Signs of teething in breastfed babies

Your baby's first teeth will usually make their grand, grumpy entrance at around 6 months old, although signs of teething start sooner. Here are common teething symptoms along with remedies to ease baby's discomfort.

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In This Article

• When do babies start teething?
• What are common teething signs and symptoms?
• What order do baby teeth come in?
• How do you soothe a teething baby?
• What teething remedies should you avoid?
• How do you soothe a teething baby at night?
• When to call the doctor about teething
• What milestones will the baby hit next?

Maybe your baby’s drooling a little (or a lot), or maybe he’s a bit more irritable than usual. While your little one likely doesn’t understand why he has an itchy chin or an achy mouth, you may be able to assume that baby teeth are on their way. 

It’s hard to predict when exactly your baby's first tooth will show up. And there may (or may not) be a number of teething signs that clue you in. In other words, you might be taken by surprise ("Ouch! Was that just a bite?"), or you might finally know for sure what those strange symptoms were about. 

Read on to learn more about teething symptoms, when your baby's first teeth will appear and how to safely soothe your teething baby. 

When do babies start teething?

There's a wide range of normal in terms of when teething in babies starts. That’s because the moment those first tiny pearly whites make their appearance can vary quite a bit from baby to baby.

Most babies get their first tooth around 6 months old, with teething symptoms preceding its appearance by as much as two or three months.

However, some infants' first teeth erupt as early as 3 or 4 months old, while others don't get their first tooth until around or after their first birthday. 

What are common teething signs and symptoms?

Every baby experiences teething differently. Some have virtually no symptoms, while others suffer through months of teething pain and fussiness.

Knowing what teething symptoms to look out for can help get you and baby through this milestone. Here are some of the first signs of teething:

1. Drooling

It's hard to believe so much fluid can come from such a tiny mouth, but teething can stimulate a lot of drooling. The waterworks start for most babies between about 10 weeks and 4 months of age, and drooling may continue for as long as your baby’s teeth continue to come in.

If you find that your baby's shirts are constantly soggy, fasten on a bib to keep him more comfortable and clean. To stave off chapping, gently wipe his chin throughout the day.

2. Teething rash

If your teething baby is drooling, the constant drip may cause chafing, chapping, redness and rashes around his mouth, chin and even his neck and chest. Patting it away will help prevent irritation. 

You can also create a moisture barrier to the area with Vaseline or Aquaphor and moisturize with a gentle, unscented skin cream as needed. Nursing cream (like Lansinoh) is great for protecting tender baby skin too.

3. Coughing and/or gag reflex

A constant mouthful of spit can make babies gag and cough. It's not cause for concern, as long as your baby has no other signs of a cold, flu or allergies.

4. Biting

Pressure from teeth poking through under the gums causes babies a lot of discomfort, which can be relieved by counter-pressure (aka chewing and biting).

Teething babies will gum whatever’s in gnawing distance, including rattles, their hands, your nipples if you're breastfeeding (though if that happens you should take him off the breast and offer a cold washcloth or other form of comfort), your fingers, crib gates and stroller guards.

5. Crying or whining

Some babies breeze through teething without complaint. Others suffer from a good deal of pain due to the inflammation of tender gum tissue — which they feel compelled to share with you in the form of whining or crying. 

First teeth usually hurt the most (as do molars, because they're bigger). Fortunately, most babies eventually get used to what teething feels like and aren't quite so bothered later on. 

6. Irritability

Your baby's mouth will ache as that little tooth presses on the gums and pokes up to the surface. Not surprisingly, it'll probably make him feel out of sorts.

Some babies may be irritable for just a few hours, but others can stay fussy for days or weeks.

7. Refusing to eat

Cranky babies yearn to be soothed by putting something in their mouths, whether it’s a bottle or the breast. But the suction of nursing may make a teething infant's sore gums feel worse. 

That’s why teething babies can be fussy about feedings, and get more frustrated when neither their discomfort nor their tummies find relief. Those eating solid foods may also refuse to eat while they're teething. 

8. Night waking

As your baby's little chompers start to emerge, his discomfort may disrupt his nighttime rest, even if he previously slept through the night. 

9. Ear pulling and cheek rubbing

Babies whose teeth are coming in may tug furiously at their ears or rub their cheeks or chins. An ache in the gums (especially from erupting molars) can be felt elsewhere, since gums, ears and cheeks share nerve pathways.

Keep in mind that ear pulling is also a sign baby's tired and a symptom of an ear infection, so try to determine what's behind it.

10. Gum hematoma

Notice a bluish lump under your baby’s gums? It may be a gum hematoma, or blood that’s trapped under the gums due to a tooth's eruption, and it’s no cause for concern.

A cold compress or washcloth on the gums can relieve the pain and may help the hematoma heal faster. If the hematoma keeps growing, see your pediatric dentist.

Signs of teething can vary widely from baby to baby, although you can probably expect to see at least some (and maybe many) symptoms. Hang in there!

What order do baby teeth come in?

While it’s hard to know exactly when they’ll arrive, the order baby teeth come in is more predictable. Most commonly, baby teeth arrive in the center first and move outward in the following pattern:

• Central incisors (two in the center of the mouth; usually the bottom pair first followed by the top pair)
• Lateral incisors (the next spot over from the middle) 
• First molars (those closest to the opening of your baby's mouth)
• Canines (on either side of the lateral incisors) 
• Second molars (in the very back)

How do you soothe a teething baby?

You can help alleviate your baby's teething discomfort with these parent-tested teething remedies:

1. Teething toys 

Teething babies love to chew, and for good reason: The gumming action provides counter-pressure, which relieves the aching as teeth push up and into the mouth. 

Teething relief products, including bumpy rubber teething toys, your clean finger or a soft, wet toothbrush (without toothpaste) rubbed firmly on baby's gums, can provide soothing counter-pressure.

Your baby may balk at first because it hurts initially, but it’s often the best natural remedy for teething pain and soon brings relief.

2. Cold temperatures

Applying cold to your baby’s inflamed and sore gums can help relieve the pain of teething. Try: 

• Refrigerated toys. Chewing is even more effective when the object is cold and numbs the gums. Keep a supply of teething toys or wet washcloths in the fridge. Do not keep teething rings and cloths for baby to chew on in the freezer. 
• Cold drinks. A bottle of cold water can provide chilly relief to achy gums for babies over 6 months old, when water can be introduced. If your baby doesn't accept the bottle, you can try offering him chilled, ice-free water in a cup.
• Cold food. Refrigerated treats such as yogurt, blended peaches and applesauce (once these foods are introduced) can be more appetizing than room-temperature snacks. Or give pureed frozen fruits like raspberries and plums in a baby feeder mesh bag, so large chunks of food can't pose a choking risk, but only under adult supervision and with your baby seated upright. Avoid having the child suck on cold food throughout the day for relief, however, because it can weaken the enamel on the erupting teeth, which can lead to cavities later.

3. Pain relievers 

If chewing, rubbing and sucking chilled foods aren't doing the trick, and especially if teething is keeping your baby up at night, talk to your pediatrician. You’ll likely get the okay to break out the baby acetaminophen (if baby is over 2 months) or ibuprofen (for babies over 6 months). Be sure to follow the dosing instructions exactly.

Keep in mind that comfort in the form of extra snuggles, kisses and lots of patience are what a teething baby craves.

What teething remedies should you avoid?

While you may be ready to accept any relief for your baby’s teething pain, there are a few teething remedies that simply aren’t safe and you should avoid:

• Numbing agents. Never use rubbing alcohol, benzocaine or lidocaine on your baby's gums. The Food and Drug Administration (FDA) warns against using topical numbing agents, which can put children under age 2 at risk for reduced oxygen levels in the blood. 
• Over-the-counter teething gels. The FDA says parents should avoid any OTC teething remedies, including herbal or homeopathic teething gels, since they haven’t been proven to work. Some may contain an ingredient called belladonna that can cause difficulty breathing and seizures.
• Amber teething necklaces. There's no medical evidence to suggest that amber teething necklaces work. Most pediatricians advise against them, in large part because they can pose a choking or strangulation hazard.

How do you soothe a teething baby at night?

Teething is a common cause of sleep regression in babies. If your formerly perfect sleeper seems to be waking during the night due to teething pain, give him a few minutes before offering comfort to see if he can settle himself back to sleep.

If he's still restless, soothe him with a few gentle pats and an “it’s okay” before quietly making your exit. If that doesn't work, try one of the teething remedies listed above. 

Since babies are often quick to start or restart a night-waking habit, a few nights of waking due to teething pain can encourage them to continue waking even after the discomfort ends.

To break that cycle before it starts, try to make comfort brief and not too habit-forming. That means avoiding a return to overnight feedings (which will come back to haunt you when this phase has passed).

If the pain seems to really bother your little one, talk to your child’s pediatrician about offering a dose of baby acetaminophen or ibuprofen before he goes to bed. Also check to see if there are any other signs of illness (ear infections, for example, tend to get worse at night).

When to call the doctor about teething

Doctors are usually hesitant to link fever and diarrhea in babies to teething. But many parents swear their little ones’ loose stools and low-grade fevers (under 101 degrees Fahrenheit) are triggered by an arriving tooth. 

In theory, it might be possible. The excess saliva your baby swallows may irritate the stomach, causing loose stools. And inflammation anywhere in the body can slightly raise body temperature.

But these symptoms are more likely to be caused by a virus or an infection, since teeth tend to arrive around the time a baby’s acquired immunity from Mom begins to wane. 

It’s time to let your doctor know about your baby’s fever if your baby has a low-grade temperature for more than three days or if the fever is higher or accompanied by other troublesome symptoms.

Also report any liquidy, runny stool if it lasts for more than two bowel movements, or if your baby refuses to feed for more than a few days.

Keep in mind that like teething babies, babies with ear infections will yank on their ears. Check with your pediatrician if you suspect your little one may be bothered by more than just teething, and if he has a fever, seems especially irritated when he’s lying down or chewing, or has pus or crustiness around his ears. 

What milestones will the baby hit next?

Teething usually begins close to the start of some other pretty big baby milestones. Around the time your child's first tooth erupts, you'll likely be ready to start him on solids.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

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