Bite me! Your guide to teething

Nine-month-old Maren is usually such an easy baby; she almost never cries or fusses, according to her mom, Amy Prestia. But lately, something has changed. Maren is teething, and she is fussy and clingy.Babe with teething ring “She fusses when I put her down, but as soon as I pick her up, she fusses and squirms to get back down,” says Prestia, who lives in Seattle. “Her tolerance for other discomforts seems much lower. Based on her behavior, I assume she is pretty uncomfortable most of the time.”

It’s no wonder that Maren is not herself while cutting teeth; teething is notoriously distressful for babies — and their parents. And the process is more complex than you might think.

“Teething actually begins when a signal is given to the teeth buds embedded in the gums that says it’s time to start growing,” explains Dr. Jeffrey Ernst of Richmond Pediatrics in Shoreline. “It’s no surprise that there is some pain associated with teeth cutting through gum. But it’s more complex than that. There are components of pain as well as effects on the nervous system associated with teething.”

Some lucky babies sail through teething with little complaint, but others are beside themselves with discomfort, and even panic. “Developmentally, it’s normal,” says Ernst. “Some kids are not wired to tolerate teething as easily as others, as with all developmental changes.” Why are the reactions to teething so diverse? “There are many factors,” says Ernst, including temperament and even parental reaction. Some babies will pick up on a very worried parents’ distress and become even more upset.

Is it teething?
Many an exhausted parent has listened to a baby scream and wondered, “Is it teething — or is something wrong?” Typical teething behaviors include pulling on or batting at ears, lots of drooling, chewing on anything within reach, irritability, crying, sleep disruption, appetite disruption, or desire for extra nursing and comfort. Teething discomfort comes and goes, which means you can’t always predict when it will occur, but it doesn’t last forever.

Teething generally does not cause a real fever, says Ernst. A slightly elevated temperature is possible, but a real fever likely means that something else is going on and merits a visit to your child’s health-care provider. Other indications that something other than teething is at work include irritability in a baby younger than 3 months, refusal to eat or extreme fussiness that persists consistently throughout a full day or more. If any of these things occur, it’s important to see your pediatrician immediately.

Try and try again
Because babies can’t tell us, we don’t know if all that fussing is because of irritation or outright pain. And because each baby is unique, we never know for sure what will work to ease teething. “Most comfort measures are geared toward either pain relief or calming of the nervous system,” says Ernst. The best advice? Try what makes sense to you — and then try and try again!

End of your rope?
If you’re going nuts with a fussy teething baby, take time to see to your own needs, too. “It’s in situations of constant crying that parents have sometimes done things that they vastly regret, that can lead to abuse,” says Ernst. “These things can happen to a normal person. When I see parents with a very fussy child, I think it’s important to remind them that when they are at the end of their rope, leave the room and leave the baby for a few minutes so they can collect themselves.” Ernst suggests that a parent hold a crying baby for 15 minutes. If baby is still fussy, put her down and take a break. “If you feel like you are losing control, walk away before you do.”

Tera Schreiber is a frequent contributor to ParentMap and an occasional soother of fussy teethers.

Some things that may help

  • Comfort measures such as swaddling, bouncing, singing, movement or whatever normally soothes your fussy baby. These kinds of things both provide comfort and can distract the nervous system, taking baby’s focus away from the irritation.

  • Teething toys or other cold things applied to gums. Seattle mom Fabia Distefano says that her daughter likes to bite on a vibrating teething toy. Mercer Island mom Karen Morgan-Frazier says that a cold washcloth is one of her son’s favorite teething comforts.

  • Tylenol is the only medication that Ernst recommends for teething. “Ibuprofen is not a great idea for children under 6 months.”

  • Calming homeopathic or naturopathic remedies can provide some relief — they’re geared more toward irritability than pain.

  • Some parents use so-called “gripe water”: home remedies that may include chamomile, ginger, dill — and alcohol. Ernst cautions parents about these remedies, because some contain a lot of alcohol.

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