Baby Health

We've put together some tips & advice which may be helpful when minding your baby's health.

Diagnosis & Symptoms

Normal body temperature is 37oC but this can vary from 36oC-38oC. Children are much more likely to experience a high temperature than adults. A temperature of 38oC in a child would be considered mildly elevated.

If a child's temperature is at this level for more than one day or if it rises above 38oC medical advice should be sought. Contact your doctor immediately if your child has a temperature of 39 degrees or higher, or has a fit, or a purplish rash which does not blanch on pressure (this may indicate meningitis).

High temperature can often indicate that a child is unwell. It may be as a result of infections such as the common cold or influenza, ear nose and throat infections, chickenpox or following immunisation.

High temperature should be treated promptly as sustained high temperature in small children may lead to fits (febrile convulsions). The fits usually last for less than five minutes.

• If your child experiences febrile convulsions:
  
• Try to protect the child’ s head but do not restrain them
  
• Place the child in the first aid recovery position
  
• Try to reduce your child’ s temperature
  
• Seek medical attention.

Preventative Measures

To prevent high temperatures, ensure that your baby is in a well ventilated area. If prone to high temperatures monitor your child frequently and do not use excessive bed clothing.

Non-Prescription Treatments

If a child has a raised temperature immediate action may be required to prevent the possibility of febrile convulsions. Parents are advised to

• Reduce clothing and remove heavy bed linen.
  
• Increase ventilation, but be careful not to let the child get cold near an open window.
  
• Lower the central heating.
  
• Sponge down the body. (Tepid water should be used for no more than 5 minutes).
  
• Increase fluid intake.

Medicinal Treatments

These include Paracetamol and Ibuprofen products. Paracetamol is a very effective antipyretic (temperature reducing agent). Paracetamol is available in liquid (CALPOL) and sugar free liquid formulations (CALPOL SUGAR FREE, PANADOL INFANT, PARALINK). The dose of paracetamol is dependent on age.

Stronger preparations, such as (CALPOL SIX PLUS, are available for children over 6 years. Paracetamol suppositories (PARALINK SUPPOSITORIES 180mg) are administered rectally and will act faster in reducing temperature.

Paracetamol may be used in combination with an antihistamine, in products such as TEEDEX or DOZOL for teething pain, colds and flu for children over the age of 6. These products may cause drowsiness. Prolonged or routine use of paracetamol without medical supervision can be dangerous. If symptoms persist for more than 24 hours consult your doctor or pharmacist.

Ibuprofen is a non-steroidal anti-inflammatory (NSAID) which is effective in reducing temperature and relieving pain and inflammation. Ibuprofen is available without a prescription as NUROFEN FOR CHILDREN or FENOPINE.

Do not give your child more than one antipyretic preparation except on medical advice.

Aspirin should not be given to children under the age of 16.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

Diagnosis & Symptoms

Iron is a vital mineral for growth and development in the infant and is necessary in the production of the oxygen-carrying pigment haemoglobin in red blood cells. Iron deficiency is the most common nutritional deficiency in the world, and is a major cause of anaemia.

Symptoms of anaemia include paleness, lethargy and reduced immunity to infection. Up to ten percent of two-year-olds in Ireland may suffer anaemia. Babies are born with reserves of iron which normally become depleted after four to six months of growth and development. Iron deficiency can be determined conclusively through a blood test. Iron deficiency may result from causes including inadequate iron intake in the diet or from poor absorption of iron.

Preventative Measures

Preventative measures are basically ensuring a healthy balanced diet or if necessary supplementing the diet with additional iron - see below

Non-prescription Treatments

Dietary alteration to include iron rich foods will increase iron levels over time. In some cases a liquid, iron supplement such as FER-IN-SOL drops, will be recommended by your doctor or pharmacist. The drops may be given by dispensing directly into the mouth with the dropper or by mixing with water or fruit juice. The duration of treatment will vary depending on the severity and cause of the deficiency. This should be discussed with your general practitioner.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

Diagnosis & Symptoms

The frequency of bowel motions of an infant can vary greatly between babies, and even for the same infant over time. This can range from four times per day to once every two days. However, it is generally regarded that young infants should have one bowel motion per day and that generally breast-fed infants have more bowel motions than bottle-fed babies. A constipated baby will have firmer and harder stools and the baby will not empty their bowels as regularly.

With more severe constipation, the infant may also be in pain or be anxious and in some cases subconsciously be holding back the stool in order to avoid pain. If this occurs, the stool will remain in the large intestine for a longer duration and will become even harder and more difficult to pass. If such a problem is left untreated, the child may even refuse to eat.

Constipation in infants can often be due to inability to fully digest the milk formula, or could be due to inadequate fluid or food intake. As breast milk is easier to digest by an infant, it is more unusual for breast fed babies to experience constipation.

In infants under three months, constipation is rare and if the problem occurs you should consult your doctor. For older babies who have started on solids, the frequency of bowel movements can depend on diet and on fluid intake. It is often at this time that babies become mildly constipated as their digestive systems adjust to the increased amounts of dietary solids. At this time, it should be ensured that babies have sufficient fluid and do not suffer dehydration.

Parents should also be aware that constipation could be a side effect of some medicines. More rarely constipation may be a symptom of another problem such as an anal fissure or a bowel blockage. If your child is regularly constipated, fails to thrive or if in pain, always consult your doctor.

Preventative Measures

Always ensure that your baby has sufficient fluid intake. Make sure when preparing the infant formula to only use the quantities stated. If you feel that your baby needs extra fluids prepare bottles of freshly boiled and cooled water. When the baby is in transition from solids to fluids, a greater fluid intake is normally required. Make sure that your child's diet has sufficient fibre, by including fruit and vegetable purees.

Non-Prescription Treatments

Increasing fluid intake and the reduction of certain constipating foods should help to increase the number of bowel motions. Extra bottles of freshly boiled and cooled water should be available for the infant. Sometimes changing the infant formula may reduce constipation.

The contents of the large intestine can be moved along by massaging the lower part of the baby's tummy or by moving the baby's legs in a "bicycle" motion.

VASELINE can be applied to the anus to prevent fissure or cracking. The use of laxatives in young infants and children is generally not encouraged by the medical profession unless absolutely necessary.

Glycerol (also known as glycerin) is a mild rectal stimulant available as a rectal application (BABYLAX). When used, glycerol should work immediately. When using the rectal tube make sure to place some VASELINE on the tube section before inserting it into the baby's rectum. Only insert the tip of the tube. Hold the baby's legs together for two to three minutes, if possible, to ensure maximum effect. The prolonged use of BABYLAX should be avoided as it may lead to irritation of the anal canal.

GLYCERIN SUPPOSITORIES are available in infant, children and adult formulations. The suppository must be removed from its wrapping by grasping the two halves of the wrapping at the tip of the suppository and pulling them gently apart. It is recommended to moisten the tip of the suppository before inserting into the rectum. Prolonged use of glycerin suppositories is not recommended. If symptoms persist consult your doctor.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

Good health during childhood is a critical factor in determining health later in life.

In order to monitor your child's development we have developed a unique interactive weight and height calculator.

Check here to see if your baby's weight and height are within the normal ranges with the Baby Weight & Height Calculator.

Diagnosis & Symptoms

Nasal congestion can occur frequently in babies. Their nasal passages are still developing and as yet are very small and will easily become blocked. Once blocked, mucous cannot be drained and will build up in the nasal area. While the mucous may not be infected, it may become a media for bacterial or viral growth. As babies under 4 months breathe mainly through their nasal passages rather than their mouth, it is important that such a problem be treated quickly.

Congestion can occur as part of a cold and if accompanied by other symptoms of a cold, you may need to consult your doctor. Environmental factors are a common cause of nasal congestion. Changes in humidity, in particular a change to a very dry or very cold environment can worsen or cause the problem. Irritants such as pollution, dust, cigarette smoke or pollen can cause nasal congestion in adults and children.

If your child is uncomfortable or anxious, or has a temperature associated with the nasal congestion, your doctor should be consulted, particularly in the case of a young infant.

Preventative Measures

Babies prone to nasal congestion should always be kept in a well-ventilated environment which is neither too "stuffy" nor too cold. Humidifiers, which provide a warm vapour to moisten the atmosphere, can be used to ensure that the baby s nasal passages are kept moist and free of congestion. If using a humidifier, make sure to place it used in a safe place away out of the reach of any children, as it will be full of vaporising water. A similar effect may be achieved by placing a small container of water on a radiator (not an electrical heater) in the infant s room.

If your baby is prone to congestion, it may be necessary to use sodium chloride 0.9% (also known as saline) nasal drops or solutions to liquefy the mucous. These should only be used on a short-term basis as over-use may dry out the nasal passages.

For many reasons including nasal congestion, never place your infant in a dusty or a smokey environment.

Non-Prescription Treatments

By helping to liquefy mucous secretions one or two drops of Sodium chloride 0.9% nasal drops should help to relieve nasal congestion. Products such as BABYSAL and CALPOL NASAL SPRAY are ideal for treatment of mild nasal congestion in babies and children.

Products containing aromatic oils such as KARVOL (a mixture of pine, cinnamon and menthol) or PICKLES SNUFFLE BABE (containing eucalyptus, thyme and menthol) are used to clear a blocked up nose. The oils vaporise, so that they are breathed and unblock the nasal passages. These products should only be used strictly in accordance with the instructions on the product and for both products direct skin contact should be avoided. The baby should not be able to touch the oils as they could transfer the oils into their eyes. After snipping the top of the KARVOL capsule, the contents are poured onto a handkerchief, which is tied down securely in the vicinity, but out of the reach, of the child. SNUFFLE BABE is in a petroleum base and can be applied to the clothing or alternatively to a handkerchief placed out of reach.

In severe cases, a nasal aspirator may be used to remove the mucous from the nostrils of an infant. To use an aspirator, squeeze the bulb and place the plastic tip at the base of the nostril. Gently release the bulb to slowly collect the mucous. This device should be used under the direction of a professional.

Liquid preparations of a combined decongestant and antihistamine, such as ACTIFED SYRUP, may be used for a short term for children over 6 years. Remember, the antihistamine component can often cause drowsiness. You should check with your pharmacist or doctor that these medicines are appropriate for your child.

If the nasal congestion is causing your child difficulties, particularly with their breathing (especially a young infant) or if there is associated fever or malaise or the condition continues for a number of days, you should always have your child examined by your doctor.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

In a British study the psychological health of over 9,000 British adults born in 1958 until age 42 years were evaluated. Birth weight and growth in childhood was measured and factors such as the father's social class and maternal smoking were accounted for. The study reported that people who had a higher birth weight and a faster weight gain from birth to 7 years old had a lower level of psychological distress into middle age.

Check your childs development, weight and height.

Diagnosis & Symptoms

Most babies experience colic which can range from an occasional mild episode to a severe and painful condition. This can start from as early as two weeks and can continue until the infant is three or four months old. Persistently loud crying and irritability of the child are signs associated with colic. The infant may eat well and gain weight but seem excessively hungry, sucking on everything that they can. Sometimes the crying occurs at the same time each day. Current theories on the exact cause of colic include that it may be a type of cramp in the intestine; others believe it is associated with drinking too fast and taking in too much air; a third theory is that colic is associated with an intolerance to milk or more specifically to the milk sugar lactose (lactose intolerance), while others believe it is associated with stress. Irrespective of the reason, colic can result in a very uncomfortable condition for babies and a very anxious time for parents.

Preventative Measures

Both preventative measures and treatments may require experimentation by the parent to find the most appropriate method of reducing colic. These include examining the type of bottle, teat, food, and how the baby is held and rocked.

Changing bottle types can be useful in preventing colic. Most bottles need air to flow in through the hole in the tip of the teat to remove the vacuum, interrupting the flow and rhythm of sucking. Anti-colic bottles such as Canon Avent range have a one-way air valve, which opens and closes with baby s natural suckling rhythm, letting airflow into the bottle and preventing the baby taking in air and developing wind. Disposable bottles are particularly useful as the bottle bag contracts during feeding, just like the breast, the baby swallows less air, reducing the risk of colic.

If the baby drinks the feed in less than 20 minutes, it is suggested that the bottle-teat be changed to a slower flow one. Regular breaks should be taken during feeding and the baby regularly "winded".

The choice of powdered milk may need to be examined. Changing to a different brand may prove successful in preventing colic. More specifically, if lactose intolerance is suspected, then a non-lactose baby food may be suitable. Many of these products contain soya including INFASOY, WYSOY, and SMA LF.

Where the infant is breast-fed, the mother may need to experiment with her diet, perhaps avoiding spicy or acidic fo od.
How the baby is rocked and held can also be significant. Most babies enjoy being held close and are comforted by close body heat.

Non-Prescription Treatments

The parent may need to investigate a number of treatments and preventative measures in order to reduce the incidence of colic. Many parents have found that colic can be reduced in severity and frequency by rocking the infant in the cradle or holding in the arms, massaging the baby s stomach in an anti-clockwise movement. Other frequently tried methods include bringing the baby for a short car journey.

Again, ensure that the baby drinks slowly and is "winded" frequently.

DENTINOX and INFACOL are dimeticone (also called simethicone) containing products for infants which help to break-up wind. DENTINOX may also be added to the feed.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

Diagnosis & Symptoms

Cradle cap is characterised by thick, flaking, scaly yellow patches on the top of the infant s scalp and also behind the ears. Also known as seborrheic dermatitis, in some cases red marks can appear on the baby s face and there can be a stubborn nappy rash associated with the problem. The condition is often thought to be due to excess oil production in the scalp. For some infants, cradle cap is associated with eczema. In some severe cases, where the condition spreads to other areas such as the face, neck or body, or the scales are excessively thick, the baby s doctor should be consulted.

Preventative Measures

Most babies are affected by this problem, which although looks unsightly is usually harmless and disappears of its own accord after a few months. The problem cannot be prevented but can be controlled by number of treatments.

Non-prescription Treatments

The scales can be softened by applying vegetable oils such as olive oil or peanut oil (also known as arachis oil) and gently massaging the oil into scales. Remember, if there is a possibility of peanut allergy, peanut or arachis oil should not be used. The oils should be combed through in the morning with a fine comb to remove the scales followed by shampooing with a gentle shampoo such as DENTINOX CRADLE CAP TREATMENT SHAMPOO.

CAPASAL SHAMPOO is often used in more persistent cases. With salicylic acid and coal tar to remove scales and prevent itching and coconut oil to soften the scales, the shampoo should only be used when necessary. A small amount of CAPASAL is added after thoroughly wetting the hair, massaging into the scalp and leaving for a few minutes before washing out. The application is then repeated to form a rich lather. Make sure to rinse the hair completely.

PICKLES SCR FOR CRADLE CAP contains salicylic acid to remove scales. Applied sparingly to the scalp, the cream is washed off after 30 minutes to 2 hours, depending on the severity of the condition and age of the child.

With all of these products, if there is a possibility of skin allergy, patch test the product on a very small section of skin. Use only a tiny amount, according the manufacturers instructions on a very small section of the skin. If the rash or irritation develops the product should not be used. If you are unsure about the possibility of allergy or any aspect on the use of these products your doctor or pharmacist will be able to advise you.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

Diagnosis & Symptoms

The inability to breakdown or digest lactose, the main sugar found in milk is referred to as lactose intolerance. Lactose is broken down into glucose and galactose by the lactase enzyme, which is normally found in the bowel, as part of the digestion process. If lactose remains intact and is not digested, it remains in the bowel, causing fluid retention in the bowel resulting in diarrhoea. Fermentation of the undigested lactose can also result in acidic and gaseous stools. Those suffering from lactose intolerance will fail to gain weight, feel bloated and flatulent, and suffer abdominal cramps. Such effects happen within 20 to 30 minutes after taking a lactose containing product. In Northern Europe, it is reckoned that about 20% of people suffer from lactase-enzyme deficiency.

Doctors often recommend a lactose intolerance test to diagnose lactose intolerance. For a positive test, the patient will suffer diarrhoea within 30 minutes of ingesting lactose. Blood glucose levels are also measured during the test and in a positive case blood glucose levels do not increase as lactose is not broken down into glucose and galactose. Alternatively, a breath test, which measures the amount of hydrogen produced from lactose, is considered to be a safer, more reliable method of determining lactose intolerance. Hydrogen is produced when undigested lactose ferments in the body.

Adults and children can suffer from lactose intolerance. Some infants are born with low or no lactase enzymes. After the age of two a child's body produces less lactase enzyme, although the symptoms may not show up until years later. Lactose intolerance may be a cause of colic in babies.

Preventative Measures

Lactose intolerance can be controlled by a lactose-free diet. Foods containing lactose, such as dairy products- milk, yoghurt, cheese, milk powder, chocolate, should be avoided. Product labels should be checked as many products and some medicines contains lactose.

For infants, soya based powders such as INFASOY WYSOY and SMA LF may be used as an alternative to milk. If a lactose-free diet is maintained then calcium supplements should be taken to compensate for the lack of calcium rich dairy products.

Non-Prescription Treatments

If milk products are to be taken, the lactose can broken down by treatment with lactase enzyme. For infants products such as COLIEF INFANT DROPS may be used to break down the lactose content of the feed.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

A range of thermometers are available to measure temperature.

Standard mercury thermometers are still used. However because of the toxicity of mercury and the risk of breaking fragile glass they are becoming less popular. The column of mercury must be shaken below the 35oC mark before placing the bulb end in the required area for two minutes. For older children the thermometer may be placed under the tongue, while for younger children it may be placed under the armpit. After use remember to store out of the reach of children as mercury poisoning is very dangerous.

Digital thermometers are battery operated and many now come with fever alarm and memory. The can be used to measure temperature by mouth, under the armpit or rectally.

Electronic ear thermometers such as BRAUN THEROMSCAN. are very popular and accurate. The ear is considered an appropriate site for temperature measurement as the eardrum shares blood supply with the temperature control centre in the brain. The main advantage is speed, the measurement may be completed in seconds. Disposable covers for the probe must be used on each occasion to protect from infection.

The latest development in temperature reading is the infra red thermometer which can measure temperature without the need to place it in contact with the body. This is particularly useful to measure temperature in sleeping babies or children.

Forehead thermometers are strips that change colour and indicate temperature. They are convenient to use, especially for a sleeping child, but are not as accurate as other methods.

Diagnosis & Symptoms

All babies experience nappy rash although some are likely to suffer more severely than others. The condition can range from a mild redness of the baby's bottom to a more severe condition which results in soreness and blistering. This can result in the breakdown of the top layer of the skin (epidermis) to leave areas of broken moist skin. As a result the skin may be prone to bacterial, fungal and yeast infections such as thrush, resulting in sore, red and raw skin. Consequently nappy rash, when it occurs should be treated early to avoid infection.

Nappy rash is caused by repeated exposure of sensitive skin to moist conditions caused by the presence of urine and faeces in the nappy. The worst areas are often creases or folds in the skin which trap moisture and provide a warm moist environment in which fungal infections thrive. Friction of the skin against nappies may also be a factor. Other causes can be irritation of the skin by soaps or traces of detergents in washing powders used to wash terry-towel nappies.

Preventative Measures

It is important to keep the area clean and dry with regular and frequent nappy changes. The skin should be allowed to breathe and if possible, the baby should be left for short periods during the day without a nappy. When changing nappies a soft flannel cloth and warm water should be used to wash the area. A baby wipe may be more convenient especially when travelling. Particular attention should be paid to creases or folds in the skin.

A protective or barrier cream or ointment (eg CALDEASE, BEPANTHEN, MORHULIN, SUDOCREM, VASOGEN, ) some of which contain additional antiseptic may be applied before fitting a new nappy. This creates a protective barrier to prevent sensitive skin coming into contact with urine, faeces and sources of infection.

All traces of detergents should be thoroughly rinsed from terry-towel nappies.

Avoid the use of plastic pants as they trap moisture and lead to the moist, warm conditions in which bacteria, fungal and yeast infections thrive.

Nappies which have a one-way layer next to the baby s skin are preferable as they allow aeration of the skin. Night-time nappies are recommended to allow a sleeping baby go 8 to 12 hours between changes.

Non-prescription Treatments

When nappy rash occurs, extra care and attention should be paid to follow the steps outlined above in order to prevent further irritation or infection. Nappies should be changed as soon as possible after wetting to limit the contact of urine with irritated skin.

Furthermore, the skin should be allowed to breathe by leaving the baby lying on, rather than in, the nappy, as much as possible. Protective creams should be avoided during nappy-free periods as they will prevent aeration of the skin.

Cleaning with water and soap may irritate the skin. VASELINE or other oily products are often used as an alternative.

If a fungal infection is present your pharmacist may be able to recommend a suitable antifungal cream such as CANESTEN or DAKTARIN.

If the skin is very raw and sore or if yellow spots appear, you may be advised to consult your doctor.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

Diagnosis & Symptoms

Many infants suffer from "sticky eyes", whereby their eyes appear to be very watery and can become sticky. There is a build-up of yellowish residue around the eye, which can become caked on the eyelashes, especially after a long sleep. This is considered to be due to poorly developed tear ducts, which do not allow adequate drainage from the eye. As the child becomes older the tear ducts develop and the baby will usually "grow out" of the problem, usually by about six months.

Where the eyes become irritated, swollen or bleeding, or if there is a lot of pus, it is always recommended to consult your doctor as your child may have a more severe form of the problem or bacterial or viral conjunctivitis. As small children are very susceptible to conjunctivitis, you should consult your doctor when these symptoms are present for a complete diagnosis and treatment.

Preventative Measures

To prevent such a problem sterile saline eye drops should be used frequently. These can liquefy the eye sections preventing the build-up of tear residues and are also used in the treatment.

Non-prescription Treatments

Regular use of sterile, saline eye drops are best at treating the problem. These should be used as frequently as required and in particular before your infant goes to sleep. Any residues of secretions which have built-up can also be removed by using the saline drops. No other over the counter, eye drops should be used unless on the recommendation of your doctor.

Diagnosis & Symptoms

A baby will develop 20 milk teeth (first teeth). The average age for the first tooth to appear is six to seven months although this can vary considerably, from birth to 1 year. Late teething does not mean that a baby is less advanced than others of the same age. The teeth appear or "cut" in a particular order. The first teeth are normally middle incisors at the top followed by the second incisors, the pre-molars, the eye teeth and finally the molars which appear between 1 and 2 years. Molars are much larger teeth and are consequently much more painful. Brushing can begin as soon as the first tooth appears. A wide variety of baby toothbrushes and toothpastes are available.

A tooth coming through the gum can be seen or felt as a small bump on the gum surface which may look swollen or red and raised. Irritability and restlessness are often the first symptoms. The child may dribble more than normal and may show rosy cheeks and chin. The baby will begin to chew on objects. Other symptoms are often falsely attributed to teething. Diarrhoea, vomiting, high fever and febrile convulsions are not caused by teething. Babies experiencing any of these symptoms should be seen by a doctor.

Preventative Measures

When the first tooth has cut, babies should be encouraged to develop the skill of chewing food. Rusks, pieces of apples (peeled) or pieces of raw carrots are often given to babies at this stage. Babies can choke very easily while eating and consequently should be supervised. If food is choking a baby, a gentle tap between the shoulder blades should be enough to bring it up.

A variety of teething rings and rattles are available in an assortment of shapes sizes and colours which the baby can chew on. These may be hard or may contain gels inside which may be cooled in a refrigerator to provide extra relief for sore gums. Products containing PHTHALATES, which had been used to soften the plastic in the teething ring, have been banned for use in teething products.

Cool drinks and smooth textured cold foods such as ice cream or yoghurt may be useful to soothe sore gums.

Non-prescription Treatments

Topical oral analgesics such as BONJELA may be beneficial in relieving teething pain. They may be applied directly using a clean finger.

Paracetamol is an effective analgesic (pain reliever) and antipyretic (temperature reducing agent) (eg. CALPOL SUGAR FREE, PANADOL INFANT, PARALINK) The dose of paracetamol is dependent on age.

Prolonged or routine use of paracetamol without medical supervision can be dangerous.

Ibuprofen, available over the counter as NUROFEN FOR CHILDREN or FENOPINE, is a non-steroidal anti-inflammatory (NSAID) which is effective in reducing temperature and relieving pain and inflammation. Ibuprofen should not be given to babies or children with asthma, stomach ulcers or other serious stomach disorders except under doctor's supervision. Do not give your child more than one antipyretic preparation except on medical advice.

Aspirin should not be given to children under the age of 16.

Further Information on the medicines listed above including dosage is available at www.medicines.ie

Alternative Therapies

Chamomilla has been used for centuries in teething for its soothing and healing properties. It is available as sachets of granules, TEETHA. Empty the contents of one sachet into the child's mouth every two hours for up to six doses.