Penelope Leach, Ph.D., gives advice on what to do when your baby's first teeth come in.


Babies cut their teeth in a fairly predictable order but at widely varying ages. Your baby's first tooth will almost certainly be one of the bottom front pair but will only probably be cut shortly before his half birthday. Getting teeth earlier or later than average doesn't mean that a baby is "forward" or "backward" -- in fact, it means nothing of significance except that once a tooth appears that toothless grin is gone forever.

For most babies "teething" starts later than you may expect and is less dramatic. Since your baby won't cut a tooth until five or six months, it's unlikely that the process will trouble him before, say, four months. And it probably won't cause much trouble then. The first four teeth are so flat and sharp that they usually come through with nothing more notable than an inflamed gum, a bit of dribbling, and a lot of chewing. If you can see a red patch of gum, and your baby seems frantic to bite down on it, try rubbing it with your finger.

"Teething" is a popular, but usually inaccurate, explanation for fretfulness and crying in very young babies. And it can be a dangerous explanation, too. Each year a few babies reach the hospital in a serious condition because parents had ascribed what turned out to be symptoms of a serious illness to teething and therefore waited too long before seeking medical help. Teething cannot cause fever, diarrhea, vomiting, convulsions, or "fits," at this age or later. If your baby seems ill when you think he is teething, consult your doctor: he is either ill and teething, or simply ill.

Teeth and Chewing

First teeth are biting-off teeth, not chewing teeth. Babies start chewing with their gums long before they acquire teeth at the back of the mouth to help them. Don't assume that a baby with one solitary front tooth cannot chew. He will start teaching himself to chew as soon as he can get his hands and the toys that they hold into his mouth. Make sure your baby also gets foods such as peeled pieces of apples or scrubbed raw carrot to chew well before six months or he may become so used to semiliquid foods that when he does have chewing teeth, at around a year, he won't use them because really solid food revolts him and makes him gag.

Chewing on hard food is good for babies' developing jaw, and feeding themselves with their own hands helps them feel enthusiastic and independent about eating. Stay close, though, in case your baby pokes himself in the eye with that carrot stick. And once a coming tooth is visible, as a small, pale bump under the gum, be especially alert. When its point breaks through, it will be so sharp that your baby could grate a tiny piece of that apple off and choke on it if you weren't there to help.

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Excerpts from Penelope Leach's Your Baby & Child, available in bookstores nationwide, are reprinted with permission of Alfred A. Knopf.Copyright © 2002