The real scoop on teething and sleep

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What’s the deal with teething and sleep difficulties? That’s the kind of thing you find yourself wondering about at 2 a.m. when your very cranky little one just can’t seem to settle down. Like with many baby conundrums, from mysterious low-grade fevers and runny noses, to weird poops or general grumpiness, it’s easy to decree teething as the culprit for bursts of bad sleep. But is it really fair to blame their budding chompers for your snoozing woes? We asked Dr. Elizabeth Super, pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program here at OHSU Doernbecher Children’s Hospital, for the straight scoop.

“Teething is a very long process that lasts through the first two or three years of life,” Dr. Super says. It can cause a bit of discomfort and even pain, but how much – and how it impacts sleep – depends on your individual baby: Some children have a lot of physical teething-related symptoms and some don’t; some teeth may cause a lot of symptoms (we’re looking at you, first-year molars) and others may not.

TeethingYeah, we know that’s sort of vague. So, what’s the sleepy parent of a sleepy – and possibly teething – baby to do?

First, decide if it’s her teeth. Teething can’t explain all sleep difficulties, so consider whether she’s been showing other symptoms during the day. Indeed, some children are more irritable or run a low fever. You might be able to see, or feel with a clean finger, a new tooth budding just under the gums. She may also have found teething toys or cool things – like wet washcloths from the fridge – comforting. If she isn’t displaying any teething symptoms (and she isn’t sick) then sticking to your usual sleep routine will help her learn to sleep better in the long run. Read more about the building blocks of a great sleep routine here.

Next, adjust your expectations. If yes to the above, then the imminent arrival of a new tooth just might be keeping him up – some babies might fuss over a dull ache, while others might cry or express pain. You can expect two to three days of sleep disruption as the tooth erupts, after which his sleep habits should return to normal.

Know that it’s fine to treat the pain. If it appears teething is painful enough to interfere with your child’s sleep, try giving her Infant Tylenol or, if she’s over six months old, Infant Ibuprofen (Motrin, Advil) at bedtime. “It helps parents to feel better that the pain has been addressed,” Dr. Super says, and it will hopefully help your child get comfortable enough to settle down. The American Academy of Pediatrics doesn’t recommend medicated teething gels that are rubbed on gums, notes Dr. Super, as they have been proven to be ineffective (baby’s drool is enough to wash them away) and can have side effects like numbing your baby’s throat and making it difficult for her to swallow.

Finally, stick (more or less) to the bedtime routine. Your response to sleep disturbances during teething can actually start to create new sleep patterns and routines – e.g., mama comes when I call and rocks me to sleep – that aren’t ideal for building your baby’s longer-term sleep skills. If teething is keeping you both up at night, trust your instincts and find a balance in your response. If a bit of extra soothing works for the few days it takes a tooth to erupt, go for it. But be mindful that the troublesome tooth should arrive in two to three days and when it does, gently steer your baby back to his usual routine. You’ll all sleep better in the long run.

Other posts in the Dr. Super sleep series:
What is your baby’s ‘sleep temperament?’
Six strategies to improve your baby’s sleep skills
Monsters under the bed: Banishing bedtime fears

Battle bad dreams, night terrors and things that go bump in the dark


Dr. Elizabeth SuperElizabeth Super, M.D.
Assistant Professor of Pediatrics
Doernbecher Pediatric Sleep Medicine Program
OHSU Doernbecher Children’s Hospital