Teething and Sleep Regression: How to Tell the Difference

Is your baby not sleeping well? Teething and sleep regression don’t have the same symptoms. How can you tell the difference? Find out here!

My baby—who had been sleeping through the night with no issues—was suddenly waking up all night long. Each time he woke up, he refused to be put down and go back sleep. Naps were just as unpredictable, too. Granted, he was never a “good” napper, but at least I could reliably get a quick break without a peep for a while.

He was also at the stage where everyone would say, “Oh, he must be teething,” especially when he seemed to show legitimate signs of teething. But when no teeth showed up and yet the sleep issues kept happening, it made me wonder whether it really was teething after all.

I figured teething could cause sleep problems simply from the discomfort that kept babies awake. But babies are also known to go through sleep regressions that prevent them from sleeping well, too.

So, how can you tell the difference between teething and sleep regression?

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How does teething affect sleep?

In researching this topic for my baby, I learned that my hunch was correct: teething does affect sleep in some way.

You can imagine how difficult it can be to fall asleep if you have sore gums. But even excess saliva can cause additional discomfort, too. As the authors of Cradlewise say:

“It’s easy to imagine your baby’s discomfort, with hard teeth pushing through their soft gums. Teething also stimulates saliva to soothe the gums, which causes drooling. And drooling can lead to a sore throat, difficulty swallowing, as well as chapped, irritated skin on your baby’s chin and neck.”

A lack of distractions can also cause your baby to cry more so during sleep than when he’s awake. With no toys to nibble on or you to keep him engaged, he’s more likely to feel pain when he’s simply lying in the crib.

Free resource: Interested in learning about teaching your baby to self soothe? Join my newsletter and get a preview chapter of How to Teach Your Baby to Self Soothe—at no cost to you. This chapter is all about the mindset needed for successful self-soothing and helping him put himself to sleep:

Teething and sleep regression: How to tell the difference

So, how can you tell if your baby is experiencing teething pain or going through a sleep regression? After all, this can affect how you respond as well as the potential solutions you plan to try. Take a look at a few ways to tell the difference, followed by what to do with each:

1. Look for signs of teething

The first step to determine whether your baby is teething is to look for signs. If he isn’t sleeping well and you notice an uptick of these symptoms, he might be teething:

Red, swollen gums. Do some areas of his gums look extra tender and big?
Teeth poking through the gums. Don’t just look for a tooth poking out—feel the gums with your fingers. Some teeth can already be felt beneath the gum that your eyes may not catch.
Excessive drool. Some drool is normal for babies, but if you find an excessive amount, yours might be teething.
Not wanting to eat. If he’s already eating solids, does he not want to eat as much? You can imagine that eating could be uncomfortable if his gums are tender.
Mouthing. Does he want to put everything in his mouth? Is he constantly trying to chew or bite things?
Irritability. All babies have their bad days, but teething can bring them about more frequently. Is he more irritable than usual during the day (and not just when he doesn’t want to sleep)?

Note that a fever, vomiting, or diarrhea are not always symptoms of teething. According to the AAP:

“When your baby’s teeth are coming through, she may also have a very slight increase in temperature. But if her temperature reaches 100.4°F (38°C) or above, it’s not because of teething. If your baby has symptoms such as fever, vomiting, or diarrhea while teething, consult your pediatrician to find out whether she has a medical condition requiring treatment.”2. Look for developmental milestones

If those are the signs of teething, what are the signs of a sleep regression? A sleep regression is commonly tied to developmental milestones that disrupts your baby’s sleep. It’s not so much drooling or swollen gums you’re looking for, but signs of milestones and leaps he’s making.

These milestones can be physical, like crawling, cruising, pulling up, or walking. They can also be mental like a burst of language or a case of separation anxiety.

If you find that sleep regression, and not teething, is the cause, give him plenty of opportunities to “practice” these milestones during the day. Instead of strapping him in the bouncer, allow him to crawl all over the floor. Play “peek a boo” to ease anxieties, or encourage new words by talking and reading to him often.

By having more chances to practice these milestones during the day, he can focus on sleep come nighttime.

3. Observe during the day

The key to learning whether your baby’s sleep issues are due to teething or sleep regression is to observe her behavior during the day, not just when she isn’t sleeping.

Ask yourself questions like whether she’s drooling a lot or has swollen gums that you can see and feel. Is she generally happy and learning to pull herself up in the crib? Or has she been extra irritable and trying to bite everything?

By observing her behavior during the day, you’re able to see which signs point to teething or sleep regression. More importantly, you’re not as sleep deprived and can make clearer decisions and observations than if you were only focusing on her sleep at night.

How to ease teething pain for better sleep

Once you’ve nailed down that teething is causing your baby’s sleep disruptions, what can you do to ease the pain and get better sleep?

1. Provide comfort and a consistent routine

Anyone who has been sick knows we could all use some comfort—a deviation from our usual routine. The same is true with your baby.

He might need extra cuddles to help him get through a rough patch or plenty of patience when he doesn’t want to stop crying just yet. Maybe you’ll give him something to chew on or spend extra time with him when he’s fussy.

On the other hand, it’s just as important to stick to a consistent schedule despite his teething woes. Teething is an ongoing process (he’s going to grow a lot of teeth, after all). He can appreciate the predictability of a consistent routine with a little bit of flexibility thrown in as well.

2. Avoid habits you don’t want to continue

As tempting as it is to resort to old habits, try to avoid those that you don’t want to continue. Maybe it’s co-sleeping or rocking your baby to sleep, or letting her nurse far longer than usual. Returning to these habits might make it harder for her to sleep well on her own again even when she isn’t experiencing teething pain.

That said, sometimes we have to do what we have to do, and I get that. Should you need to revert to old habits, plan to return to your normal routine down the line. Maybe you’ll rock her to sleep this week but re-sleep train once she’s back to normal. Or you’ll hold off on sleep training while teething, at least until after the acute pain has passed.

3. Ease your baby’s discomfort

While you can’t make the pain disappear, you can help your baby better manage it. For instance, offer him safe objects to chew on, like teething rings kept cool in the freezer, a wet washcloth, or a pacifier. Massage his gums with your fingers, or apply a cooling gel to help decrease the discomfort.

Then, prevent potential rashes from developing. Wrap a bib around his neck to easily wipe excess drool, even when he’s not eating. This can also protect parts of his neck and upper chest from collecting moisture.

Lastly, check with your pediatrician about offering an over the counter pain reliever. This can ease minor pain and help him sleep well. Try to give it about 30 minutes to an hour before sleep so that it has enough time to work.

4. Move bedtime earlier

Many babies can benefit from an earlier bedtime if they’re especially fussy with teething. The longer the day stretches, the more exhausted we all tend to be. With an earlier bedtime, you can avoid those witching hours and have him get much-needed rest sooner in the evening.

Conclusion

It’s never easy when your baby isn’t sleeping well. To top it off, you may not be sure whether teething or sleep regression is to blame. By observing her throughout the day and night, you can spot the symptoms that point to teething or the developmental milestones that may lead to a sleep regression.

If teething is the culprit, provide comfort while maintaining a consistent routine. Avoid habits you don’t want to continue (or at least be prepared to go back to your old habits down the line). Ease discomfort through teething toys, cooling gels, or medicine, and consider moving bedtime earlier to make up for loss of sleep.

Hopefully, you have the answers you need—even if everyone around you says, “Oh, he must be teething!”

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2 Comments

Tina says:

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So I have a 10 month old. We co-slept till he was about 8 and he was literally breastfeeding all night long. At 9 months I was just feeling unwell due to anxiety and sleep deprivation so my husband and I worked together to transition him to his crib and reduce the night feeding to twice. Initially it all went well but for the past 2 weeks he wakes up every 2-3 hours and won’t sleep until I breastfeed him. He is so stubborn at that. I think this is because he his cutting his first two teeth and may be uncomfortable.

Another things to add is that his crib is in our room as we don’t have an extra room at the moment and also we rock and sing to him until he is drowsy and put him on his bed. But sometimes he’ll wake up, stand up in his crib and start crying (both at nap times and night time. We have a good bed time routine though. I need a permanent solution as I’ll be going back to work in less than two months.

1. Nina Garcia says:
  
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  It’s definitely exhausting when, 10 months later, you’re still sleep-deprived, even though you’re long past the newborn stage. It’s likely that your little guy has grown used to the way he has been falling asleep, from cosleeping to breastfeeding, which is why he cries when you try something new.
  
  The trick then is to be consistent with what you choose, know that the short-term pains are for long-term gains, and replace those old habits with new ones. I do believe that my ebook can help massively, especially if you’re open to trying something new and stay consistent (meaning, you won’t sleep train one night then cave in the next, and back and forth).
  
  I was also in a one-bedroom when I applied this method to my eldest, so what we did, just to give me and my husband more personal space and time, was we set up a temporary sleeping arrangement in the living room. We literally brought out an air mattress and slept there while we sleep trained, then moved back in the bedroom once our son was sleeping through the night.