My covid Tale/ Remedies for common symptoms

 I am just getting over my second bout of Covid. Amazingly, I still know a handful of people who claim they have never had it. Those lucky ‘novids’ are becoming rarer and rarer. While I was sick this time around, I found myself frequenting some Reddit communities. There was some comfort in seeing that others were going through the same stuff that I was dealing with; It was also interesting to see what folks were doing to allay some of the symptoms. Most importantly perhaps, it was a safe place to simply whine.

For those of you out there, like me who are interested in trying to figure out the covid trends, this post is for you.

My personal Covid History

I managed to avoid Covid altogether until April 2023 when it finally caught up with me. It couldn’t have happened at a more inconvenient time. Sandy and I were on a small cruise in the Galapagos. When Sandy got a sore throat he decided to use one of the tests that we had brought with us. There were quite a few older passengers on board and he didn’t want to take any chances of spreading anything. We were pretty horrified when the test turned positive. He reported his results to the ship’s doctor and was understandably quarantined to the stateroom. I was negative so I still had free reign for another couple of days as long as I was masked. Clearly he caught it from someone on the ship, but most people weren’t testing. Sandy and I tried hard to stay as far from each other as we could manage, but we were sharing a stateroom, with one bed. At night, we built a wall of pillows between us. Spoiler alert, to no one’s surprise, that didn’t work. After 2 days, I tested positive and we were quarantined together. We spent the remainder of the time on the ship looking out our giant window, counting turtles in the ocean and watching birds. Add in amazing room service and I imagine there are worse places to be stuck.

The final night, the staff on the ship closed off the upper deck, so that we and one other couple who had tested positive could dine under the stars. We laughed together when we discovered that they too had tried the pillow wall. That effectively doubled our statistical analysis. Pillow walls don’t work at eliminating transmission.

When the cruise was over we were moved to a hotel in Quito Ecuador. The altitude there is 9300 feet. There were no more turtles. Sandy was bored and had nothing better to do than check my temp and oxygen what felt like every ten minutes with his newfangled electronic gizmos. My temp was high. My oxygen saturation was low. It sucked on so many levels. We got through it.

Covid Redux

Lauren and Family came up for a visit in early July. One of my joys was the mornings. Lauren would bring me 4 month old Coby between 6:00 and  6:30 every morning and that time was my private baby snuggle time while the rest of the family slept. Once Elliot woke up I belonged to him. It was a great week.

We went all over the place with the kids. This included all of their favorite SF restaurants, the aquarium, the exploratorium, you name it. We were aware that Covid levels were starting to rise, but no one seemed to be wearing masks.I had gotten a booster in March, so I was optimistic that I still had some protection,

A week into the visit Coby got uncharacteristically fussy. He was somewhat congested and felt a little warm. We tested him on a Thursday morning and he was positive for Covid. How and when the baby got it when the rest of us seemed fine, remains a mystery.

Sandy had knee surgery scheduled the following week. Oy, right? In order to minimize the exposure, the kids packed up and drove home to LA. Between horrible traffic, the miserable baby, the 3 1/2 year old who had really wanted an extra ride on muni and a very large dog. It was NOT a fun drive.

The day after they left I started getting congested. I was very surprised that I was negative.

According to Sandy, I was also snoring loud enough to put our dear departed Uncle Bernie (famous for his sonic level night time noises) to shame. That might be the thing that spared Sandy from ultimately catching it. He moved into Alana’s old room in order to try to get some sleep. I proactively slept there the following night because the post nasal drip and throat tickle were keeping me up. I tested negative again on Sunday.

On Monday, I was clearly sick and sure enough my test had finally confirmed that indeed I had Covid.

This was 3 days after Coby’s positive test. It is hard to know when he started to be contagious and 4 days before Sandy’s prospective surgery.

I was able to do a virtual visit with One Medical that same morning. They gave me a prescription for Paxlovid. Within several hours after the first dose, I was assailed by a horrid taste in my mouth that lasted the entire 5 day course.

My symptoms were firmly in the miserable but not scary category. The first several days were mostly post nasal drip, piercing headache and nausea. Days 3-5 were colored by stuffy ears, a moderate sore throat, brain fog and fatigue. I never had a fever, although there were times when I felt warm.

Sleep was tough simply because of the taste in my mouth. I was up sucking on mints every 30 minutes. Having other people complaining on Reddit about the same issue kept me company during the wee hours. Of course, as with anything on social media, take most of the information with a grain of salt. Avoid going down any rabbit holes that don’t feel positive.

I tested neg on Friday, just 5 days after my positive test. Thank you Paxlovid. My energy is not quite back to normal but is heading in the right direction. Sandy’s surgery went great. All in all I feel fortunate that it wasn’t any worse.

The moment I tested positive, Sandy and I were ships passing in the night; we were masked when we were on the same floor but mostly kept our distance.  We had HEPA Air purifiers running. We were scrupulous with hand washing.

He stayed negative! It can be done.

Remedies.

Congestion/post nasal drip

• I confess to 2 nights of Afrin. This allowed me to breathe but it is making the deal with the devil. Try hard NOT to do it for more than 2 or 3 nights max. But in the beginning the congestion was so thick that I couldn’t even do the neti pot; the Afrin cleared the way. If you overuse Afrin it can cause rebound congestion and it is VERY hard to kick the habit.

• I started Flonase nasal spray

• Netipot/sinus irrigation throughout the day 

• Xlear nasal spray may have some protective properties. It is worth using after an exposure

• My MD suggested Mucinex. I didn’t need it this time but it is worth having on hand.

• Blue Poppy Cold Quell is something Dr Den suggests for all of her covid patients

• Alternate warm and cold compresses to your forehead

• Tap and massage your sinuses just to loosen things up

• Steamy showers

• Humidifier at night

• This may sound gross, but try not to swallow all that mucous. Spit it out, keep a dixie cup or tissue handy.

Nausea

• My sister Amy had covid a week before I did, she got zofran for the nausea. If you find that you can’t eat or stay hydrated, reach out to your doctor for a prescription,

• Ginger chews from Trader Joes, were good for the queasiness and also gave a few moment of relief from the paxlovid mouth

Sore Throat

• Manuka honey

• throat coat tea

• Popsicles

• Lozenges

Nasty taste in the mouth

(some people are more sensitive to this than others. For me it felt like I was chewing on a leather boot that had stepped in dog poop)

• Mints

• Lozenges

• Mini m&ms

• Red hot candies

• my friend Dee-Dee swears that tangerine flavored jellybeans were a game changer

Ear Discomfort

• For the stuffy ears warm garlic oil felt great. 

• The use of flonase will also help with this, but it isn’t instant.

Hydration

• Stay hydrated, I fell in love with aloe juice that I got from Trader Joes

• Other people like coconut water/pedialyte

• ice chips! Amy claims this saved her from going to ER for an IV

• Drink Drink Drink!!

Brain Fog

• Take a break from screens

• Try to get reasonable sleep.

• Vitamin B, D and Beef liver enzymes might be useful

• My friend Oran who is a reflexologist suggests pushing on each fingertip.

Mindfulness

I leaned into gratitude. This time around at least I was home and not impacted by altitude. I didn’t have kids to chase or a job to get to. I had a partner making my garlic oil and tending to me from afar, both of us masked. Dear friends checked in and dropped off soup.

Contagiousness

My son-in-Law Adam tested positive the same day that I did. Like many people reading this, he did indeed have kids to chase as well as a job to deal with. I tip my hat.

Amazingly Lauren and EJ didn’t catch it,

COVID is everywhere right now

Alana had a birthday gathering and she asked people to test before coming.

At least 3 people with no symptoms whatsoever tested and found that they were positive!

Be careful out there!

And sometimes a cold is just a cold

A week later Lauren got a sore throat. It lasted for 2 days. She remained negative

Alana also just had a cold for several days and remained negative, even with a PCR test.

CDC guidelines for isolating.

The updated guidelines lump all respiratory viruses (Flu, Covid, RSV)  together.

If you test positive for any of those, stay home and keep your distance from family members who are healthy.

Once you are fever free for 24 hours without the help of medication you can resume your normal activities.

You should take extra precautions like wearing a good mask, reasonable distancing and great handwashing for another 5 days.

With Covid, there is about a 20% chance of rebounding, especially after Paxlovid, so be quick to test again at the first sign of new symptoms. The rebound is most likely 3-7 days after you thought you were out of the woods.

Keep in mind that PCR tests will likely remain positive for weeks after an illness. They are very useful for figuring things out when you are just starting the illness, but are not a good indicator of whether or not you are still contagious.

What Dr Ted is seeing with his covid patients

Typically the kids have had sore throats and fatigue. Not everyone has a fever.

Most of his patients are similar to what I described; somewhat miserable but not scary.

He has seen some pneumonia so don’t ignore any respiratory distress.

There are some patterns but no rules because everyone's immune system is different.

One thing that is reassuring is that babies under 3 months born to a mom who had a booster in the third trimester have very decent protection. Poor Coby was just past that magic window.

Dealing with Excessive Heat

 How to recognize heat stroke/ tips for keeping cool

Temperatures are soaring.

If you look at a map, you will see that most of the country is dealing with temperatures over 90 degrees, many over 100.  Truth be told, most of you don’t need to look at any maps to know that you are sweltering. A lot of places are used to hot summers, but many are experiencing unprecedented heat waves that are lasting longer than usual. Records are being broken right and left.

 The important number is actually the heat index. This is calculated based on the temperature and the humidity. Humidity makes things worse. If you are in a place with high humidity the sweat doesn’t evaporate as quickly and this keeps the body from releasing heat as fast as it may need to. If you want to calculate the heat index of where you are, you can use this link.

https://www.wpc.ncep.noaa.gov/html/heatindex.shtml

Don’t hate me - I have my sweater on here in San Francisco. I can’t live anywhere else. In extreme heat and humidity, I turn into an impossible creature.

For all of you who are not dealing with our local fog, here are some of the most important considerations when dealing with the heat. Even if it suddenly cools off, it makes sense to be prepared for the next wave.

Being overheated can have serious consequences.

Keep in mind that young infants don’t regulate their body temperature very well, so this puts them at greater risk. Scroll down for more info about this.

 Symptoms of heat exhaustion might include:

• Fevers 100-104

• Clammy skin

• Muscle cramps

• Nausea

• Dizziness

• Lethargy

If not tended to, this can lead to heat stroke, which can be deadly!

Signs of Heatstroke include:

• A temp at near or above 104 (fever reducing meds are not useful in this circumstance)

• Flushed skin

• Elevated heart rate

• Weakness

• Dizziness

• Loss of consciousness

Medical intervention is essential!

Hydration is an essential part of preventing heat related complications. 

It is important to replenish the fluids as well as the electrolytes that you lose when you are hot and sweaty. Pedialyte or similar electrolyte drinks may be better than plain water. Breast milk is perfect (of course). Even if your baby seems to be nursing well, if it is very warm out, keep an eye on the number of wet diapers! You may need to sneak in some extra fluid.

Nursing moms need to remember that they are losing fluid every time they feed their babies. It is essential to replace that as well as adding extra, so drink up! Perhaps start your day with one of the large water bottles that measures the amount. Fill it at the start of the day and it makes it much easier to track your intake.

Someone who is dehydrated will have:

• Less urine, and the urine will be dark

• Low energy

• Dry mouth

• No tears

Even if your little one is no longer in diapers, pay attention to how often your child is peeing and look at the color. Darker, infrequent urine might be your first clue that they need to be drinking more.

Ideas for staying hydrated:

Set a timer on your phone as a reminder that it is time for everyone to take a sip.

• Maybe have an iced-tea party.

• for kids, get a cool cup, a cool straw or fun ice-cubes to make it enticing

• Pedialyte comes in popsicle form which can be a big hit. 

• Other good hot weather treats are watermelon and some mildly salty snacks.

• It might surprise you, but milk is one of the best beverages for hydration

• Frozen breast milk can make a wonderful ‘milk-sicle’

Ideas for staying cool at home:

• Find the coolest room in the house. It is often downstairs..

• Families may end up sleeping on the living room floor if it is less oppressive. Make it an adventure and call it camping.

• Keep the shades down during the day.

• Have a fan going if you are lucky enough to have one. Make sure the fan is placed in an area where curious kids can’t poke their fingers in there. Even better, get one of the fans that is toddler safe. For those of you without fans, put your order in now. Often in the midst of a heatwave there are none available. It is worth owning at least one so you are prepared for the next heatwave.

• Baths are great. Unless the water is obviously dirty, don’t drain it and you can get in and out throughout the day.

• Keep wet washcloths in the freezer and offer the frozen clothes throughout the day.

• There are cool little cooling towels that can make a big difference. Once you wet them, they stay nice and chilly for hours.

• If you have a yard or a place to put it, investing in one of the little plastic wading pools can give your kids hours of cooling fun.

• Dress in minimal lightweight clothing.

Come up with some fun indoor activities that don’t require a lot of running around. Lots of kids love water play. Cover an area with a plastic sheet (a shower curtain is a great cheap option). Fill a plastic bin with water and then there are unlimited options ( including cleaning the bin with a big sponge!)

If this week requires a little bit more screen time than you like, don’t stress it. Try to be clear that there are some ‘hot weather’ rules that can be a little more relaxed.

If you don’t have air conditioning, see if you can find local places where you can hang out for a cooling break. Malls and libraries are often good options.

If you do go outside...

Beware of hot metal. Make sure you test the temperature of  any slides or metal equipment before you let your child play on them. I once had a patient get a burn on their finger from pressing a metal doorbell, so I am not kidding around. Metal can get very hot.

Shade is best, but if you are in the sun, make sure your kids have a big floppy hat, sunglasses and sunscreen.

Don’t forget about your pets! Make sure they have plenty of water (add some ice cubes.) If possible when walking them, keep to grass. Extremely hot pavement can actually burn their paws.

Also…never ever leave kids and pets in the car. This is especially critical when the weather is hot.  I am aware that folks with Teslas do have a pet comfort setting, but no child should ever be left in a car regardless of the temperature.

Keep in mind that in many hot areas of the world, the cultures have embraced the concept of the siesta. They take a collective break during the hottest part of the day. That sounds like a plan that most parents would be soundly in favor of…. Now we just have to get the kids on board.

Other heat-related considerations:

Fungal diaper rash

With increased heat and sweating, fungal rashes can become a problem. Yeast loves damp dark warm places, so a sweaty diaper area (or underwear area for potty-trained kids…or adults) is the perfect breeding ground for fungal rashes. These rashes in diapers can look like discrete red dots, occasionally coalescing into lumpy bumpy raised patches. Unfortunately, this can mimic the red papules of hand-foot-and-mouth. Dr. Ted has seen kids with diaper rashes sent home from daycare to get assessed for hand-foot-and-mouth. If you suspect that you might be dealing with a fungal rash, air out the diaper area and add over-the-counter Lotrimin three times a day. It’s extremely safe and well tolerated at all ages. There is NOT an infant formulation. You can also add some apple cider vinegar to the bathwater, which is antimicrobial and balances the pH (white vinegar is probably fine, but skip the balsamic).

Swimming considerations

The excessive heat warming fresh waters has created some unfortunate growth of naturally occurring bacteria, such as pseudomonas. Pseudomonas can present in a couple of ways. It can live in poorly controlled hot tub waters, creating a red spotty rash called hot tub folliculitis, but more importantly it can cause an excruciatingly painful swimmer’s ear. Luckily, pseudomonas can’t grow outside of wet environments, so drying the ears fully after swimming will not allow the bacteria a place to grow. We do not recommend Q-tips as they can traumatize the eardrum. Try using Debrox drops after swimming to dry out the ear, and any bacteria inside won’t be able to grow.  

Blue green algae

If you’re going to any rivers or lakes, check your local resources to make sure there aren't any dangerous blooms. Here is the website for  California, but it is easy enough to google wherever you are located.

Dogs can be impacted by this as well as your kids, so check before you swim!

Dr Ted’s Tidbits: Time to nerd out with science!

“Heat regulation in newborns is fascinating. We rely on sweating to get rid of heat. Water from our skin absorbs heat and carries it away with evaporation (see Nurse Judy’s bit of this, above), but newborns don’t make a lot of use of those valuable sweat glands for at least the first couple of weeks. Newborns also have an immature part of the brain that regulates body temperature called the hypothalamus. Without input from the hypothalamus, babies rely on outside forces to control their core temperature. In particular, babies are bad at cooling themselves off. So you’re in a place with a heat index over 90, it’s important to be proactive about keeping your baby from overheating.

Teething: Common symptoms/An array of remedies/ Not included..the going rate for the tooth fairy

 Typical infants have 20 primary (baby) teeth which have started to develop in the womb. The teeth start to erupt through the gums around 6 months of age. The baby teeth are then shed at various times throughout childhood. At the end of this post, you will find a chart with the typical range of ages when most teeth start to come and go.

Over the years, I have seen kids that didn’t care about the rules, ignored the charts and did things their own way. I know of one baby who was born with teeth! Another started out with the upper canines and looked like a little vampire. As you can imagine, those parents were so happy when the rest of the teeth popped through. There is some heredity involved. If one of the parents was very early or late it is possible for the baby to follow suit. If you are lucky enough to have the option, check with grandma to see if she remembers anything special about your teething pattern!

It is rare for teeth to actually make an appearance before 4 months. Once in a while parents will notice a smooth round white bud on a baby’s gum. This is a little benign cyst called an Epstein Pearl. It is not a tooth and it usually goes away without causing any bother.

Many parents think of teething as something they are only dealing with for their young infants. Think again. If your 6 year old is going through an extremely grumpy phase, or has a mysterious bout of mild, clear congestion that has been hanging on for a few weeks, take a feel in the back of the mouth and see if those first permanent molars are starting to pop through. Once your child reached the age of 21, all 32 of the permanent teeth have usually erupted and they can no longer blame their grumpiness on teething.

Just like the timing varies, the symptoms may also vary greatly from child to child and even from tooth to tooth. By far, the most common first teeth are the ones in the bottom middle (and they are so cute once they come through).

Take your clean finger and run it along your baby’s gum. If the tooth is imminent you may feel that the area of the affected gum feels soft and boggy.

Let's talk about the symptoms.

Many healthcare providers and dentists dispute that there is any real relationship between teething and any of the symptoms below, but I have been an advice nurse for a long, long (long) time. I used to speak to parents of teething babies all of the time, and I maintain that there is a connection.

Fussiness: Teething is uncomfortable. Most parents report that the babies seem fussier than usual right before a tooth pops through. Do what you can to relieve symptoms (see below), but if your baby is inconsolable (screaming with NO break) for more than 30 minutes and there is nothing you can do to calm them down, please call your pediatrician to have them checked. That would be an extreme reaction to blame on teething and it would be good to see if there is something else going on.

Drooling: Drooling starts weeks and sometimes months before you actually see a tooth pop through. Many kids will get a drool rash on their chins and cheeks. There are several products that I find quite useful for this. Clean off the area with a gentle cleanser (Cetaphil is a good brand where there is no water needed, apply with a cotton ball and wipe off). Follow it up with aquaphor, cerave ointment or simple petroleum jelly. You can use any of these multiple times throughout the day. A mild drool rash (flat redness without cracked or broken skin) does not necessarily require treatment. No judgment if you chose not to fuss with it.

Gnawing/biting: Biting on things will feel great to the baby; not so good to your nipples if you are nursing. There are quite a few differing opinions about this, by all means follow your own instincts!

The most gentle parenting approaches will suggest that if your baby starts biting you during feedings, try to stick your finger in their mouth to break the connection, say their name, pat them on the back and then calmly take a break from the feeding. Most babies can be trained to stop this.

However, if the issue persists, I actually recommend a loud “ouch!!” and immediately remove them from the breast. Sometimes you may need to make the association mildly unpleasant to break the habit. Biting = the potentially loud, well deserved yelp and loss of breast! If you are too gentle some babies will think it is quite amusing and will continue to bite at will.

It’s not just your breast that they are chomping on. You might notice that even more than usual, kids will try to put absolutely everything in their mouths. Even the screen door isn’t safe

Poor Sleeping: If your little one is miserable, in my opinion, this is not the time for sleep training. I would go in quietly and try one of the teething remedies listed below. If you are going through a rough patch remember that parents should take shifts (if you are a single parent I send you a hug). Give yourselves each a few hours when you are off duty. There is no reason for both of you to be up all night. If you have the option, it is often best for the NON-breastfeeding parent to go in, unless it is time for a feeding. This is a slippery slope; I would try not to feed for comfort throughout the night.

Bleeding/bruised gums: It is not unusual to have a little bit of bleeding on the gums. Once in a while you may also see a purple/bluish bruise on the gums right before a tooth breaks through (official term for this is an “eruption cyst”). This will usually resolve without any intervention although something cold will feel soothing.

Mildly elevated body temperature: Many dentists are of the opinion that teething does not cause an actual fever, but I commonly see it associated with an elevated temperature. Six months is often when babies are losing some maternal antibodies, so the timing might indeed be coincidental. In any event, if a fever goes higher than 100.5 then I am not likely to blame it on teething. Any fever that is lasting more than three days is worth a call to the doctor's office to check in.

Loose stools: just like with fevers, you will likely get differing opinions on whether or not teething can be the culprit and again; I will state here that it is common enough that I think there is a connection. Some folks speculate that swallowing all that saliva and drool might be the reason. If you have a baby with loose stools, you may want to go with the bland, starchy diet and consider trying probiotics. Breast milk is safe, but other milk-based products may aggravate the situation.

Rashes: If your child has sensitive skin and/or eczema sometimes, you might notice that the general rashiness flares up during active teething. This includes the diaper area.

Congestion: Many young teething kids seem to have a clear runny nose and congestion. This can last for weeks and weeks. Sometimes it causes a post nasal drip that in turn causes a little hacking cough. 

Ear tugging: When kids are working on some of the upper teeth they tend to poke and play with their ears.

Uh oh, many of these symptoms are the same thing we look out for if we suspect an ear infection. Even though teething may well be the cause, if you are dealing with a child who is very fussy, feverish, and is having trouble sleeping, I suggest you have someone take a peek in those ears.

It is worth having an arsenal of tools at the ready for dealing with the months of teething that you have ahead of you.

Gum massage: Not every infant will let you stick your finger in their mouth to rub their gums. And if they already have some teeth, you might earn some extra hazard pay. But if they’re struggling on cutting their first set, a simple massage with your fingers is the easiest and most cost efficient intervention available.

Frozen washcloth: Wet half of a washcloth and put it in the fridge or freezer. The baby will be able to hold the dry half and chomp happily on the frozen side. For an interesting twist, consider soaking the washcloth in chamomile tea before chilling it.

Distraction: There is nothing as nice as a body massage and a warm bath by a calm singing parent.

Feeding bags (baby safe feeder, or sassy teething feeder): If your baby has had some solid foods introduced, these feeding bags are great for teething relief. Add a cold hunk of fruit or veggie (pick a food that they have been introduced to already so that you don’t need to worry about any odd reactions) and let them gnaw away happily. With the mesh bag you don’t need to worry about them breaking off a piece that could be a choking hazard. You can find these bags online pretty easily.

You can also fill one of the bags with a frozen ‘Milksicle'. Take 3 or 4 ounces of breastmilk, or formula, and combine it with some fruit, like banana, pear or mango. Puree until very smooth and stick it into an ice cube container. Pop out a frozen cube and add to the mesh feeding bag. You could also just use plain frozen breastmilk.

Cool cucumbers: Cool cucumbers can feel like a spa in your mouth! This is for kids who have proven themselves to be able to handle actual pieces of food, but for your toddlers who are cutting teeth, these might be a hit. Peel the cucumber, slice into circles, get rid of the seeds. Put the cucumber circles in a bowl in the fridge to keep cool.

Chewing options: 

• Teething Tube

• Sensory teething rings

• Cool teething rings: make sure they are made out of a safe material. Do not tie any teething rings around your baby's neck.

• Chew beads: I have had multiple parents tell me that these beads seemed to help but make certain that they are not a potential choking hazard. Check carefully that nothing that can get loose.  Your little one needs to be supervised when using them. These should never be in a crib. I worry about strangulation with any necklace.

Chinese herbs: There are very safe pediatric herbal tinctures. One, called Tender Teeth, can be obtained at The Acupuncture Den, a family practice located in San Francisco. Please contact Dr. Den to arrange a pick-up or mail delivery if you’re not in the city. Beyond just the herbs, an acupuncturist can offer relief with acupuncture and/or non-needle techniques. Many parents report babies taking a long and deep nap after a treatment!

Homeopathic drops: The ones I am most familiar with are Camilia by the Boiron company. Click the Boiron link for a coupon.

Orajel: Orajel’s new formula is safe. The older formula which actually numbed the gums was recalled years ago due to safety issues. Make sure you read the labels carefully to make sure that it is Benzocaine free.

Brandy/alcohol: Ask great grandma what she used to do for teething and she may tell you that she used to put whiskey or brandy on the baby’s gums. Obviously giving our babies alcohol is not something that most doctors would suggest today: I cannot officially endorse doing this on your own as medical advice. But I actually wouldn’t worry if you caught grandma rubbing a drop or two directly on the gums, it probably does help. Some folks also say that rubbing pure vanilla extract on the gums is an effective home remedy. That may be from the alcohol content (I am referring to a tiny amount applied topically, no swigging booze!)

Acetaminophen (Tylenol) and Advil (Ibuprofen) are useful but I prefer not to overuse them. Make sure you are using the proper dose.

Start with the other approaches first. If possible, I would prefer to keep these as remedies for night time use only. Tylenol and Advil are quite safe but if they are used for a long period of time they can be stressful to the liver and kidneys. If you find that you have gone more than 5 nights where you are depending on these meds to keep your child comfortable, give your doctor's office a call to see if you need to make sure that nothing else is going on.

DO NOT USE

Any product that contains Benzocaine or Belladonna!!

Once your child has teeth, it is especially important to keep bottles out of the crib. Milk has sugar and can cause tooth decay if a baby sleeps with a bottle in their mouth. It is never too early to start brushing the teeth. Let's get your baby in good dental habits. It is important to use a soft toothbrush and non abrasive toothpaste. The current recommendation is to use fluoride toothpaste; just a teeny bit the size of a grain of rice.

Once they have a mouthful of teeth it makes sense to start shopping for a pediatric dentist that you can establish a relationship with. This will come in handy if you have any tooth questions or mouth injuries.

Your next task is to figure out what the going rate for the tooth fairy is! I can’t help you there.

Wishing you easy teething!

Updating this post was inspired by Coby, who has all of the teething to get through

Thanks to my models EJ and Sawyer who have beautiful smiles

And as always enormous thanks to Dr. Ted who helps me achieve the the balance of data and collective wisdom.