Chances are you’re cheering as your baby masters each new skill: rolling over, clapping, sitting up.
But there’s one milestone you may not look forward to: teething. It can be a challenge, and it can make your normally happy, playful baby cranky and uncomfortable.
Teething tends to happen at around 6 months of age, the same time that children naturally start to get sick more often. The immune protection they got in the womb begins wearing off.
It can be hard to tell what’s causing your little one’s discomfort. Is it teeth? Or an illness?
Give your pediatrician a call whenever you're concerned, but certain symptoms can offer clues.
It’s Probably Teething if Your Baby:
Is crankier than usual. You might notice them fussing, or wanting to be held or comforted more often. About two-thirds of teething babies show signs of fussiness.
Drools all the time. Expect some slobber as teeth begin pushing outward. More than half of all babies drool when teething, recent research shows. Sometimes all that extra saliva can cause a rash to develop on the chin, cheeks, and neck.
Gnaws on things. An even more common symptom, according to that same research: gum irritation. It affects more than 85% of teething babies.
Your child may respond by biting or chewing on toys or other objects. Or you may see them rubbing their gums or cheeks. They may feel better after gumming a cold washcloth, pacifier, or teething ring.
Has a slightly raised temperature. Fevers have often been linked to teething, but evidence shows that’s not really true.
In a 2011 study, Brazilian researchers had dentists check on 47 babies every day for 8 months. They found that the children had slight increases in temperature on the day a tooth erupted and the day before. But they didn’t have what doctors would call a fever, which in a child is 100.4 F or above.
Is less interested in solids. If your baby has already started on solid foods, you may notice that they want them less in the days leading up to a new tooth. As long as your child is still drinking plenty of breast milk or formula, it’s not something to worry about.
It’s Probably an Illness if Your Baby:
Is so fussy that you can't comfort them. The phrase “cutting a tooth” makes it sound like your little one will have severe, stabbing pain, but teething pain is pretty mild. A bit of extra fussiness is normal. But if your baby cries so much that they can’t sleep or be consoled, see your doctor.
Has a high fever. A temperature of 100.4 or above likely points to an infection. But keep in mind that a teething baby who's constantly putting their hands in their mouth may have picked up a germ here and there, so your child could be getting a tooth and have a cold. If the temperature is higher than 102 and you have other concerns including fussiness, then consult with your child’s PCP.
Has no appetite for solids or liquids. Some babies shun solids while a new tooth is pushing its way through. But if your child is also refusing to nurse or take a bottle, talk to your pediatrician.
Has a runny nose, cough, vomiting, or diarrhea. There’s no evidence that teething causes any of these issues. It’s more likely that your child has a bug.
Has a rash that’s not just on the face. Lots of drooling can sometimes create a rash around your child’s mouth, but one that spreads to cover their torso, arms, or legs could be caused by an illness.
Symptoms continue for more than a few days. Irritability, gum rubbing, and a slightly raised temperature may be due to teething -- but only in the days right before and after a tooth’s arrival.
So if your little one seems miserable for several days in a row and you still don’t see a tooth, then there’s probably something else going on. Reach out to your child’s doctor
Ramos-Jorge, J. Pediatrics, September 2011.
Children’s Hospital Los Angeles: “Your Infant is Teething: Know the Signs and Symptoms.”
Mouthhealthy.org: “Eruption Charts.”
Massigan, C. Pediatrics, March 2016.
Macknin, ML. Pediatrics, April 2000.
Mayo Clinic: “Teething: Tips For Soothing Sore Gums.”