic potions a legislative pass when it comes to showing safety and efficacy. And yet….lessons do not seem to have been learned.
The Mitchell and Webb stuff is great, another one is Dara O’Briain: http://www.youtube.com/watch?v=YMvMb90hem8&feature=player_embedded
I use an amber necklace on my son and it does work to soothe him. While there may not be ‘scientific’ evidence to tell me the how’s and why’s I see the difference and that’s all the evidence I need. I also wear one myself for chronic pain, because I breastfeed and don’t want to take any of the ‘scientifically proven non-harmful’ drugs that are too often recalled or later proven to actually cause harm.
Let me get this straight, your argument is “There’s no evidence, therefore it’s safe and effective”??
Yep, that’s how everyone should do it, those drug company should stop wasting millions on safety and efficacy trials, just have a few people, “Think” them safe and away we go.
Sorry, but the anecdotes do not move me. Plus, there is no chance you’ll change your mind so polite reasoning is no necessary.
this is a very interesting point. many trials are only intiated because a drug company has a vested interest in selling their product. and it’s why a lot of at-first-convincing research is also flawed.
Agreed, which is also why post licensure monitoring is also required and how the problems are found and those recalls are enacted. All this requires rigorous evidence.
I guess I wont be getting it …
Thanks for visiting.
Just two quick notes. First, my odler child’s pediatrician recommended them. When I voiced my skpeticism, he replied that though there was no “talking science” behind them, he’d seen them do good in his 15 years of practice (this in a country where the beads are more commonly used than in the US). The second point is that demanding a safety study on them is silly, given that they’ve been used for so long. Designing and conducting such a study makes sense if time hasn’t already done so. As for an efficacy study, it is a bit naive (and not, um, “scientific”) to say that since there are no studies proving amber or succinic acid’s efficacy, it/they must not be effective! Why would anyone conduct such a study??? There’s no money behind it. Finally such a study would be close to impossible given that we have no objective way of measuring pain in the verbal population, let alone teething babies. I like science but I don’t think it’s fair to trot it out in a somewhat sloppy manner in order to look down at other people’s choices. The theory behind amber beads’ efficacy is in-line wiith Paracelsus’ principles, which, though they are now taken to be homeopathic principles, are also cornerstones of allopathic pharmacology.
Two quick points multiplied?
First, you are assuming that people cannot be confused as to causality. This is patently incorrect, people thought bloodletting was perfectly safe an effective for hundreds of years. Presumably they would have thought careful study equally pointless. Before you reply that that was before modern science etc. the difference comes in with that careful study, people are still people and can be fooled.
Further, I couldn’t find any information that sucinic acid is useful as an analgesic in any population, not just babies. The study need not show efficacy in teething specifically just in a related enough field to provide plausibility. Also there is no good reason to think the sucinic acid even comes out of the beads at body temp, so that would need further plausibility.
As for there being no money in such a study, are you kidding? Selling these beads is already profitable. Imagine taking the principle behind them an marketing it to the entire populace for everything. That would mean big bucks for the company who pulled that off.
Finally, there is only medicine. Allopathic etc is only used when you have an ideological axe to grind. Something either works or it does not, you either apply strict safety and efficacy to a practice or you do not. You can’t have it both ways and still call both medicine.
Thank you for this! I’m trying to convince new mothers that any necklace around their babies’ necks is dangerous, but most of them prefer anecdotal evidence…
Your article is well researched and will inspire me to found more and better arguments. And to not let myself be discouraged by the amount of baffling answers / arguments I get.
You have lots of patience. Keep up the good work!
It’s always nice to get a positive comment, thanks.
I would caution over emphasising the dangerous aspect of this, the risks are low in absolute terms and you risk coming off as a crank yourself. I would suggest re-iterating how little evidence there is to support it, how implausible it is and how anecdote can be used to support any position and that without controlled evidence we can not make a reasonable determination.
Also there is a time to let these things go. If after all of your arguments they are still wiling to keep going then admit defeat and wish them luck. It’s not worth causing antagonism over. It’s better that you part with them still respecting your opinion than for them to consider you simply dogmatic and not worth consulting.
Best of luck.
I would point out that health authorities consistently state NOT to put necklaces or strings around a baby’s neck. These necklaces pose a risk of strangulation and choking, and are definitely against mainstream baby care advice. I don’t think that pointing this out is scaremongering in the least. The risk is definitely non-zero.
Agreed that the risk is non-zero. In my opinion this combined with the fact that there is no evidence of efficacy tips the balance away from using these necklaces.
I also agree that pointing out this risk does not in itself constitute scaremongering. But there is a risk of such if the possibility of strangulation is hyped beyond the evidence. This is what opponents of mainstream medicine do (eg anti-vaccinationists) and I think we should be careful not to cross that line.
If a parent is aware of the possible risks and is vigilant and responsible then the chances of an adverse event are much reduced.
Just to be clear, I don’t think the “It works for me” argument is good enough to justify use of these items, but if a parent is adamant in their use then advising about the risks and letting them make their own decision is the best we can do.
Cold comfort if something bad happens I know. But we can’t force people to follow our advice, and if we could…would we want people controlling our decisions in such a manner?
Thanks for visiting.
Unfortunately, your article reads much like the first reports of a snow-capped peak in Central Africa (present day Tanzania) during the mid 19th century. Everyone that visited Kilimanjaro could see it was real, but at the time of it’s European discovery, there was no way to document it’s existence beyond eyewitness reports. Since the mountain’s existence was a scientific impossibility, people that didn’t see it knew it couldn’t exist…
Everyone I know that’s used amber beads to ease teething strife say they work. I only hope the people reading this are keen enough to reach the point of your entry that reiterates the lack of evidence to support any implausibility or safety ‘concerns’. Indeed, it seems you’ve thoroughly proven that the entire point it moot.
…I agree with tsinn, you would have made your life much easier if you just visited the mountain to see for yourself.
You may have a point, but what you suggests would leave room for every other thing that people attest but for which we have no good evidence. What of alien abductions, bigfoot, fairies, angels, telepathy, ghosts, witchcraft, voodoo, leprechauns, ley lines, chemtrails, mind control, the evil eye, the myriad alternative medicine treatments, the many mutually exclusive deities that have adherents in the hundreds of millions? Must we accept ALL because there are those who say they are real?
You may choose what to believe how you wish, I’ve chosen reason and scientific evidence.
In the end there was good evidence for the mountian. I’ll be waiting for the same for amber beads and happy to change my mind.
Yes, that is the proper measure. If someone feels something is real (leprichans, angels, et al) – especially if it has not been proven otherwise – we must accept it as their truth. Of course, you needn’t adhere by the same beliefs, but that is your perogotive…
Ultimately, you miss the underlying dilemma within your post. If someone feels that an amber necklace alieviated pain, then it’s likely that no amount of science will change that “fact” for them. Now, if the same necklace doesn’t work for you, either from lack of prior evidence or due observation, then you are in no different position than the former individual – aside from the likelihood you won’t be using the necklace. So, just because you haven’t found something to be true for yourself, does that mean it’s untrue for others?
In the end, it would be wise to tread more carefully over such issues that have no definitive answer. It’s one thing to build a case outlining a lack of evidence – perhaps even against the ubiquitous bigfoot sightings – but nobody on either side of this issue stands to benefit when you make conclusions that can only be empirically founded, especially when you have no experience with the item.
I understand that it’s difficult to let individuals do what they like; humans seem destined to strive for unanimity in all things, but that isn’t feasible. It’s just unfortunate that you will speak so vehemently against something you’ve never tried to experience.
Then we use different definitions of “true”.
I also don’t see my post as vehement, so I guess were working from different definitions of that as well. Thanks for the insight on the mutability of the world depending on belief.
I realize why you are unhappy with my remarks, but you needn’t be so defensive. I happen to agree with the foundation of your statement as I have no evidence to believe the necklaces work and recognize that they present several hazards beyond everyday encounters.
However, I think you do a disservice to your argument by expounding to a point of belittlement and mockery of others. If you feel that your comments should be otherwise accepted, you would do well to note the manner in which readers are receiving them and adjust accordingly. Of course, this only relevant if you wish to remain an unbiased source of information on debated issues. If that is not your aim, I have misjudged this blog entirely and apologize for the unsolicited insight.
On another note, I wanted to thank you for allowing varying comments to be posted regarding this topic. Some bloggers will filter these remarks to leave only the feedback that supports their argument – an unfortunate fact, of which I’m afraid many readers are unaware.
I didn’t intend my comment to read as defensive. More aghast that you advocate such solipsism. As such it seemed like there could be no common ground. As for bias, I recognise that complete removal of bias is impossible for an individual and direct you to the byline of my blog at the top of every page: “Just the biased facts”.
To address a point of yours that was made earlier about lack of evidence to support implausibility. That is quite backwards, evidence must be shown that something works – not that it doesn’t. Lack of plausibility refers to the fact there is no good reason to think it could work ie that the active ingredient is either absorbed or does what is claimed even if it is – I am willing to bend on either of these points if someone can show me good evidence to do so. Anecdote does not count.
Could you point out to me where in the post I have been belittling and mocking (I’ll cop to that with the tin-foil crack, but to me that is not where the legitimate claims about the beads are coming from – ridiculous claims do not deserve respect by default). I have have many comments of praise for this article and just as many disagreeing, you are the first to take issue with the tone.
I try to allow every comment to be posted, I will filter and block those who are rude and insulting. I though can be as insulting as I like.
Again, I apologize. I now better understand the individual with whom I have been speaking.
Cheers!
Yep, it’s all me. Glad we got that sorted out.
Thanks for the comments.
..yawn
…Stretch.
I know it’s rubbish, but people still use them.
Thanks for your well-thought out post. I own a children’s store and people have been asking for these all year. I have not brought them in because the idea of wearing a pain-relieving substance on a baby all day makes me wary. I have asked these parents if they would dose their teething babies with Tylenol all day long just for teething discomfort and they have all said, “no!” in horror – I can’t see any difference. Except for the fact, of course, that we don’t know what a “safe” dosage is with these necklaces (that through continued anecdotal evidence, do work). The local health food stores don’t even carry them, and I will assume that’s because Health Canada has not approved them (??). My children are older, and between Sophie the Giraffe, frozen wet washcloths and the ocassional dose of Tylenol, we survived teething. I DO carry the hazelwood necklaces because a) they have Health Canada approval and b) they are supposed to work in the opposite direction (pulling crap out of your body instead of putting it in – your next researched post, I hope!)
Thanks for the comment. Interesting about the Hazelwood necklaces having Health Canada approval, I will certainly have to look into that. Thanks.
I had a look around about the Health Canada approval. Much seems to be made of the fact that these necklaces have a “Medical Device Establishment License” from Health Canada. But this seems to be a category error, according to the Health Canada website a Medical Device Establishment License is:
“Medical Device Establishment Licensing was implemented to allow users to be made aware of who is importing and/or selling medical devices in Canada. It requires establishment licence holders to provide to Health Canada the assurance that they have met the regulatory requirements and have documented procedures in place, where applicable, related to distribution records, complaint handling, storage, delivery, installation and servicing, with respect to the medical devices they sell.”
I take that to mean it is regulating the “Establishments” ie importers/manufacturers/sellers of medical devices. This is not about the device itself. Perhaps these sellers are just getting the name confused. As you sell these items do they have some sort of approval stamp or ID number or something that could identify what sort of approval they have?
The claims made for Hazelwood necklaces (neutralise body pH) seem no more plausible to me than those made for Amber. The idea that the body (under normal conditions ie no underlying illness) needs help to stop it becoming too acidic, as well as the corollary that this is the cause of a wide range of illness from rashes to cancer, seems to be popular in Altmed circles now.
Unfortunately there is no more evidence for this notion than there is that Amber is a pain reliever.
I’ve just scratched the surface here, certainly I need to look into this further. Your help would be appreciated if you can give me more info on what exactly the Health Canada approval is.
Thanks again.
Thank you so much for writing this; it’s been disturbing me that I know people using these and claiming they work. They need to be aware that correlation does NOT equal causation, so just because the baby appears calmer or is dribbling less when the necklace is worn (Why does drooling bother parents so much? Babies don’t seem particularly distressed when they’re slobbering!) doesn’t mean the necklace caused this.
And of course, there’s the “placebo by proxy’ factor to consider: if someone has just forked out on something that’s “supposed” to work, they’re far more likely to perceive their child as being happier.
Seems to me there’s a lot of misinformation floating around in parental circles and I admire you for doing your bit to clear this up. I think mums and dads deserve better than old wives’ tales, “anecdata” and hearsay, and to be armed with critical thinking skills (rather than letting paranoia and fear take over) is the way to go.
Thanks for the comment, and I love the term “anecdata”, thanks for introducing me to it.
You make a good point about placebo as well, the way you’ve phrased it is how I would describe “investment bias” ie the bias created in someone because they’ve made a significant investment into it – whether cash, time, hopes etc.
But the idea that placebo is this one thing that means “mind/body interaction” in the person receiving treatment is becoming quite popular and I think is misguided. Placebo is a collection of artefacts that contributes to an inert treatment appearing to work. So that may include regression to the mean, inaccurate reporting, poor observation, lack of blinding (as in amber beads) etc…
Speaking of misinformation, I only recently discovered that there is scant evidence the “Gripe water” for grumpy babies. We used it all the time when our boy was younger, though I had never heard of it before my wife started buying it. It was stocked with the more reputable stuff so I didn’t really think about it. Even so I did do one experiment where I substituted plain water and that seemed to work just as well…I gather though that any real effect can be attributed to the sweet taste of the water.
So nice to read A well written article with some form of scientific grounding or in this case lack there of. These beads remind me of the power balance bracelets that were all the hype a year or two ago. My wife bought this for our child and I can’t believe that she has been taken for such a clown. What next time traveling amulets made out of gold spray painted lumps of coal, you never know they may or may not work why not try them out
Thanks,
I try not to be too judgemental of those who are taken in by things like this. Often they just don’t know the facts (like me and the gripe water above). Where sympathy wanes is when after learning the facts they say something along the lines of “I don’t care if it does nothing I feel better using it” or some such thing….even son it can be painfully distressing to be powerless while your child is in obvious discomfort. The illusion of control is still a powerfully attractive option for some, even if at some level they know it’s an illusion.
with regard to the power balance bracelets, before christmas I saw one in one of those “$2″ stores that are springing up all over the place here and had to laugh. Almost bought it just for fun.
Great article – it helps with parents making informed decisions. It is always good to read another side of the argument. This has made me want to do a bit more research before buying.
onefuriousllama left a comment twice to say that these cause autism – is there any evidence of this?
Heather, thanks for the comment,
ah, senior llama is engaged in the activity that is commonly referred to as “Joking”, in this case to get the “joke” one needs to be fully aware of various other claims around the causes of autism and claims made by those who attack modern medical science.
A commentary on the methods of pseudo-science and fear mongering you might say.
Thanks for clearing that up – he sounded so serious that I wasn’t sure. I have heard of the odd other thing “supposedly” linked to autism which seem to be a load of rubbish also.
Thank you for the insightful read. I’m not going to use this product until actual scientific evidence of its effectiveness and safety of the succinc acid is produced. Magic mushrooms are natural- doesn’t mean I’m going to feed them to my baby.
Thanks for visiting,
Waiting for proper evidence…that may take a while.
A good point about the mushrooms, the idea that natural = good is widespread at the moment. Unfortunately it distracts from the real question which is what is the risk vs benefit.
This was an interesting read and I have yet to draw any conclusions as to my feelings on teething necklaces. However, for future reference, you may want to reconsider using wikipedia as a source for information. While it may be a convenient place to find “facts,” no intelligent person seeking credible information would cite the database. This is rule number one in writing any sort of research document. I’m not trying to offend, just offering insight.
It’s a blog post.
I think I’ll live.
Funny, I ran across this blog as I was searching for a new baltic amber teething necklace for my 2.5 year old tot that has become quite attached to his first teething necklace that he has been wearing, round the clock, since he was 8 months old. It’s still in fantastic condition, but it is getting too small. Do they work? Who knows? All I know is teething wasn’t an issue for us, and the pinched nerve in my own neck finally resolved while I was wearing my own amber necklace. It could be all completely coincidence, but I’ll give a nod to at least some placebo efficacy with these necklaces. For us they’ve just become a trademark, and I have no concerns with their safety, as my own rough and tumble little boy is going on nearly two years of wearing his day in and day out with nary a fray in the knotted silk string. The necklace is my son’s security item, his personal “attachment” to it is so much better for him in the long run than a paci, bottle, or a blankie drug through the daily filth.
I was a total skeptic about the necklaces as well. And as a first time parent I was trying everything to ease my poor daughter’s pain. I was having to medicate her on average of 3 – 4 times a week at night just so she would sleep through (otherwise the pain woke her up several times which made the next day even worse for her). The medication I was using was over the counter teething specific syrup (which contains anti-inflammatory, anti-hystamine and a pain killer in an alcohol suspension). Then in the space of a week I had 5 different people swear by the necklace – after seeing how much she was suffering. I did a lot of research on it (I’m a born again Christian and don’t want to inflict some spiritual voodoo type healing crystals on my child unknowingly) and I saw the succinic acid info and thought I’d try it – anything’s better than the medicinal cocktail she was being fed. And despite my skepticism, it worked – she became a different baby! She still has bouts of teething where she requires pain killers to get her through the night (and sometimes the day) but these are much fewer and further between. I’m honestly not writing this to dispute your article in any way – I just wanted to post my first hand experience. And to be honest, even though it seems to work, I’m still skeptical, and still concerned that the acid isn’t necessarily good for her. But for now, as long as she’s not in pain 24 hours a day, I’ll go with it. Hopefully her teeth will come through soon and we can just be done with the whole thing!
Thanks. Believe it or not, I did my own pubmed search and still bought the darn thing despite the absolute lack of evidence of efficacy. How gullible am I? I can tell you based on MY personal anecdotal experience that they don’t seem to do a thing to aid in teething pain. Happily traded mine for a new cloth diaper.
Thanks for the comment, it’s nice to have the negative anecdotes to counter the positive ones.
And I wouldn’t say gullible, we have a certain expectation that products meet some minimum standard and it’s not always easy to determine if you have missed the relevant evidence. No one yet has pointed to any deficiencies in my search but that doesn’t mean there couldn’t be decent positive evidence tomorrow.
Hello I found your article this morning after we put a baltic amber necklace on our baby boy and he began to have a severe allergic reaction immediately. His face swelled, his nose ran, and he was beginning to have difficulty breathing. He was opening his mouth and gasping. It was horrifying. Once we took the necklace off he immediately began to look and feel better. We were literally on our way to the door to take him to the emergency room and we had calls in to our pediatrician’s office. I wish I had read this article before subjecting our 5 month old (our first) baby to unknown levels of untested chemicals. I have shared this article and our experience with our friends who have babies as well.
Thanks for the comment Brandon,
Given the severity and speed of the reaction I would be hesitant to ascribe it to the amber beads, I’ve never heard of such a thing and none of my research indicates that it is a significant possibility. I would consider a. that the amber beads are in fake and may not be amber, or b. that the reaction was actually to something else and the beads were a coincidence.
I’d suggest having your baby checked out just to be sure, don’t want to settle on a diagnosis too quickly and overlook other options that may present a danger in future.
Much as I’d like to have a serious adverse reaction to point to I’d rather have your baby be safe.
Thanks for the response. I agree that it seems unlikely that it could be the amber beads, but the strange thing was that he wasn’t exposed to anything else new this morning. I supposed it could have been something to do with the packaging the necklace came it or other materials in the necklace, but the bottom line was that he was totally fine and within minutes of having the necklace on his face was red, his eyes were swelling shut, and he was gasping for air. We took the necklace off right away and while we were getting ready to go to the emergency room he recovered almost as fast. It was really strange and horrifying.
ok, well good luck.
Hi, i was really skeptical about amber too, a friend had beads on her baby since he started teething and used panadol a handful of times, whereas my neice has had panadol alot due to teething, and i thought might as well try it for my neice and nephew if their parents wanted to, ( my nephew is a very unhappy, cranky thing!) they have just started searing them, however my neice’s are off already, thats fine, and i will be interested to see what happens with my cranky nephew! But i thought id give them a go… So i joined two together and wore them as a bracelet, as a result my knee has felt better, however, i put new thicker earings in, my ears were bright red, but no pain, i could not believe it! I havd ended up wearing them for a while now, a just took them off last night, and today have had a migraine, 3lots of drugs later and alot of nausea, my mum asked where they were, so i put them back on, an within half hour my migraine was gone! They usually last on average 3 days! And i realised i have not had a migraine since i started wearing them.
So i am starting to turn my skepticism, and i would say give them a go! Y not!
I’m glad you appear to be getting some benefit but the plural of anecdote is not data.
see post “I was a Skeptic, but…”
Before we can start looking for a reason why they work we have to objectively determine that they do work, anecdotes are not objective. But we find our own experience more powerful than abstract concepts like plausibility, therefore I predict that most people will be highly unconvinced by my insistence on hard evidence unless or until they have a contradictory anecdote.
Thanks for the comment and I don’t intend to sound harsh but if heard so many of the “but it works for me” type argument…
Oh i am also a nurse who believes in science and logic. If something works, it works, not because of some higher being, but because there is a logical reason for it, amber beads- just dont know the logic yet
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