The first three months of baby's life can be challenging to new parents, but thankfully, by the fourth month, most families have settled into a routine and life has calmed down. No wonder parents sometimes feel sucker-punched when baby starts teething sometime between four and six months of age. Teething can be very unpleasant for babies and their parents, but there are strategies to help minimize the trauma.

When do babies get their first teeth?

Teeth are actually developing before the baby is born; the first tooth typically appears sometime between four and seven months. Teeth usually erupt in the following order: First, the two bottom center teeth, followed by the two upper center teeth, then the lower side teeth appear followed by the upper side teeth, and finally the first and second molars erupt between 24-36 months resulting in a full set of 20 baby teeth by the third birthday. The sad reality is that parents need to prepare for episodes of teething discomfort for about 2-3 years. 

What are the signs and symptoms of teething?

Not all babies exhibit symptoms when they teeth, but most parents report at least one or more of the following:
  • Drooling (which can cause skin rash)
  • Fussiness and irritability. 
  • Sensitive gums, which may cause baby to refuse to nurse or eat.
  • Mouthing and biting.
  • Sleep difficulty.

Some parents report mild fever, runny nose and even diarrhea just before a tooth erupts, but some pediatricians deny that teething can cause these symptoms and caution parents to consult their doctor if baby is feverish or has diarrhea. One note of caution: New parents often confuse symptoms of ear infection with those of teething. If baby is running a fever and tugging at his ear, a visit to the doctor is in order. 

What are some ways to minimize discomfort?

Some natural remedies that can offer relief include:
Freeze a damp washcloth for baby to gnaw on. 
  • Offer teething rings filled with liquid that can be refrigerated.
  • Hard biscuits like zwieback (often called teething biscuits) can help relieve baby's need to bite and chew, but be sure to watch him carefully for choking if he isn't used to eating solids. 
  • Firmly rubbing baby's gums with a clean finger can temporarily stop pain.

There are also topical pain-relieving gels that can be applied directly to swollen gums. Be sure to check with your pediatrician before using them the first time and follow the dosage instructions carefully to avoid overuse. 

Another option is acetaminophen liquid or drops if baby is especially uncomfortable. This can be especially helpful just before nap and bedtime since the effects of acetaminophen usually last at least four hours. Never give infants and young children aspirin, though, as aspirin use has been linked to Reye's syndrome, a rare but potentially fatal condition. 

Finally, if baby is drooling a lot, apply a thin film of petroleum jelly to his chin several times a day to prevent rash and skin irritation. Use a soft cloth to blot saliva and avoid rubbing inflamed skin.

Baby's first tooth is a source of pride for new parents. With a little knowledge and preparation, it can be a relatively pain-free experience, too.