Most babies will get their first tooth around 4–7 months of age. Once a baby’s teeth start to appear, they will arrive one or two at a time over several months. Often (though not always), the first teeth to appear are the two on the bottom—front and center. The two middle teeth on the top usually appear next. After that, it’s a parade of teeth with one following another. Their molars (back teeth) and canines (also called eye teeth) are among the last. The process takes about 2 1/2 years with most children having all 20 primary teeth by their third birthday.
Experts disagree over whether teething causes a runny nose, diarrhea, and fever. It may be just a coincidence when both occur at the same time, since not all children have symptoms. What is common among most babies is pain or discomfort. If your child is teething, expect the following:
- Swollen gums
- Constant drooling
- Unusually fussy
- Refusing to eat
- Unable to sleep
- Chewing and biting
If your baby seems uncomfortable, try these simple tips:
- Cold teething ring. Giving your child something to chew on may ease his discomfort. A solid rubber ring designed for teething is a popular choice but a cold, wet washcloth works just as well. Chilling teething rings in the fridge is usually ok but avoid frozen teething rings which can damage gums.
- Cold foods. If your baby is older than 6 months and eating solid foods, he may enjoy cold applesauce or yogurt.
- Rub gums. Gently rubbing a clean finger across his gums can also provide temporary relief.
- Distraction. Try to distract your baby from his discomfort with extra snuggling and playtime. If weather permits, a walk outside and some fresh air may help calm you both.
- Avoid drool rash. To avoid skin irritation from excessive drooling, keep a clean cloth handy to gently dry your baby's chin. Also, change your baby's clothes if they become wet from drool. If needed, apply a thin layer of a healing ointment like Aquaphor or Vaseline, which will act as a barrier between your baby's sensitive skin and the drool.
- Pain reliever. If all else fails, an appropriate dose of acetaminophen or ibuprofen (but never aspirin) may help.
Avoid using teething medications that contain benzocaine (such as Orajel and Anbesol) and lidocaine on infants and children. Benzocaine poses a risk for methemoglobinemia, a rare but serious condition that reduces the amount of oxygen in the blood. Viscous lidocaine risks —stemming from incorrect dosing and accidental ingestion — include brain injury, heart damage, and death. The Food and Drug Administration (FDA) also warns against using homeopathic teething products which may contain belladonna, a toxic substance.
Teething and breastfeeding
Much has been written about teething babies biting while breastfeeding. As long as your baby has a good, deep latch, there’s little reason to worry about biting. To prevent biting consider the following:
- Check your baby’s latch. When your baby is well-latched—a wide open mouth filled with breast—he can’t bite. Keep in mind that if he gets sleepy and slips off the breast, he may bite on his way out.
- Watch your baby for signs. Biting is most likely to happen when your baby is full and no longer nursing. As soon as your baby stops sucking and swallowing, slide your finger into the corner his mouth, break the suction, protect your nipple, and take your baby off the breast.
- Give your baby your attention. Some babies will bite if your attention is elsewhere—on the phone or TV, for example. Engage with your baby while breastfeeding, and see if this helps. You may also minimize distractions by dimming lights, turning off the TV, playing music, or going to a quiet room.
- Don’t try to force your baby to eat. If your baby refuses to breastfeed due to the pain of teething, he may use biting as a means of keeping the breast out of his mouth. Be patient and continue to offer the breast. If he persists in his refusal, offer your expressed milk by cup or spoon until the pain eases.
Many mothers instinctively pull back when bitten. Ideally you should gently press your baby’s face into the breast for a few seconds when he bites instead of pulling him away. Pressing his face into your breast causes him to release the breast. After all, he has to breathe! Remove the baby from the breast and give him a cold, wet washcloth or cool teething ring to chew on instead.
To learn best ways to breastfeed a teething baby, read this.