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Ask Dr. Sears: Excessive Drooling

Q. My grandson has been an excessive drooler since birth. He is 20 months old now, with a full set of teeth, and we're still changing his bib every thirty minutes or so. Another concern: He hasn't started talking yet. Do you think these problems are related?

A.
As long as your grandson's overall development is normal (walking, running, playing, and gesturing), it's unlikely there's a relationship between his excessive drooling and his delay in talking. Infants and children sometimes exhibit certain normal and harmless behaviors that are nonetheless nuisances  -- I refer to these as "quirks." Excessive drooling is a very common quirk, and in fact, excessive saliva production can be healthy. Saliva bathes the teeth and gums, washing away accumulated food and bacteria. The enzymes in saliva also help break down the carbohydrates in food, operating as a head start in the digestive process. In addition, saliva is a natural intestinal lubricant: Infants commonly suffer from gastroesophageal reflux (regurgitation of the acidic stomach contents into the esophagus); saliva lubricates the lining of the esophagus and helps neutralize the acidity. It also contains a healthy substance called epidural growth factor, which helps the intestinal lining mature.

Since your grandson is still in the teething stage, you should expect excess drooling over the next six months, or until all his teeth are in. Here are some home remedies you can use to prevent the sometimes irritating effects of excess saliva.

Use a barrier cream on the skin. Irritation around the mouth and cheeks, known as drool rash, is common. At night, baby rubs those chubby cheeks against a drool-soaked bed sheet and wakes up with a rash on his cheeks. Before bed, apply an emollient ointment, such as Soothe and Heal by Lansinoh, around his mouth and cheeks. This will act as a barrier against the irritation.

Believe it or not, excess drool can also result in irritation of your baby's bottom. Saliva is a natural laxative, which may lead to more frequent, looser stools and exacerbation of diaper rash. Apply the same protective barrier ointment on baby's bottom.

Have baby sleep on his side. Excessive saliva can puddle in the back of the throat, often causing a rattlelike cough and noisy breathing, which you may mistake for a cold. This is harmless, but may interfere with your grandson's ability to sleep well. Now that he's well past the SIDS danger stage, putting him down to sleep on his side or tummy may keep the drool from collecting in the back of his throat and waking him up.

Consult baby's doctor. Some babies with generalized developmental delay will show a diminished swallowing mechanism, causing excess saliva to pool in the mouth and give the appearance of constant drool. It's unlikely this is the case with your grandson, but his pediatrician should nevertheless do a thorough developmental assessment of baby's overall muscle coordination. In my experience, when excessive drooling is caused by a developmental problem, there are always other obvious signs of delayed development, which your grandson does not exhibit.

In the meantime, be prepared to keep that drool cloth constantly at the ready. Once all his teeth are in, this drippy stage should pass.

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