by Jessica Martin-Weber
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Ever noticed that when your baby is teething their crankiness and discomfort seems to get worse at night? Or even how sometimes they seem TOTALLY fine during the day and then suddenly at night they can’t seem to settle and are fussy and cranky and you’re not even sure why only later to notice they have puffy red gums or even a brand new tooth?
It’s not your imagination, this really does happen and there’s a reasonable explanation too. Which means there’s also something you can do about it.
What’s the deal? Why are teething symptoms worse at night?
Teething babies are often at the age of exploration of the world around them. They are ready to move! Even if they aren’t very mobile, they’re rapidly taking in information, interacting socially, and physically developing new skills daily. A little bit of teething isn’t going to slow them down, they’ve got people to see, places to go, adventures to take, play to make! Even if they do have moments during the day, there’s a lot going on around them to distract them at least a little bit from what’s going on in their mouth and head.
Once regular night time and day time sleep patterns are worked out in the brain, right around 4 months, babies have the same general physiological cycles related to sleep in their bodies as adults do. During the day the build something that’s called sleep pressure in the brain which makes them ready to sleep at night (give or take… and that doesn’t mean they won’t fight sleep, just that their brain is ready for it biologically), their bodies naturally release melatonin as daylight fades and artificial light lowers, and their cortisol levels naturally drop to make it easier for them to sleep at night. Just like adults, as they get tired and ready for sleep, they can become more emotional and little challenges will suddenly seem bigger.
What does this have to do with worsening teething symptoms? Lower cortisol levels means that stressors like pain aren’t being managed as much by the brain and become more noticeable. Not only are there less distractions to take their attention off the discomfort, there is even less of the chemical cocktail the body produces that helps with coping with such discomfort.
Meaning more ouch.
That’s not all, either.
The body does most of the growing it needs to do during sleep. Sometimes our children literally do wake up bigger in the morning, their bodies having been busy during the night before. While asleep, the body can efficiently direct energy to growth and healing. Exactly why doctors have been telling us to sleep when sick, rest is essential for growth and repair. This includes teeth! It is very possible your baby’s teething symptoms get worse at night because their teeth really are moving more at night. A process that involves shifting bone and slowly cutting through gum tissue causing headaches, mouth pain, and general discomfort. No wonder there are tears!
With nothing to distract them, lower levels of chemicals that reduce pain, and more movement of the teeth at night all combine to create a perfect storm of middle of the night fussiness or downright screaming.
What can help?
While you can’t change the natural sleep patterns in the body, you can help make your baby more comfortable through teething. Nothing is a guarantee but every little bit of hope help and any of these steps may at least help reduce discomfort so there’s a bit more rest for everyone.
Respond quickly. Don’t wait for your baby’s fussing to escalate to full-fledged wailing in distress. Being responsive to their early communication that they need help will help them emotionally regulate and manage the stress of their discomfort as calmly as they possibly can.
Rule out other concerns. Just to be sure that your baby’s distress is about teething pain, check out your baby to rule out any other concerns. This will allow you to relax as much as possible that their discomfort is unfortunate but not alarming. With your anxiety lower, your baby will pick up on your calm and feel safe and secure that you are there with them even though they’re uncomfortable.
Nurse more! Breastfeeding releases chemicals in the baby’s brain that actually lower pain levels. Nurse is already co-regulating for emotional distress, the oxytocin released in calming and connecting but studies show that a baby being latched and sucking, receiving their milk from their parent, can reduce pain and even keep it from starting. Nursing more could be the ticked to getting through those nighttime teething pains.
Skin-to-skin. Easily accomplished with nursing but possible to do otherwise too, skin-to-skin as pain relief and soothing measures for pain is an incredibly effective non-pharmacological means to help your baby feel better.
Protect naps. Sleep begets sleep and lack of sleep can show up as hyperactivity at night. Protecting sleep during the day means that nap times are even more important. You may decide that more or longer nap times are worth the possible nighttime sleep shortening if teething is going on for a while and your little one just can’t seem to get enough sleep at night.
Earlier bedtime. If sleep has already been disrupted, having an earlier bedtime may help get more quality sleep in before the pain and discomfort kicks into high gear during the night. It isn’t uncommon for babies and toddlers to have difficulty sleeping after 11pm or midnight meaning you’ll easily see 1am, 2am, and 3am when they are teething if they’re really uncomfortable. Getting to bed earlier (you too!) may mean there’s more sleep happening that is better quality before the disruptions get started.
Rocking, swinging, swaying. There’s a reason most of us automatically start swaying or rocking when we hear a baby crying even if we’re not holding the baby ourselves: rocking soothes the brain! Studies show that rocking or swinging lowers stress levels, reduces pain and discomfort, and soothes emotional dysregulation. As simple as it may seem, rocking your baby at night really does help them feel better and you too!
Pain relief mediation. Liquid infant Ibuprofen or Acetaminophen may reduce your baby’s pain enough for them to get the sleep they need… and maybe you too! Be sure to use according to directions and try not to use more than 3 nights in a row and check with your child’s healthcare provider before administering.
Teething gel. There are safe, soothing teething gel options you can put directly on your baby’s gums to help reduce inflammation and pain. Be sure it doesn’t have benzocaine or other numbing agents in them as that can create a risk of choking and impair their swallowing.
Teething tablets. With a safe blend of herbs, teething tablets dissolve easily for baby and
Have realistic expectations. Cutting teeth IS painful. It’s a lot of work and it is understandable that your baby complains about it. They want help making the pain goaway for good reason. Having realistic expectations about teething will help you stay calm even when you’re exhausted and feeling helpless and your baby will be able to draw from your calm for their own calm.
Remember this is temporary. Teething does stop at some point. Your baby isn’t going to be cutting new teeth forever. There may be long stretches of teething (my baby once cute 12 teeth one right after the other, teething for a few months straight) which makes it really difficult to remember that this is temporary but keeping that in mind can help get through those long nights.
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