Bonjela is an orally-applied medicine used commonly to sooth babies' gums during teething. Photo: 123RF
It is the liquorice-like taste of teething for toddlers, but for one mother, Bonjela almost cost her daughter's life.
Concerns over the medication's safety has promoted MedSafe to restrict sales of Bonjela for infants.
However, Jessica*, says the restrictions do not go far enough.
In 2019 a seemingly innocent dose of Bonjela to soothe her baby's teething gums almost killed her daughter.
"She got rushed to Starship Hospital, and put into an induced coma because her blood had turned acidic from the the active ingredient in Bojela, I was unaware at the time of the dangers posed," Jessica said.
She used Bonjela for her daughter on the advice of her GP.
"She was teething really badly, we told the doctors we had given her Pamol, Neurofen and Bonjela. Their response was 'It's ok, it's just Bonjela, keep giving it to her'."
It was advice she would regret taking.
"This is an over-the-counter medication, you can walk in and buy 10 packs if you like. Nobody stops you. Nobody asks any questions. We were so, so fortunate that she didn't die."
Jessica said she felt both anger and disappointment in the wake of her child's accidental overdose.
"A lot of parents just do what they think is best for their babies and when you hear them crying you want to help them. It is appalling that you can tell your doctors this is what I'm giving her and it still has such an adverse affect."
The infant version of the popular household medicine would be restricted to pharmacies from May next year, though MedSafe group manager Chris James said the adult version would still be available with the word "teething" removed.
"There will remain Bonjela available in general sales for adults and older children because Bonjela is also commonly used for mouth ulcers," James said.
The active ingredient in Bonjela is choline salicylate, which can be very harmful to babies if too much is given. It can cause salicylate poisoning.
"So we have made this discussion following some expert advice to help encourage parents buying Bonjela for oral treatment such as teething to get advice from their pharmacy."
James said MedSafe strongly recommended people always follow the dosage instructions.
"Bonjela is very effective and safe to use in recommended dosages, there are no concerns when the product is used according to instructions."
However, Jessica was not convinced there was sufficient warning.
"Not too many mums with a screaming baby at two o'clock in the morning are going to Google the ingredients of their Bonjela to make sure it's ok, but if there is a pamphlet wrapped around the tube there is much better chance of people being aware."
More education was crucial to avoid another mother living her nightmare, she said.
"I just want there to be much more information as to what is in Bonjela and the risks around it and to use it very, very sparingly."
Jessica's daughter is now four - healthy, happy and thriving.
"Ninety-nine times out of a hundred your baby could be perfectly fine but it's that what if, and as a parent you have to look at those what if's and you want to know what your baby's taking."
MedSafe says to rub a pea sized amount of gel to the affected area no more than every three hours and not to use it more than six times in 24 hours.
"You can overdose your baby by applying too much gel or using it too often."
Whānau Āwhina Plunket principal clinical advisor Karen Magrath said they supported MedSafe's reclassification.
"Teething can be a really upsetting time not only for pēpi but the whole whānau. There are a number of things we recommend to ease the pain, other than teething gel."
Those included gently rubbing gums with a clean finger or the back of a cold spoon, wrapping ice cubes in a clean face cloth and placing it on your baby's cheek, giving your baby something to chew on such as a clean teething ring or chilled fruit wrapped in a muslin cloth, she said.
"There is little evidence that teething gels are effective and most of the gel is likely to be quickly removed by the tongue and saliva."
Magrath said if parents did choose to use teething gel they should only purchase from a pharmacy.
"It is very easy to unintentionally give babies too much teething gel."
Signs of salicylate poisoning/Bonjela overdose are: Vomiting, unusual sleepiness, fever and rapid breathing.
As a result of the reclassification the makers of Bonjela, Reckitt Benckiser NZ, has introduced a new Bonjela product to soothe teething which does not contain choline salicylate.
The new formulation of Bonjela for infants has been listed as a medical device with Medsafe and it is available to consumers now for infants aged over six months through supermarkets and pharmacies.
In a statement the company says it takes the health of consumers very seriously and when used as directed, Bonjela containing choline salicylate is safe to use.
"Bonjela has worked closely with Medsafe to ensure consumer safety is the number one priority. We agree that products containing choline salicylate should be made available in pharmacy where there is a pharmacist available to help emphasise to parents the importance of using these products as directed."