The Truth About Teething & How It Affects Sleep

This may well become my least popular blog post because goes against many parents’ deeply ingrained beliefs about teething, its symptoms, and how it affects sleep. But I promise you, there is good news at the end!

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I can’t tell you how often I talk to parents who are utterly convinced that their child has been “teething for months” and have delayed addressing any sleep issues because of it. They’re afraid that their child is really in pain and that it would be unfair to try to sleep train during it. Many studies like this one support that the majority of parents and even health care professionals believe that teething disrupts sleep and causes a whole host of symptoms, from mild to serious to bizarre. These beliefs about teething are so widespread and ingrained in our parenting beliefs that they are very hard to change.

It usually goes something like this. “My 9-month-old has been teething for the last 5 months. She drools all the time, is irritable and cranky, sometimes spikes a fever or spits up, and is up multiple times a night. She now has 4 teeth. I don’t want to work on her sleep when she’s obviously suffering and needs me. “

The problem with a lot of these assumptions is that not only do babies get 20 teeth in their first ~2 years, they also get a large number of minor colds and viruses, all of which can cause similar symptoms to what is blamed on teething. Additionally, spitting up milk, drooling, minor rashes, crankiness and irritability and sleep disruption, are all things that happen to most babies throughout their first year for a variety of different reasons. To connect it directly to teething is more confirmation bias that actual evidence proving causation.

Now I know that this might bring many parents up in arms (ok, lets hope it doesn’t get that extreme 😊) but at least a little perturbed that I’m questioning their experience. Let’s just say that 1) I’m not questioning your experience, I’m just questioning your interpretation of the experience, and 2) Let’s look at the evidence to see if there’s a framework that fits better.

If you’ve been following me for a while, you know I highly value evidence-based approaches to all things sleep related. I look at the research on sleep training, attachment, baby/toddler development, sleep science, etc. and allow it to let me question my own subjective experience as a parent. Not all parenting topics have been well-studied at a scientific level or the evidence isn’t conclusive. But there’s a fairly large number of comprehensive studies now done on the subject of babies teething, teething symptoms, and beliefs surrounding teething – and they’ve been quite conclusive!

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The truth about teething is that it really doesn’t disturb baby’s sleep! It also doesn’t cause severe illness-like symptoms, such as vomiting, fevers over 101(f), severe rashes, or diarrhea. But don’t worry – there is confirmation of some mild symptoms being associated with teething – drooling, gum rubbing, extra sucking and biting, irritability, ear-rubbing and even a mild temperature elevation have been associated with teething. But even these mild symptoms are only moderately associated with teething and could still be caused by something else (a cold could cause a low fever, overtiredness could cause irritability, drooling can happen during the whole first year, teeth or no teeth, etc.)

The danger in automatically thinking that all these symptoms are teething symptoms is:

  1. You may not address actual health concerns that could be the real cause- If your baby is vomiting multiple times in a day (not just spitting up) or has a fever over 101, its’ more likely he has a virus or infection that he may need medication for.

  2. You may end up over-medicating with Tylenol/Ibuprofen or using unsafe teething-relief products (please don’t let your child sleep with an amber necklace!) when a better nap schedule is actually what they need.

  3. You may delay addressing sleep problems unnecessarily, leading to lots of sleep deprivation for parent and child alike.

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So, what’s the good news? The good news is, teething isn’t AS big a deal as many parents have been led to believe. Which means there are other solutions to address these challenges that will actually be more effective – yay! If your baby has a fever over 101, take him to the doctor! If he’s been drooling for 6 months straight, get some teething bibs and just accept you have a drooly baby. If she’s waking up 10 times overnight, address the sleep schedule and sleep associations and start sleeping through the night. You and your baby do not need to be a victim of infinite teething misery.

Many parents won’t believe it until they see it, but a child on a great sleep plan will usually sleep through most of, if not all of their teething. I’ve seen it with my own eyes in my 2 kids, and I’ve gotten countless reports from my clients – a well-rested, sleep trained baby will usually erupt a new tooth without a peep at night, and this is exactly what the research suggests. Of course, some babies are just more sensitive than others – if they are really fussy during the day and pulling at their gums, it might make it harder for them to settle initially. In that case, give Tylenol. But before blaming all your sleep woes on teething, assume there are a number of other factors actually at work, especially if the sleep problem has been going on for more than a week.

If you’re ready to start addressing your baby’s sleep problems and come up with a plan that will help you sail through teething, set up your free sleep call today!

Lindsey McGonegal