Why Teething Pain Really Bites for Babies and What to Do

Inevitable teething pain aches can bring late-night wakings and uncontrollable drooling. Find out what's normal and how to help your little one cope.

You’ve finally mastered that sleep training with your son and suddenly he’s waking up in the middle of the night screaming at the top of his lungs. Or maybe your daughter was always a great eater and then – poof! – she’ll hardly take a bite of anything. Is it teething pain or something else?

We asked Dr. Daniel Schnaar, M.D., a Beaumont pediatrician with Child Health Associates in Troy and Novi, to explain the teething process and how you can make that teething pain more manageable for your child.

What to look for

“Although every child is different, most babies start seeing their teeth break through their gums at about 6-7 months,” Schnaar says. “Children start feeling their teeth moving through the gums even earlier than that – usually about 4 months.”

Baby’s first teeth usually break through in the middle on the bottom gum. Although you can’t see them coming through at first, the teeth are very sharp and can cause significant discomfort.

“Kids are usually uncomfortable and parents are at a loss of what they can do,” Schnaar says.

Waking up at night, pain with biting down and drooling are common signs your baby is teething. Other symptoms include runny nose, slight fever or loose stool.

By 1 year of age, most kids have four teeth on top and two on the bottom. Although the molars aren’t as sharp, they can cause more swelling.

“The pain of the molars may cause babies to pull on their ears, which parents may think is an ear infection,” he says.

When that happens, see your child’s doctor. “There is no way for (the parent) to tell if it’s an ear infection or teething.”

How to soothe their pain

Fortunately, there are several ways a parent can ease their child’s teething pain and soothe sore gums.

“The safest thing for a parent to do is gently massage the baby’s gums,” Schnaar suggests, adding that applesauce and other cold, soft foods are a good idea. “Anything cold is very helpful for the pain.”

Massage baby’s gums with a clean, cold washcloth or offer a cold teething ring to chew on.

“I do not recommend putting them in the freezer,” Schnaar notes. “Put them in the refrigerator so they’re flexible. They can help with the pain and reduce swelling.”

When your child is 6 months or older, it’s OK to give infant Tylenol to help with the pain. “Even if the label says every four hours, I certainly wouldn’t do that for a baby that little,” he says. “Maybe just one dose at night so the baby and parents can get a good night of sleep, but I wouldn’t do it more than four to five nights in a row.”

What to avoid

While products like Orajel have been used in the past, it’s no longer recommended.

“Another product we don’t recommend is teething tablets from Hyland’s, which is a homeopathic company,” Schnaar says. “The teething tablets contain belladonna which reduces drooling, but that’s not the problem – the problem is more about the pain.”

The tablets aren’t regulated and could contain too much belladonna, he says, yet many parents still use them because they hear success stories on social media.

And as for the amber teething necklaces many children wear, which are advertised to help with teething pain?

“The experts say the amber teething necklaces don’t work,” Schnaar says, and they should never be worn while a child is sleeping. “Anything around the neck of the baby can get caught on something and choke the baby, so we worry about that.”

When is it more than teething?

A fever above 100.2 usually has a cause other than teething, Schnaar explains.

“Babies can drool and get a fever from a throat infection, so it’s not always from teething,” he says. Watch your baby closely. “The higher the fever, the more likely the baby should go to the doctor.”

Illustration by Brent Mossner


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