Our teething advice will help you take a bite out of this often painful milestone.
The Daily Grind
Brooke Dubray faces the trials and tribulations of teething -- times two. Her 20-month-old twin daughters, Sophie and Gaby, cut their first teeth at 5 months, and those first teeth -- the same one on each girl -- surfaced a day apart. Since then the twins have gotten each new tooth within a day or so of each other. The girls' "tough nights," which can keep the Corte Madera, California, mother from clocking a good night's sleep, also frequently hit on alternate evenings. "I am often exhausted after being up with them crying," says Dubray. However, instead of viewing their teething as double trouble, Dubray -- who also has a 4-1/2-year-old son, Luc -- takes solace in having a little more veteran's know-how this time around: "Teething with the twins has been easier since I understood it from having a child before," she says.
While Dubray's twins' teeth arrived "on schedule" (at 5 to 7 months), don't be worried if your 6-month-old is still sporting a gummy smile. "There's nothing to be concerned about if your child's teeth come in later," says Michael J. Hanna, DMD, a dentist in Pittsburgh who is also the national spokesperson for the American Academy of Pediatric Dentistry. "Each tooth has its own timetable and will come in when it's ready." In fact, it's not unusual for the first tooth to appear as late as age 1.
Teeth generally arrive in pairs. The first to pop up are usually the two bottom front teeth (central incisors), followed by the four upper teeth (central and lateral incisors). Around baby's first birthday, he may get his first molars in the back of his mouth, and then come the canines (the pointed teeth between the molars and the incisors). Around age 2, the second molars arrive behind the first set. Sometimes, though, the teeth break through in batches. Brooke Graham Doyle, of Seattle, recalls how her 20-month-old daughter, Meghan, sprouted her four molars in two days! There are 20 primary teeth, and while it may feel as if teething lasts forever, the first teeth seem to hurt the most, and as each new one comes in, your child may take the process a little more in stride.
Teething or Something Else?
Most teething pain hits before the tooth breaks through the gums. The telltale signs: grouchiness, a decrease in appetite, increased drooling, and puffy, inflamed gums. (Bridget Pelosi, of Berkeley Heights, New Jersey, put her 18-month-old son, Gavin, in a bib all day -- otherwise he'd end up soaked from his "intense drooling.") Other symptoms, such as ear pain, diarrhea, and especially fever, are often attributed to teething, too, but they are not "true" symptoms, experts say.
"There are no studies that show that teething causes fever," says Laura Jana, MD, a spokesperson for the American Academy of Pediatrics who is based in Omaha, Nebraska -- yet many of her patients say their children experienced it when teething. And the same goes for ear pain and diarrhea. It could be that a child is suffering doubly: "Kids get a lot of teeth over the first couple of years and a lot of viral infections, so they are bound to overlap at certain times," says Dr. Jana. Your goal is to make your child comfortable, so do what it takes to bring him relief. However, if he has a fever that is persistent or above 101 degrees, call your doctor because that isn't teething, she says.
Ease Teething Pain
Babies' reactions to teething and tolerance for pain can run the gamut. Dr. Jana was lucky: Her kids' teeth never really bothered them. But plenty of parents called her in distress because their kids were in agony. Below are some tips for tackling the pain. (Note: Certain items may pose a choking hazard for very young babies, so use your best judgment.)
- Give massage a whirl. Gently rubbing your child's gums with a clean finger or a wet gauze pad can be soothing. It feels good and helps break down the gum tissues. "If you start from day one massaging their gums, it makes teething that much easier for the child," says Dr. Hanna.
- Try something cold. Cold decreases pain and inflammation, so a chilled teething ring (especially one with bumps or ridges) is often tops on parents' lists. Check it daily to make sure baby hasn't broken through it. Teething rings only stay cool for about 20 minutes, so keep a few backups in the fridge. Your baby can also find comfort from her pacifier, and many babies just like to chew, whether it's on a board book, a toy, or a crinkle blanket. Colleen Moriarty, of Haddam, Connecticut, froze a twisted washcloth for her children. "They loved it!" she says.
- Gnaw on this. Dr. Hanna recommends freezing a skinned banana for up to one hour, cutting it in quarters, and holding it while your child chews on it. Dubray put ice water in her twins' sippy cups, and they sucked on the cup's edge.
- Try infant Tylenol. Emily Haskell, of New York City, says Tylenol was a godsend with her now-4-1/2-year-old son, Charlie. "This is very safe when used properly," says Dr. Hanna. But it's important to pay close attention to the labels because infant Tylenol is very concentrated -- more so than the child variety -- and too much can be bad for a baby's liver. Base dosage on baby's weight, and do not administer it more often than every four to six hours. If you need to use Tylenol that frequently for more than two days, consult your pediatrician, advises Dr. Jana.
- Distract baby. For many, the pain of teething is worse at night when babies have no distractions. Dubray finds that rocking helps soothe her girls.
Babies do need extra TLC when they're teething. When Kate Clow's daughter Nora screams out in pain, "I pick her up and give her hugs and kisses," says the Summit, New Jersey, mother of her 18-month-old. In this as in many cases, Mom proves to be the best medicine.
Tricia O'Brien is the features editor of American Baby magazine.
Originally published in the August 2006 issue of American Baby magazine.
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