South Australia Health has announced they will no longer sell their popular teething gel after a review of the treatment found limited evidence to prove its active ingredient lidocaine is effective and that it may be harmful if too much is swallowed.
In a statement posted to Facebook on Monday, SA Health advised they would be discontinuing the Women's and Children's Hospital (WCH) Teething Gel and recommended parents stop using teething gels completely.
"As of 21 May 2019, the WCH Teething Gel is no longer available for purchase.The WCH Teething Gel contains lidocaine, which is no longer recommended for infant teething pain," they wrote.
The warning extends beyond their own brand to include other teething gels.
"There are several teething gels sold in Australia, but many of these may also cause harm if too much is swallowed," SA Health continued. "While these teething gels may be available from community pharmacies, SA Health no longer recommends the use of any teething gel for infant teething.
"Teething gels that contain salicylates may also cause harm if too much is swallowed," they continue. "Salicylates are related to aspirin and have been linked to a serious illness called Reyes syndrome in children."
The announcement from SA Health has prompted an outcry from parents, many of whom swear by the gel for soothing their babies' teething pain.
"Oh my goodness. I come from interstate to get this," commented mum Annie Wan.
"This stuff was a life saver to me and my entire mother's group," added Belinda Nixon. "It was a saviour to stop pain in our kids."
"This product has been helping teething children for years," wrote Dannii Wilkie." It's RIDICULOUS that they have decided to pull it. Teething rings & cold cloths to bite on for ALOT of kids simply doesn't cut it. You're making a HUGE mistake no longer providing this very much needed product."
Do parents need to be concerned if they've used the gel?
"If you have used the WCH Teething Gel as directed on the bottle, you do not need to worry," SA Health advises. "Very little lidocaine gets absorbed when it is rubbed on the teeth or gums. Lidocaine may be harmful if infants or children swallow too much at one time."
So what should parents use instead?
SA Health now recommends using teething rings or a clean, cold cloth for bub to bite.
"Pain relief, such as paracetamol or ibuprofen, may help some children," they note, adding that medicines should only be used according to directions. "It is recommended that your child is reviewed by a doctor, nurse, midwife or pharmacist if more than 2 or 3 doses of pain relief are needed," they add.
The warning comes as earlier this month, New Zealand mum Jessica Vermunt took to social media to share that her daughter had been "minutes from dying" after she gave her baby too much Bonjela.
"I'm aware that she [the baby] had more than normal but the point remains that this has the potential to kill your child and there is no real information or warnings about the severity of it," Ms Vermut wrote.
At the time, a Bonjela spokeswoman said they were aware of the incident and were seeking further information.
"All Bonjela products in Australia and New Zealand were thoroughly reviewed and approved by the Australian Therapeutic Goods Administration, the regulatory body for safety and efficacy" she said. "As with all medicine, parents should use oral teething and mouth ulcer gels only according to the directions on the packaging and should speak to a healthcare professional if they have any concerns."
SA Health's decision to stop sale of lidocaine-containing gel is in line with current international guidelines.
In 2014 the US Food and Drug Administration (FDA) recommended against using gels with lidocaine for teething pain. "Oral viscous lidocaine solution is not approved to treat teething pain, and use in infants and young children can cause serious harm, including death," the FDA wrote at the time. It followed a review of 22 case reports of serious adverse reactions, including deaths, in infants and young children aged five months to three-and-a-half years, who were given gel for the treatment of mouth pain, including teething and accidental ingestion.
The American Academy of Pediatrics (AAP) followed suit, advising: "The AAP does not recommend putting any prescription or over-the-counter pain relievers or medications that contain lidocaine or benzocaine on babies' gums. These products are not useful for teething pain because they wash out of the baby's mouth in minutes.
"Infants can be harmed if they accidentally have too much lidocaine or swallow too much of the drug."
And in the UK, the Medicines and Healthcare Products Regulatory Agency (MHRA) restricted the sale of teething gels for babies and children that contain the active ingredient lidocaine sale through pharmacies from 2019.
Dr Sarah Branch, Deputy Director of MHRA's Vigilance and Risk Management of Medicines (VRMM) Division said at the time: "Our review showed there is a lack of evidence of benefit to using teething gels. To help babies and children with teething, parents and caregivers should try non-medicine options such as rubbing or massaging the gums or a teething ring."
Parents seeking more information about WHC Teething gel can contact the Parent Helpline on 1300 364 100.
You can also read the FAQs relating to the gel here