Just before I left the room at the end of Emily’s 6 month check-up, I asked “Do you have any other questions?” Emily’s mom thought for a minute and then said,”Dr. Singh, what do you think about those amber teething necklaces?” I’m guessing that she knew my answer as soon as she saw the look on my face! As a pediatrician I love seeing the adorable things that my patients wear to the office. However, the amber teething necklace is the one accessory that concerns me whenever I see it.
Made of baltic amber, these necklaces propose to help teething pain through a number of ways—as an anti-inflammatory, as an immune booster and, most commonly, as an analgesic (pain reliever) secondary to the succinic acid. Succinic acid is a naturally occurring compound found in all of our bodies. The necklace manufacturers claim that it is released from the beads at body temperature and then absorbed through the skin thereby inducing pain relief.
This claim is problematic for several reasons. No study has ever demonstrated that succinic acid actually plays any role in pain relief nor is there any evidence to support that amber releases the substance at body temperature. Baltic amber is extremely hard and durable. It is difficult to believe that it would seep out succinic acid (which has a melting point of 187 degrees Celcius) at body temperature. And even if we believed that succinic acid does relieve pain and that it oozes out of the beads at body temperature and that it passes through the skin, most baltic amber contains 3-8% succinic acid which would make the amount being absorbed so miniscule it very likely would have no effect.
While the benefits of the necklaces are as yet unproven, the risks are very real. Any jewelry around a baby’s neck when unsupervised (in the crib or in the car seat) is a dangerous choking and/or aspiration hazard. Most parents leave the necklaces on all night despite the explicit warnings on the sellers’ web pages that state they are only to be worn when baby is being directly supervised. The individually knotted beads make them no safer, as even one bead could be aspirated into a baby’s airway. And the “safety clasp” that is supposed to break away with tension only induces a false sense of security as most of the necklaces are produced by small vendors and their manufacturing is not regulated.
So with all of the risks and no definite benefits, why do parents continue to buy these necklaces? It is, of course, because we all love our babies and can’t stand seeing them in pain. We would do anything to reduce their discomfort even if common sense tells us it is unlikely to work. And the prospect of using something “natural” always seems appealing even though there are many substances found in nature that we would not let near our babies. But, when you look at the severity of the possible side effects vs. the unproven benefits, it is simply not worth the risk.