By Alicia Hart, ND
Teething has come up a few times here in the last couple weeks, and I realized I do have quite an opinion on the process. Having had an early teether (4 months) and twins on very different dentition schedules with different processes for their tooth eruptions, we’ve pretty much tried it all at our house.
There are a number of studies out which discuss which symptoms do and don’t come with teething- most of which say something along the lines that there’s no such thing as teething associated diarrhea or fever. They also note that 75% of parents notice teething fevers or diarrhea, so what I’m choosing to take away from this science is that the majority of parents may notice some systemic symptoms around the same time that kiddo is popping teeth through. Please be mindful of your child’s individual temperament and process, and bring them in if something is out of the normal or outside of my fever guidelines.
That big giant caveat aside, I’ve had 3 kids and I fall in that 75%, so we’re going to talk about symptoms, process, and alleviation methods.
Teething: how do I know when baby is teething?
Most babies begin drooling profusely and stuffing their hands in their mouths around 4 months. This is not teething, it’s developmental. It also doesn’t mean they want food, but that’s a post for another day. Each child will have their own pattern that you’ll get used to over time, usually beginning around 6 months. I have one who is totally miserable, has a fever, and cries every time you set her down, and then has a new tooth in 6 hours. She also generally erupts 3 or 4 at a time. I have one who suddenly gets green poop and is low level fussy for a week, slowly develops red bumps on his gums, and then gradually over a two week drooly period had a single tooth appear. I also have a dude that would refuse to sleep, get a weird rash, and have a fever with teething.
In general, according to some other scientists, you’re looking for drooling, sleep disturbances, irritability, and a low grade fever. Sounds like pretty much every disturbance babies get, right? I’d add in there that they will have a raised, red area on their gums and will probably be chewing on something you care about, and usually will be 6 months old or more. Usually you’ll get worse fuss with the canines (between 12 and 18 months) and molars (between 12 and 24 ish months)
What do I do about it?
Well, it’s teeth. You don’t have to do anything, humans have been getting teeth for a long time. That said, those kids do get pretty cranky so there’s a few methods that you can try.
1) Babywearing. All they want is to be up anyway, and there’s some evidence to suggest that it actually decreases their pain response. Bonuses of this method: you can do this as much as desired, it lets you get out of the house, and is generally the only way I got anything done with my twins anyway. Cons: If your core is weak (say, from a diastasis recti from carrying twins) your back may hurt. It puts the yelling closer to your ears. You can overheat in summer. Check in with your local babywearing group to make sure everything is as optimal as possible, or swing by the office if you want me to double check.
2) Cold things. Top remedies in my house were frozen blueberries or peas or breastmilk cubes in a mesh feeder. I love these because they’re simple and need almost no prep before handing off to kiddo. A Costco sized organic frozen blueberry bag gets me through weeks of teething, though your mileage (and number of teething children) may vary.
3) Herbal remedies: Lemon balm, Chamomile, and Catnip turned into tea and soaked onto a washcloth that you put into the fridge has a good flavor, is mildly sedating, and really helps with the sleep disturbances and upset tummy that can come with the teething. You can use any of these herbs individually or you can put them all together for a stronger combo. Bonus: All of these things grow like bonkers here in the PNW, so you can just harvest out of your patio garden instead of heading to the store. Cons: None. I’m serious, these are all great children’s remedies and I use them all the time.
4) Give them something to chomp on. Ideally not a plastic teether which may pass endocrine disruptors on – we use raw carrots, wooden teething toys, and silicone necklaces at my house.
5) I have also been known to use systemic analgesics if I’m not sleeping due to the teething. I don’t use Tylenol/acetomeniphen in my house due to it’s relationships with cell death, glutathione depletion and increase of asthma symptoms and association with ADHD , but Advil/ibuprofen works just fine in our house. You need weight based dosing so come in for a weight check if needed.
What things shouldn’t you do?
1. Don’t run away. This is just a phase, and it will pass.
2. I’m not a huge fan of amber teething necklaces. Now, don’t burn me at the stake for not being an adequate hippie. Lots of people swear by these- but keep in mind that there is no reason for amber necklaces to relieve teething pain (the succinic acid that is supposed to be the main method of action is not extracted at body temperature and is not released in a studied therapeutic dose) and it’s a massive choking hazard. All of the scientific articles I found on teething necklaces were so Skeptic ™ that I didn’t think it was useful to link them. Do your varied reading and decide what you think- there’s not enough evidence (in my own children or in the literature) to make me recommend it right now.
3. Teething gel is the actual worst. Not only is it associated with salicylate poisoning and methemoglobinemia, it can screw up kiddo’s gag reflex and cause aspiration and choking. This is another point that I’m not going to cite, but because there’s so much evidence it’s impractical. Google “teething gel infant ncbi” and you’re going to get buried by a ton of studies. I haven’t read all of them, but I do not recommend teething gel for infants.
4. Same for clove oil (or worse, clove essential oil). It’s not considered safe until age 2, and needs further dilution. It irritates mucous membranes (like gums) and can also thin the blood- something no toddler running headfirst from obstacle to obstacle needs.
5. Don’t feel like you need to treat it. If you’re medicating kiddo left and right, giving them only chilled food, and not setting them down 24/7, you are totally overdoing it. Pain can be healthy and normal- it is a signal that our body gives us to let us know that we need to slow down or be more careful. It’s important for children to learn to respect and interpret their own body cues, empathetic TLC is often all you need to help them understand what’s going on.
For further reading (in case you didn’t click through)