Positive Relationships: A parent's guide to ... Teething

Placid babies suddenly become demanding, while previously smiley babies become grumpy. So, what is teething, and what can you do to help your child?

The process of developing teeth begins back in the womb. Tooth buds that will go on to create those first teeth are formed in pregnancy. At birth, your baby's jaw is primed with their milk teeth. The bad news, though, is that for some babies the appearance of their first teeth is a painful journey which we often dub as 'teething'.

Most parents will find that the signs of teething occur somewhere after their child's fourth month. The actual appearance of the first teeth is likely to take place somewhere between five to seven months, when two little white pearls appear in the lower jaw. These are the child's lower central incisors. The upper set usually come through a few months later. However, some children are actually born with one or two teeth in their mouth, while others take their time.

The way that children teethe also varies. Some parents get off lightly and literally spot teeth as soon as they have appeared. Most parents notice changes of some kind in their children. It is common for parents to notice that their baby is dribbling more, and also gnawing on their hands or anything they can get into their mouth. Many also find that their baby will cry more and sleep less. This can be hard going for some parents, especially if their children are not great sleepers at the best of times.

Parents may also report their baby having a raised temperature, nappy rash or diarrhoea. While these symptoms have been seen as part and parcel of teething, medical practitioners suggest that they need to be seen as and treated as separate conditions, to avoid a serious condition being overlooked. The advice for parents is to always get your child checked out if they seem to be poorly.

So, why do so many parents report that their babies are often ill when they teethe? One suggestion is that babies' immune systems might be compromised by a lack of sleep and poor intake of food. This would make a baby more vulnerable to colds and other opportunistic infections and illustrates the correlation between teething and high temperatures.

For those of you going through the teething stage, there is plenty of practical advice around. In my experience, just knowing that there are things you could try can be very comforting. First of all, consider whether you should give your child some pain relief. Even if you think that this is too drastic a step, I would suggest getting some in stock - who knows what you might need in the middle of the night!

Visit your local pharmacist and talk to them about which type of suspension you should use. You should also make sure that you understand the dosage and how often you can give it. Exceeding the dosage can be very dangerous, and this is why giving adult medicines is never an option. The pharmacist may also suggest teething gels. Some of these will temporarily relieve the pain in the gums, but again, there is a limit on how often these can be used.

Many parents keep pain relievers in 'store' for the evening so that they and their baby can at least catch a few hours' sleep. While the medicinal route can be very effective, you may also want to try out the many 'teething aids' that are on offer. Some of these work by allowing the baby to chew or bite on something hard. Then there are those that work by cooling the baby's gums. This reduces swelling and gives pain relief.

Combining both approaches is worth considering. This means looking out for teething rings that can be cooled or frozen, or giving your child a cold face cloth to chew on. If you decide to freeze items, make sure that they are not so cold as to give your child a cold burn.

There are numerous suggestions on parents' forums on the internet about things that you can freeze and give to your child. Most of these are safe to use, but always think about whether that piece of chilled carrot or pouch of peas might pose a choking hazard. It is, therefore, best to stay with your child if you give them anything to suck on, in case it starts to choke them.

TEETHING TIPS

• - Seek medical advice if your child becomes very distressed, has a high temperature or is pulling at their ears.
• - Talk to your pharmacist about pain relief options.
• - Look out for teething rings and other physical aids.
• - Try distraction with toys, outings or simply rocking to music.

CASE STUDY

'When my daughter was six months old, she seemed as if she were teething. She had a hot little spot on her cheek and she was constantly biting on her fist. She was also dribbling like crazy, and so I thought that it was just a matter of days before she would get her first tooth. A few days later, she was back to her normal self, but there were no teeth. This happened several times over the next few months, but despite having all the signs of teething, no teeth appeared.

'It didn't help that my daughter was the only baby in my NCT group who had not got any teeth. I took her to the doctor at 12 months. By this time I was getting quite worried. He suggested that I take her to the dentist. The dentist was quite reassuring and said that I should pop back when she was 18 months and if necessary, he would take an X-ray. A couple of months later, I was playing with her when she put her head back and laughed. I caught sight of two little teeth proudly sitting in her top jaw! I was so excited that I phoned my husband at work. The bottom teeth arrived a couple of weeks later, and by the time she was two, she was just like all the other children.'