Teething is an event that every baby and toddler go through. Ezra just got his first tooth this week! Children will get 20 teeth by the age of 3. Most parents dread and talk about teething as if it turns their child into a little, cranky monster. Teething is also named as a common culprit for sleep issues. While sleep can be affected for a short time due to teething, months and months of sleep trouble is not a result of teething. Let me explain...
Chewing
One of the most well-known signs of teething is chewing. When a tooth is working through the gums, it can be a little sore. Chewing on an object, or their hand, helps to relieve some of that soreness.
However...and this is a BIG HOWEVER...chewing on things is also simply a way that a baby explores and plays with an object. Babies usually begin to do this around 3 months of age. While some babies can get teeth as early as 4 months, most won't get their first one until 6-8 months, and some even later. What this means is that if your baby is chewing on things, but there's no tooth in sight, then he's not teething. Sorry...he's just being a baby. It's what babies do. I hear it all the time from parents:
"He's been teething for a few months now, so we assume that's why he isn't sleeping well."
I say, "Oh wow, how many teeth does he have?"
"Well...none yet, but he's been chewing on EVERYTHING, and he's always cranky, so I know there's got to be a tooth right around the corner."
Then I nicely tell them that this just isn't the case. Their baby is just being a baby! He's using his hands and mouth to explore and interact with the world around him. It's called mouthing. For a young baby, mouthing objects is the only way he knows how to play with and learn about them. Chewing is only a sign of teething if they're really trying to gnaw on something more than usual or when baby is agitated along with chewing.
Besides excessive or agitated chewing, the other signs of teething are:
swollen gums
drooling
rubbing cheek and/or ears
excessive fussiness
sudden changes in eating or sleeping patterns
Some sources also name a slight fever as a sign of teething; other sources say no. My babies never had a fever with teething, so it's certainly not accurate in all cases, at least. If your baby is chewing on things with none of the other above signs, then it's not likely to be teething.
Let's talk about the extreme fussiness for a moment. Another major culprit of a cranky baby is overtiredness. If your baby hasn't been sleeping well, that alone could be the cause of your baby's cranky demeanor. I'm a little crankier when I don't get sleep, aren't you? So, crankiness alone is not a sign of teething, especially if your baby doesn't sleep well. When a generally happy, well-rested baby is all-of-a-sudden fussy, then you know something is going on. But if your baby is always cranky, then that's not a true indication of teething.
Discomfort
Experts say that the pain from teething only lasts for a couple of days before and a couple of days after a tooth has come through the gums. So, we're talking a week max. If your child has been having sleep issues for longer than a week, it is not due to teething, unless he's had multiple teeth come in one right after the other.
You may have heard the phrase, "cutting a tooth" in reference to a baby teething. But did you know that a tooth doesn't actually cut through the gums? Think about it...do you ever find blood when your child gets a new tooth? I have 2 children with a full set now, and Ezra just starting to get them, and I have never seen blood when a new tooth comes through. This is because the gums actually spread open and make a way for the tooth to come through. Nothing is cutting or ripping open.
So, teething can definitely cause some discomfort, but it's likely not as painful as you may assume. Some babies can be soothed by medicines, while others may not even need that. For some babies, chewing on things and/or being distracted and comforted can ease the discomfort enough.
Sleep
With all that in mind, how- and WHY- does teething affect a baby's sleep? Like I said above, sleep troubles that persist longer than 5-7 days are not due to teething. Yet, when a child is actually teething, the discomfort can cause temporary sleep issues. Experts deduce that this is because things are calm and quiet when it's sleep-time, therefore, they're more intuned to any discomfort.
Have you ever had something bothering you? You've probably noticed that when you're active and busy, it's not at the forefront of your mind. However, when you lay your head down to go to sleep at night, your thoughts about it likely start to rage. This is because it's quiet and you've got nothing to do but sleep or focus on the problem. Similarly, babies may be able to be distracted during the day so that teething doesn't bother them as much. However at night, they may need more comfort or even some rememdies because there's nothing to distract them from the discomfort.
Babies may fight sleep a little more or wake more often at night when they are teething. The best thing to do is to offer the comfort needed, and any remedies you want to, but try to still stick to your same routines. If you have a sleep-trained baby who regresses with teething, you can simply do a training refresher once the tooth is through. Sleep-trained babies are usually able to handle disruptions, like teething, a little easier. For a baby who already has sleep issues and dependencies, teething will likely just exacerbate those. This is probably why it seems to have such a major affect on their sleep.
Ezra's First Tooth
Ezra's first tooth came through a couple of days ago. His gums are swollen and white where the second tooth is about to come through, so it looks like they'll be back-to-back. He has been a bit more fussy and clingy during the day for a couple of days. His naps have been completely normal, though- not one fuss and he's still taking a 2-hour nap in the morning and a 1-1.5- hour nap in the afternoon.
Tuesday night, however, he fought bedtime pretty hard, which he rarely does. I ended up giving him some Motrin and rocked him and sang a little. He eventually calmed down and went to sleep. He then woke up once crying (he's been sleeping 11 hours straight). I simply went in and patted his bum for a moment and then he went right back to sleep. Last night, bedtime was back to normal- he went to sleep on his own without a fuss. He did wake up once at night, but I didn't even need to go in. He cried out, then was quiet and went right back to sleep. So, that's the extent of his sleep troubles caused by teething, so far! Really nothing horrible. He just needed a bit more comfort than usual for a night, which I was more than happy to give him!
Every baby is different, of course. Some may be a bit more sensitive and need a little more comfort. Ezra is just an example. My main point is: long-term sleep issues are not likely a result of teething.
Teething can certainly cause some mild discomfort and temporary sleep issues. However, it shouldn't last more than a week, at most, and should not completely derail your child from sleeping at all. If you've been blaming your child's sleep issues on teething and realize it's not the case, contact me for help. We can figure out what IS causing your child's sleep issues and solve them together!
~Ashley Bell, pediatric sleep consultant
