Teething and Sleep

Are you unsure if teething is the reason for your baby’s night wake ups or short naps? Then make sure to read this blog! 

Every baby will have their own pain tolerance when it comes to teething. As a Sleep Consultant and Mom of 3, I have seen it all! 

Teething will feel like the easy answer for why your baby is having night wakings, but it isn’t always to blame and it is important to determine the true cause. 

Teething starts between 4-8 months old and they may experience pain 1-2 days prior to the tooth erupting. Their gums may appear red and swollen and you may see the white of the tooth below. When your baby lays down to sleep, the horizontal position can place more pressure on the gums which can result in more pain, causing them to wake up. They may also experience pain or discomfort for 2-3 days as the tooth is breaking through the skin. 

Signs your baby is teething: 

-Increase in chewing/biting on toys and hands. They may look frustrated and in pain while doing so. 

-Increase in fussiness or irritability. They may want to be held more

-Increase in drooling 

-Swollen, red gums 

-Refusal to eat

-Struggling with more wake-ups at night, or shorter naps. 

Typically you can see the outline of the tooth, then the gums will get swollen. If you look at the top ridge of the gum line you will see the white of the tooth right before it breaks through the skin. 

Your baby may be drooling or chewing on hands and toys for months before they actually get a tooth. These alone are not a sign of teething, just your baby learning the skill of bringing things to their mouth (which helps them to learn to eat) and helps wear down the gum line, to help prepare for the tooth. 

Typically babies or toddlers who are teething don’t struggle as much to fall asleep when teething, but can struggle more to connect sleep cycles. This can lead to shorter naps and more nighttime wakings or early morning wake ups. 

Fever of 100.4F/ 38 C or higher and diarrhea are not signs of teething. If your baby is experiencing one or both of these symptoms, there is most likely another cause for this. 

Teething Versus A Regression: 

Increase in night wakings and short naps can also be a sign of a regression. The way to know the difference between the two is usually from the signs/symptoms they are experiencing during the day, how they are falling asleep and how easily they fall back to sleep. 

Teething: 

-usually able to fall asleep 

-not falling back to sleep as easily during the night. Still upset even after offering a feeding 

-usually a sudden, quick onset and doesn’t typically last more than 5 days in a row. 

Sleep Regression: 

-increase in separation anxiety. You may notice them crying more when you leave the room during the day and even crying when you leave the room during a nap or bedtime. 

-Learning a new skill (rolling, sitting, crawling, standing, making new sounds, talking)

-Needing more assistance to fall asleep or back to sleep during the night

-can last up to 2-3 weeks. May not happen consistently everyday 

When does teething start? 

The AAP (american association of pediatrics) says that most babies cut their first tooth between 4-7 months of age and the American dental association says it ranges from 6-10 months old. But don’t be alarmed if your baby is older than this and still doesn't have their first tooth. Some babies don’t start to get their teeth until 12-14 months. Talk to your dentist or doctor if you have any concerns. 

Most commonly the first teeth your baby will get are the bottom two incisors, then the top two incisors. See graphic below for how the teeth typically come in. 

Teething usually lasts until they are 2-3 years old, after they get their second set of molars. Most commonly, toddlers tend to have less pain associated with their molars coming in. This could be due to the larger surface area of the tooth, or the fact that they have experienced pain before. As your toddler starts to talk more, they are able to communicate with you about their pain, or if their mouth hurts. 

How to help with teething pain?

-Wet a clean washcloth with water or breastmilk/formula and stick it into a bag to keep it clean. Place it into the freezer until it becomes stiff and offer as a teething aid 

-Offer teething toys, you can even put these into the freezer to help soothe the gums. 

-Use your finger to rub and massage the swollen gums.

-If your child is old enough, you can put frozen berries in a mesh bag and let them chew on it, or even frozen yogurt. Offer cool foods from the fridge that are easy to eat such as applesauce, fruit pouches or yogurt. 

-You can make breastmilk or formula popsicles and give them to your child in the tub so it is less messy. 

-Distract your child with something they like to do such as going outside, going in the bathtub or playing one on one with them. 

-Talk to your doctor about pain management like tylenol (acetaminophen), Motrin (Ibuprofen) or natural medications like Hyland’s baby oral pain relief or Camilia. 

Things to avoid? 

The AAP (American Association of Pediatric) cautions against using these products and medications: 

-Medications and pain relievers that are applied directed to your child’s gums (like gels) 

-Medications that contain Belladonna and Benzocaine in them 

-Teething necklaces that could cause strangulation or a choking hazard. 

-Avoid teething toys that have liquid in the middle. When put in the freezer and become frozen, this can make the plastic too hard, and can cause bruising to your child’s gums. Another risk with these types of teether toys is that they could break or be punctured, causing this unknown liquid to go into your child’s mouth and to be potentially swallowed. 

How to help your child sleep? 

Aside from the suggestions above, another thing to try is to offer an earlier nap or bedtime. Oftentimes babies or toddlers become more irritable and fussier during this time. This can make it harder for them to fall asleep, connect sleep cycles and even want a bit more assistance to sleep. To help your child during this time, I would put them down 5-15 minutes early for their nap or bedtime based on their age, cues and what is working for them. This will cause them to be less tired, allowing them to fall asleep more easily on their own. If your child has a short nap, you can give them 5-10 minutes to try and fall back to sleep, then rock them back to sleep and hold them for the remainder of their nap. You can try to transfer them to their crib, but this may result in them waking up. Offering this assistance will help your child to get the sleep they need in the day and not be overtired at bedtime. If they don’t fall back to sleep, then offer an earlier bedtime by 15-30 minutes. A tired baby or toddler will have increased cortisol levels, making it harder to fall asleep, stay asleep and need more support to fall back to sleep if they wake. 

When your baby or toddler is falling asleep independently, it will be easier for them to fall back to sleep when they wake up between sleep cycles. If your child needs assistance to fall asleep, you are going to notice they will struggle more when they are teething, needing more assistance to fall asleep, fall back to sleep during the night and having short naps. Helping your child to learn this skill will allow everyone to have a better night's sleep.

If you are unsure if your child is waking up because they are teething or not, check out my blog on Reasons For Night Wake Ups.

If you are struggling with your child’s sleep and not sure where to start then book a free discovery call and we can help create a sleep plan that will work best for your child and family’s specific needs.