One of my favorite TV shows from the last few years is Myth Busters on the Discovery Channel. For some strange reason, watching Adam and Jamie prove things to be false that everyone just knew were true kept me tuning in each episode. So, in homage to this, I thought I would try some myth busting of my own about some common Pediatrics myths that many doctors themselves believe and, by extension, their patients.
Myth 1: Fever is a common symptom of Teething.
Teething as a cause of fever is a common misbelief amongst doctors, parents and grandparents. Teething has been used to describe just about every ill symptom and misbehavior in an infant. Interestingly, even though this belief has been shared widely over the last century, it wasn’t until 1992 that a group of Pediatricians decided to put it to the test. Over the course of 5 months they had mothers take daily temperatures in 46 healthy infants in anticipation of the eruption of the first tooth. In none of these cases, at the time the first tooth arrived, did a child’s temperature exceed 100.4, the definition of fever. In addition to no fever, cold symptoms and diarrhea were not present as well.
Thinking back to our grade school years we likely already knew this was a myth since when we lost our baby teeth we didn’t then spend long periods of time with fever, colds, etc. as our adult teeth grew in. One lesson I’ve taken from this is that it is never a good idea to chalk a baby with a fever up to teething because it may mean you miss a more serious diagnosis.
Citation: Fever associated with Teething. Arch Dis Child. 1992 Feb; 67(2): 233–234.
Myth 2: My child’s runny nose has turned dark green, which means they have more serious infection and need antibiotics.
Even amongst medical professionals, the significance of the color of snot has been much debated so it is no wonder this folklore has found its way in our collective medical beliefs. Most uncomplicated colds will follow a natural course of lasting around 10 to 12 days with a runny nose changing to a yellow to green color around days 3 to 5. This change in color is not an indication that the infection has worsened, but that your body’s immune system is mounting a counterattack. As white blood cells and antibodies swarm to attack the infection they cause a chemical process called oxidation to occur that makes nasal discharge change in color. The green or yellow nose usually lasts 2-3 days and then returns to clear before completely resolving. As long everything follows this expected course then all that is needed for a child with a runny nose to get better is time. If on the other hand the green runny nose has gone on for more than 2 weeks, then it is time to consider seeking medical attention as a simple cold may have morphed into a sinus infection.
Myth 3: Adding cereal to an infant’s formula will help them sleep longer.
Infant sleep problems are common, so it easy to see why this advice would be welcomed by sleep deprived parents. Despite the fact that I personally wish this advice was true, a number of good studies have shown that adding rice cereal to an infant’s formula makes no difference in the length of sleep. One study explored this by having 106 infants split into two groups with one starting rice cereal in their formula at 5 weeks old and the other at 4 months old. The sleep of both groups was followed from 4 weeks old to 21 weeks old. The addition of rice cereal at the earlier age did not increase sleep compared to the group that had a delayed start of cereal. The reason why the rice cereal likely made no difference in sleep is that hunger is only one of many reasons that babies wake up at night, and rice cereal does not significantly slow the transit of the food out of the stomach. My take home message from this is that there is no easy solution to helping infants sleep through the night since everyone is a little different, but that working on sleep training during infancy will pay off overtime.
On a side note, one potential downside to mixing cereal with formula is that it has been shown to increase the risk for a child becoming overweight.
Citation: Infant sleep and bedtime cereal. Am J Dis Child. 1989 Sep;143(9):1066-8.
I hope my foray into Myth Busting has been of some interest and help. It was certainly fun doing the research. If you have any other questions you’ve been wondering about, Canyon View Pediatrics is here to help.
By Patrick McVey, MD
Canyon View Pediatrics