Teething and Baby Sleep

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Teething is such a hot topic in early parenthood.  In my opinion, it gets a lot more credit than is should, especially for issues around sleep.  

Part of the reason why this topic is talked about so much is because there are differing views on the topic depending on which pediatrician you speak to.  Some pediatricians say teething should not cause any symptoms, some say there are just symptoms a few days prior to when the tooth pokes through, while others say symptoms include:  

  • runny nose
  • diaper rash
  • fussiness
  • chewing
  • drooling
  • low grade fever

No wonder this is such a confusing topic!

The average age babies begin teething is 6 months.  Some babies cut a tooth as early as three months, but the average range is 6-12 months for the first tooth to poke through (how cute is it?!)

One of the biggest excuses or delays I hear when parents are looking for an improvement and change to their baby’s sleep habits is, “I want to start sleep training, but my baby is teething.” Teething does get a lot of blame for sleep disruption for the first 2-3 years of a child’s life.  This is a long time to wait to work on sleep for the child and caregivers, especially if they are getting broken sleep night after night.

How do you decide if teething is to blame?

First, the discomfort of teething should only last a few days.  Discomfort can occur about 3-4 days before a tooth cuts through the gum, then the gum swells in anticipation of the tooth cutting through, which can cause mild discomfort. 

Drooling:  Many parents associate drooling as the first sign baby is teething, but drooling may not always be to blame.  Yes, some babies do drool excessively when a tooth is coming through, but many other babies just drool a lot, simply because they do not know how to handle all of the saliva in their mouth, but it doesn’t necessarily mean they are teething.  If a baby has been drooling for months, this should not be an indicator that baby is teething.

Chewing:  If baby starts putting everything in their mouth, from fingers to anything they can find on the floor, this may not be an indicator of teething.  Chewing on things and being curious about sticking different objects in their mouth is what babies do naturally.  It’s just part of being a baby!  For some, it could be teething, but if it has been going on for a while, it most likely is just curiosity and exploring on baby’s part.

Fussiness:  This may be the strongest indicator that baby is teething.  If baby seems fussier than usual on a particular day, and the cause is not a cold/illness, or overtiredness, they could possibly be cutting a tooth.  The best way to tell is to look inside baby’s mouth, and if there is a bump on the surface of the gum, this most likely means that in a few days, you will see a tooth poking through!

Keep in mind, every baby handles teething differently.  Some parents may be living their lives and one day they notice “ta-da!”, their baby has a tooth!  Other parents have said a few days prior to their baby cutting a tooth, they noticed more irritability or baby is sleepier than normal.

The good news is, if you have a baby who is sleeping well, this should help them get through the discomfort of teething.  Think about when we, as adults, get sick.  If we are under the weather AND not sleeping well, we wake up feeling even worse the next day.  This is similar for babies.  If they are not sleeping well, the lack of sleep can magnify their pain, but if they are sleeping well, this can lead to more mild teething symptoms.  Sleeping well is part of a preventative measure for teething.

How to Alleviate Discomfort

First, always check with your pediatrician before administering any medicine to your baby.  We also want to keep in mind that we do not want to be giving baby medicine all day and night for teething.  If you think medicine is necessary, I recommend giving it to baby 15-20 minutes before you lay them down in their crib to sleep for the night.  My favorite pain relief medicine for teething is either Motrin or Tylenol.  If baby wakes up about 6 hours later, this is a good indicator the medicine has worn off and teething is causing discomfort.

Instead of offering medicine during the day, you can offer baby a teething ring, teething toys, or freeze a washcloth for baby to suck on for some relief to the gums.  I have also had mothers freeze a chunk of breastmilk and rub it on baby’s gums.

One thing to consider is we also want children to be able to self-regulate pain.  We do not always need to alleviate every little pain all of the time.  We want children to learn to eventually monitor and manage pain, which is a learning process.  I am not saying to not offer relief if they are clearly in pain, but I do not think medicine around the clock for teething is necessary.

If You Suspect Teething at Night

It is fine to increase comfort to baby in the middle of the night and/or for naps (pick baby up, offer water, extra cuddles), but when you start changing sleep skills, this is when new sleep issues can be created.  As a rule of thumb, if you are introducing a new sleep prop or even an old one, and you have been doing this for 3 nights or more, there is a good chance you are creating a new habit (or old) that will have to be broken if you do not want it to continue.  

Remember, teething pain does not last for weeks.  It should only last for a few days.  If baby has not been sleeping well for weeks or months, ask yourself:  Does my child fall asleep independently?  If yes, then that is the foundation of good sleep.  If the answer is no, I suggest taking some steps to solving the heart of the issue, which is the association with sleep props and teaching baby how to fall asleep independently.  Once a baby learns how to fall asleep on their own, this should help alleviate teething symptoms.  

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