Is there a relationship between teething and diarrhea?

No Scientific Relationship Between Teething and Diarrhea

There is no scientific evidence supporting a causal relationship between teething and diarrhea in infants. While this belief is common among parents and some healthcare providers, it is not supported by medical evidence and could lead to delayed diagnosis and treatment of potentially serious conditions.

Medical Evidence vs. Cultural Beliefs

Scientific Perspective

• Current medical observations show that teething primarily causes only mild symptoms such as restlessness, drooling, and finger sucking 1
• Teething does not cause diarrhea, fever, rashes, seizures, or bronchitis 2
• Symptoms commonly but incorrectly attributed to teething include:
  • Fever (reported by 71.7% of mothers in one study) 3
  • Loose stools/diarrhea (reported by 58.3% of mothers) 3
  • Vomiting (reported by 35% of mothers) 3

Healthcare Provider Perspectives

• A significant disconnect exists between medical evidence and healthcare provider beliefs:
  • Only 9.1% of pediatricians believe diarrhea is associated with teething
  • However, 52% of pediatric dentists believe there is an association 4
• This discrepancy creates confusion for parents seeking medical advice

Dangers of Misattribution

Delayed Medical Care

• Attributing diarrhea to teething can lead to delayed medical attention for potentially serious conditions 3
• Diarrhea in infants can rapidly lead to dehydration, which requires prompt medical intervention 5
• Infants are particularly susceptible to dehydration due to:
  • Higher body surface-to-weight ratio
  • Higher metabolic rate
  • Dependence on others for fluid intake 5

Harmful Traditional Practices

• In some cultures, harmful practices are performed to "treat" perceived teething symptoms:
  • Gum lancing/cutting (incising the gums) 6
  • Rubbing garlic on gums (12.1% of mothers in one study) 1
  • Rubbing herbs on gums (6.5% of mothers) 1
• These practices can lead to serious complications:
  • Severe dehydration and shock (47.8% of hospitalized cases) 6
  • Severe pneumonia (40.3% of cases) 6
  • Meningitis (26.9% of cases) 6
  • Generalized sepsis (17.9% of cases) 6
  • Mortality (6.1% of cases in one study) 6

Proper Management of Infant Diarrhea

When an infant presents with diarrhea, it should be evaluated and managed as a potentially serious condition:

1. Assessment of dehydration status:

   • Mild dehydration (3-5%): Increased thirst, slightly dry mucous membranes
   • Moderate dehydration (6-9%): Loss of skin turgor, tenting of skin, dry mucous membranes
   • Severe dehydration (≥10%): Lethargy, prolonged skin tenting, poor perfusion 5

2. Rehydration therapy based on degree of dehydration 5

3. Evaluation for infectious causes when appropriate:

   • Stool cultures are indicated for bloody diarrhea
   • Consider exposure history (day care, travel, etc.) 5

Conclusion

Diarrhea in an infant should never be dismissed as a normal teething symptom. This misconception can lead to delayed treatment of potentially serious conditions and harmful traditional practices. Healthcare providers should educate parents about the true symptoms of teething and emphasize the importance of seeking prompt medical attention for an infant with diarrhea.