What you need to know about teething and pain relief
Q: My son has been teething for a few weeks: at certain times of the day he dribbles a lot, chews on everything in sight and seems to be a bit hesitant when feeding (both breast and bottle). At other times of the day he's fine.
I'd like to know about the role of pain relief in teething - we don't want to give him medications unnecessarily, but we don't want him to be in pain either. It can sometimes be hard to know if he is in pain or if there is another reason why he could be upset.
I'd also like to know about the best pain relief options when teething is prolonged.
Answer from Dr Evelyn Lewin, a GP with a diploma in obstetrics and gynaecology. She is also a mother of three.
A: It certainly sounds like your son is teething. Dribbling and mouthing everything in sight (even more so than usual) are classic signs.
As a mother of a baby who is currently teething, I get what you mean about being unsure about when to give pain relief.
Before we discuss that, let's talk about teething.
Dentist Dr Jon Kozeniauskas says the first baby tooth erupts anywhere from 6-12 months of age. However, he says, "Teething discomfort may begin as early as four months of age."
While he says the actual tooth takes up to 16 days to erupt through the gums, symptoms such as irritability and drooling can be present for longer.
Teething usually finishes by age of around three or four years, when children have a full set of 20 primary teeth.
So yes, teething can feel like it's going forever (especially when you consider that your baby may finish teething one tooth just as another is starting to erupt!).
Don't freak out; there are ways you can help your baby through this.
And the good news is there are lots of things that can help.
Putting pressure against the gums helps relieve pain - this is why your baby is so frantically trying to chew everything in sight. The feeling of cold against the gum is also soothing. For that reason, I give my baby a cold teething ring (one I've popped in the fridge beforehand) to chew on when teething.
Pharmacist Ren Rubinstein says a clean washcloth rinsed in cool water and placed in the freezer for about half an hour "works a treat". She also recommends teething rusks, or even your (clean) finger to gum on.
Dr Kozeniauskas adds that some teething gels can also help.
If your baby is super whingy, she may just want some extra cuddles and comfort.
But let's say you've tried all that and none of it helped. Now what?
As you mentioned, it's hard to know why your baby's upset. So before giving my baby medicine, I like to ask myself a few questions, starting with the basics: could she be tired/overtired, or hungry? Does she have a dirty nappy?
Then I move on to medical concerns: Does she have a fever? A rash? A cough? Any other symptoms? If your baby is sick in any other way it's important not to attribute grizzliness simply to teething. Read this list for possible causes and how to treat each one.
Say you've run through your list and you're pretty sure the culprit is teething. Now you need to ask: Does my baby look like he's in pain?
The thing about teething is that while it upsets some babies, it doesn't seem to bother others much. If your baby has signs of teething but is otherwise happy, there's no need to give pain relief.
But if he does seem to be pain, you might consider giving over-the-counter child-safe pain relief, such as paracetamol. Stick to the recommended dose, and never give a baby aspirin.
And remember that while teething is normal and part of all babies development, it's time see your doctor if your baby is upset for long periods of time.
What are your best tips for getting through teething with your little one?