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Teething or Growth Spurt?

Teething or Growth Spurt?

By Amalah

Dear Amy,

I love all things you and have gained much wisdom and perspective from your advice, baby-related and otherwise.  You are the reason for both my foundation brush and my cloth diaper collection, and your weekly pregnancy calendar kept me sane (and entertained!) while I was expecting.  Thank you.

Advice Smackdown ArchivesI am now turning to you from the deepest, darkest depths of sleep deprivation for thoughts on dealing with the early stages of teething.  My son is almost five months old and is exhibiting many o’ sign:  constant faucet of drool, chomping on hands, fussier and clingier than usual, and…a return to newborn-style sleep patterns at night, waking every couple of hours to express his discontent until I soothe him back to sleep with the boob.  OMzzzzzzz.

Until now, I could generally count on him falling asleep at 8 PM, waking once around 2 AM to nurse, and then sleeping again until 6ish when we get him ready for the morning commute.  Just when I thought we’d finally established a nice and manageable routine (HA), this teething business kicked in, and now my whole world is crumbling.  I realize now that I was seriously unprepared for dealing with such erratic sleep patterns while no longer on maternity leave (I know, welcome to The Rest of Your Life as a Parent, Sucker).  I’ve tried occasional infant Tylenol before bed and cold teething rings, which seem to help marginally, but the only thing that really seems to help at night is good old fashioned nursing.  He hasn’t had a fever and is otherwise active and alert, so I don’t think there’s anything else going on.

I guess I just want to know how you dealt with the teething stage(s), and when it starts to get better.  Am I going to be getting up every two hours to console my little guy until the braces are off, or are there ebbs and flows to the fussiness?  Are there better ways to soothe him (bonus if those ways also helped me sleep actual sleep at night)?  I want him to feel better, and I want to be a functioning human again.  (This morning I spilled an entire bag of pumped breastmilk all over myself and I know I don’t have to tell you just how devastating that was.)  Any advice, perspective, or even just a fist bump of empathy would be greatly appreciated.

Sleepily yours,

Teething is a weird, squishy concept — because yes, technically babies are “teething” for the first two whole years of their lives, when the second set of molars comes in.  But the “symptoms” of teething tend to ebb and flow so much that it’s hard to know whether teething really is to blame. So…sometimes teething gets used as a catch-all bad guy for all sorts of other misery and crankiness.

So while yes, it sounds like your son is showing some teething symptoms (the drool and hand-chomping), I’m going to re-diagnose him and say that you, my dear, are smack dab in the middle of the four-month sleep regression. Which is not actually related to teething, though they do sometimes coincide. It’s a developmental spurt, related to your baby’s rapidly changing cognitive skills. Basically a growth spurt…in his brain. And it really, greatly affects his sleep.

And it usually hits at the EXACT time and in the exact same manner you’re describing here — just shy of five months, after a decent sleep routine has been established. Then BAM. Baby stops sleeping through the night, starts demanding extra feedings and generally inflicting all kinds of misery on mom and dad, who thought they were past this whole “waking multiple times at night” newborn-like behavior.

The good news is that it’s not forever. The spurt will pass, and he will very likely return to his old sleep routine. Almost like magic. The length is different for everybody — sometimes it’s just a couple nights of interruption, while other babies struggle with it for several weeks. (My babies averaged just over a week, I THINK. But don’t quote me. I WAS REALLY VERY VERY TIRED AT THE TIME.) (And then sadly, some babies get past the four-month regression just in time for a physical growth spurt, and then teething REALLY starts…just in time for the next big developmental spurt and subsequent sleep regression at eight months.)

The bad news is that, since it’s not teething, all the Tylenol and chilled teething rings and folk remedies aren’t going to do much. You actually want to skip the Tylenol altogether, because it’s likely really unnecessary at this point.

(And for the record, on teething: My boys tended to react to every OTHER tooth, weirdly enough. Noah just popped his first tooth out of nowhere, but then the SECOND tooth was the one that required the Tylenol and teething tablets (update: the FDA now has a warning on homeopathic teething tablets and gels) and cold washcloths and stuff. Third tooth, no problem. One-year molars, a nightmare of biblical proportions. And so on. Ezra agonized over his first tooth for weeks…but then HIS one-year molars just showed up. Like I looked in his mouth one day and there they were, all four of them. Huh. So even if your son is working on teeth in earnest and it’s contributing to the sleep problems, that doesn’t mean that every tooth will cause the same level of distress.)

But as for the sleep regression? The only way through it is through.

And how to get through it? Well, depends. I’d suggest considering bed-sharing temporarily, so you can nurse lying down and not have to wake up so brutally and completely. Or have your husband give him a bottle, since it’s not like these extra-fun-bonus feedings will hurt your supply if you skip them. Or, if you don’t want to use your daycare stash of pumped milk at night, AT LEAST hand over any non-nursing getting-out-of-bed duties to your husband, like diaper changes and rocking and crib-fetching and such. You’re not on maternity leave anymore, so don’t feel like all the nighttime business needs to fall solely on your shoulders, just because you’re the mom and breastfeeding. Delegate the misery! And then try to get some naps over the weekend at catch up on the sleep you’ve missed while baby spends the afternoon in Daddy’s (or Grandma’s or a sitter’s or a friend’s) care.

And remember that it’s not forever. It’s just for awhile. Until the next time.

If there is a question you would like answered by Amalah on the Advice Smackdown, please submit it to

About the Author

Amy Corbett Storch


Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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  • Sam

    July 22, 2011 at 12:50 pm

    Crazy…. are you me? Because MY baby is 5 months and does the same and I spilled 8 ozs of bmilk this morning! But I also forgot to put away all the milk I pumped yesterday so CCry.

    And if I didnt bedshare I’d be exhausted.

  • Kari Weber

    July 22, 2011 at 12:57 pm

    I can’t tell you how much I sympathize with this poster… My first was ONE BIG SLEEP REGRESSION after another until he was like 2 and a half! But, I learned how to cope.  I totally second the temporary bed sharing.  If he still goes down okay at night, let him sleep in his own bed until the first waking (or until after the second depending on how quick they come) and then just bring him to bed with you.  Don’t agonize over it, don’t waste a lot of time TRYING to get him back to sleep… Heck, depending, don’t even change the diaper! Just pick him up, get back in bed, get him comfortable, and go back to sleep.  I did this for a long time, but when it was over, and time for him to go back to his own bed full time— no problems.  I think sometimes parents with fussy children agonize over the bed-sharing because they imagine all kinds of problems ending it.  Ignore that thought.  You will be fine, the baby will be fine, you will SLEEP! If husband isn’t super comfortable, or it keeps him awake… I suggest a guest room, or the couch for him.  Or you, if you like the guest room! LOL! 
    Most importantly, as Amy said: This too, shall pass.  Even if it is disruptive to your “normal” now, it won’t last forever.  You can do it… take each day at a time. 

    Oh! And lastly, 5-6 months was about the time that my littlest started LOVING his Fisher Price Lullaby Seahorse (I think it may have a SLIGHTLY different name), AND his Little Giraffe lovies.  Seriously. BUY THE SEAHORSE! See Amalah’s blog for more on THAT magic (circa: Ezra’s infancy)

  • JenVegas

    July 22, 2011 at 1:21 pm

    I’m here to tell you it gets better….but later. In my case, much later. My 7.5 month old has been a bundle of milestone & travel related sleep regression for the past 2 months and last night he slept for 10 WHOLE HOURS. In a row! Of course, I woke up every 3 hours in a panic that he might be dead. But he wasn’t. And now that I’ve spoken of it he will probably never do it again but I’m taking that chance and hoping against hope that we get a repeat performance tonight. Hell, I’d take 5 hours in a row as long as I can get him back to sleep.

  • Julie

    July 22, 2011 at 1:59 pm

    Exact same place here, so here’s your fist bump of sympathy. 🙂 In our case, a lot of it is due to learning to roll over, so he wakes himself during the night. But a lot of it is also due to being too excited about watching the world and playing to eat much during the day, and then wanting to nurse all night to make up for it. So ask his daycare folks if he seems to be eating less during the day. If so, try getting a little extra into him before bed with a quiet nursing session in a room where he won’t get so distracted – maybe that will get you an extra hour before the first wakeup. 🙂

    Good luck!

  • Lemon

    July 22, 2011 at 2:13 pm

    Can the four month regression start at a different time, like say, five months? My kid just turned five months and *just* this week started getting up at night again. She has been sleeping very well since the end of April in a great routine (about 9pm to 6:30am with an occasional 5am) but just this week started going back to the 4am and 1am feedings. She’s also really clingy all of a sudden, something that she has never been before. I thought it was all teething related (excessive drool, stuff in mouth, hand sucking, gum sucking), but I have honestly never heard of a four month regression and now I’m curious.

  • Candace

    July 22, 2011 at 2:54 pm

    Totally just went through this with my six month old. The key for us is also to put him to bed EARLY. Like, 6:15 to 6:30ish. You know, when he starts to get fussy? He is tired! Especially since you are waking him up at 6 for the morning commute. This way he gets his full 12 hours of nighttime rest, which is required at this age, and you get a litte more “me” time. NO, he wont wake up earlier and if he is up around midnight or one for a little bit, it wont be any different than what you are experiencing now. But then he will give up that midnight feed and it will be smooth sailing from there on out. My six month old goes from 6 to 6 like clockwork, we dont go to him at night unless he is really crying, if he is just a little fussy we leave him and he generally goes back down. But last week he did have his six month growth spurt and we were back up at 3 every night for a week, but now is back, six to six. So seriously, TRY IT! Early bedtimes rock my freaking world. My 22 month old goes from 7:30 to 7:30 every day too. So I promise, it works 🙂 At least, it did for me.

  • Susan

    July 22, 2011 at 5:32 pm

    First – kudos to whomever picked out the accompanying photo. What a cute baby! Second – mine is 19 months now but I remember the 4 month sleep regression like it was yesterday. Like everyone else, I say bed share. It helped my son stay asleep and if he did wake up again it was easy to nurse/soothe him from my bed. I looooved it because I was out of the home 12 hours on my work days and it felt like reconnecting with my son to have him next to me. It didn’t last long because as soon as he got more mobile in his sleep and started turning around he didn’t sleep well with us anymore and back into the Pack n Play he went

  • EW

    July 22, 2011 at 10:10 pm

    Bed sharing didn’t work for us at all, but I did find it easier to bring my daughter into bed to nurse after she was 4 months old (before that, it was easier to go downstairs to the rocker so I could turn a light on to see what the heck I was doing).  I’d get up, change her, bring her into bed, then take her back to her crib once she was done, and got to where I could do that without waking up much.  One warning, though — while she’d slept through the night (7+ hours anyway) at 2 months, once we started nursing in bed, she woke up once or twice a night until she was 13 months old and we finally night weaned by giving her cow’s milk in a bottle.  I’d been dreading that step, and was sure she’d be starving.  The first night, she screamed as she waited for the bottle, then drank two ounces.  The second night, she went back to sleep before she even got the bottle.  Turns out, she wanted the cuddling more than the food.

    With my son (who is two months old, and I still need to be sitting up with a light on to feed him), I’ll probably go to nursing in bed for sleep regressions, but switch to bottled breastmilk after a couple of weeks to see if he really wants the food or not.

  • heather

    July 23, 2011 at 1:04 am

    My lil’ one is 2 and I still shudder when I think about the HELL that was the 4-month sleep regression. It does pass, but I literally took my kid to day care one day and then called in sick so I could go home and sleep. I didn’t trust myself on the road to my job… I was that sleep deprived. What ultimately worked for our family was realizing that you can’t make a kid sleep. You CAN’T. You can set them up to be as tired, scheduled, bedtime routined, as possible but you can’t make them go to sleep or stay asleep. My husband and I eventually started taking care of ourselves and instituted “sleep defense” where one of us would take the 10-2 shift of sleeping on an air mattress in the babies room and getting up with her. The other would get a blissful 4 hours of full REM sleep cycle. At the wake up after 2, we would switch. This only lasted a few nights (maybe a week?) before the regression ended but it was the difference between life and death.

  • Brianna

    July 23, 2011 at 6:18 am

    Oh god. My guy’s sleep regression lasted at least a month. And he was up every hour from midnight on until six. Nothing made him sleep but the boob. I wont lie it was awful. I got really sick in the middle of it too, probably from lack of sleep. I have him in the cosleeper and most nights he ended up in bed with me, just do whatever works and gets you the most sleep! He only wakes about once a night now. But we are bracing for the 9 month regression now soon!

  • Hillary

    July 25, 2011 at 9:17 am

    Yeah, I was just going to second the ‘getting sick’ piece of this sh*tstorm. As if you needed any reminding, but take your vitamins! And if you have pain, take your tylenol! Your body is getting pretty beat down by the sleeplessness and constant nursing and working and you may wind up getting sick. Take it from a person who managed to get 1) mastitis, 2) a sinus infection that lasted A MONTH, and 3) hand, foot and mouth (yes, if you’re an adult with as crap an immune system as I had at the time, you can catch this nasty bug from your child) during the 4 month regression. So, take care of yourself, even if it means taking time off work so you can catch up on sleep or calling in a relative to help out for a few days.

  • Kate

    July 25, 2011 at 9:35 am

    yeah, this. I wish someone had TOLD me about this before I was all smug with “my 7 week old sleeps through the night!” ughh. This started at 4.5 mos and, like pp Kari, our life was pretty much one big pile ‘o sleep regression, ear infections, other illnesses and separation anxiety until 20 months. If I had to do it again (oh wait, I do, when baby #2 is born next month!) I would be much less concerned with sleep training (but he has to learn to go to sleep by himself!) and just do whatever I needed to do (like bedsharing) to get some sleep. Also remember that, even if it is long and drawn-out like it was for me, It’s STILL only temporary. This will not be your sleep-deprived life forever.

  • Emily

    July 25, 2011 at 10:45 am

    I automatically thought ‘sleep regression’. Go Amalah! Our 4month sleep regression started at 3.5 months and lasted until 6months or so. It is so rough when your nice schedules get thrown off for seemingly no reason. Just remember that this is one of the most important sleep regressions – you cannot create bad habits and sleep associations. For instance, my kid cut out the middle of the night feeding at 3months. It would have been SO much easier to bring the feeding back than deal with the trying to put them back to sleep 50 times a night deal. Well, or so I thought. but since it was a sleep regression, I probably would have still had her up 6x a night whether I gave her the food option or not. but, since she had already been sleeping 12+ hours without food, I decided to keep that out of the equation and just try to help her get back to sleep. I resisted turning to cosleeping because I didn’t want the habit – although I would bring her in at about 4am because I just couldn’t do it anymore. I don’t remember much about that part of life other than being a zombie. Kiddo scared me with a 9month sleep regression type of behavior for a couple nights, but luckily that ended up being teething and the development of realizing that she knew how to crawl and only lasted 2 nights.

  • Heather

    July 26, 2011 at 11:42 am

    The same thing happened when my daughter was around four months.  Her previously good sleep got progressively worse and worse until she was waking up every 1-2 hours and it sometimes took almost an hour to get her back down because she would wake up and scream as soon as she touched the sheet.  Switching her to her crib didn’t help.  Finally, out of utter desperation after two hellish months of this I broke down and read Dr. Ferber’s book.  I was firmly against “crying it out,” I had read all the stuff Dr. Sears says on the subject.  But…Ferber’s book actually made a lot of sense.  And I was flat out losing it.  So I decided one night that I was going to let her cry for 10 minutes and see what happens.  (When watching the clock, I realized I had never let her cry for longer than a minute or two before). She didn’t even cry for 10 minutes and went back to sleep!  So I tried it again the next time she woke up…same thing.  Fast forward three days later–she slept through the night, and she has done so every night since (she’s 11 months now).  I know it isn’t as easy for every baby, and CIO doesn’t work for every baby, but it’s worth a try.  I was starting to lose my sanity and I could tell the sleep deprivation was really affecting my daughter too.  After she started sleeping through the night, she was a different (much happier) kid.  

  • Sarah

    July 27, 2011 at 4:21 pm

    Amy, THANK YOU from the depths of my sleepy heart for this thoughtful and really helpful reply, and thanks, too, to all of the lovely commenters for the insight and support. I feel like I have been to a much needed group therapy session. As predicted you were the right person to ask, and I think you have accurately re-diagnosed our situation (i.e. the teething joys are still to come!). We have been co-sleeping and it has definitely helped with the logistics of soothing, and I’m delegating more to my husband so we can suffer as a team. That has helped my mental state somewhat. I think you all have also identified other issues that are going on: He’s rolling now and waking himself up more, and he probably needs to be going to bed sooner, as sad as that makes me. Heather, now that you mention it, I have not let him cry more than a minute or two (especially now that he’s sleeping up in my grill) and I’m wondering if giving it just a little bit longer might be worth a shot. Kari, I will buy the seahorse–I would buy a field of Trojan horses if it would get me some sleep–and Sam, oh my god, I am so sorry about the milk because that was the worst day of all. I think what helps most is hearing from all of you that you’ve been through it, and it has gotten better. Eventually. So, here’s to the future!

  • Irene

    August 1, 2011 at 9:50 pm

    Totally agree with this being a sleep related issue, but I’m learning to be wary of using the word “regression” as it indicates that sleep development never waxes and wanes. When our LO was four months old we were in exactly the same boat – convinced it was teething – but it was really her sleep cycles changing and developing. New milestones. What helped us immediately was Dr. Marc Weissbluth’s book, Healthy Sleep Habits, Healthy Child. Life changing. A note – it’s probably difficult to adopt his suggestions if you’re co-sleeping. But I will say this, we went from waking every two hours. to 10 consecutive hours of rest. It was a pure taste of heaven for me when I was at the end of my rope and NEEDED SLEEP. Now, at almost 9 months old, our LO sleeps 12 hours a night without a fight and often without a peep. If she wakens, she puts herself back to sleep. One of the best parenting choices I ever made.

  • Naomi

    September 3, 2014 at 9:13 pm

    I’m in the middle of the third week of my son’s sleep regression. It is AWFUL. I haven’t gotten 3 consecutive hours in over two weeks. I’m shaking from exhaustion. I moved him to a 7:00 bedtime from an 8:00 bedtime and all that happened was that he stopped going to bed easily and now takes 2-3 hours to go to sleep as opposed to bath, nurse and sing and sleep (35 minutes tops). I am in HELL. At first I thought he wasn’t getting enough to eat, then I thought he was teething, but now I know. Does this regression ever end? BTW although he was full term (overdue actually) this regression started smack in the middle of his 3rd month–he won’t be 4 months until tomorrow 🙁

  • Kitty

    January 5, 2015 at 2:07 am

    THANK YOU! This question, answer and posts are so lovely to hear right now. My guy is almost 7 months – and has been waking every other hour the past few nights. He also cut his first tooth and it looks like the other is just below the surface. While mine might actually be teething- all of the sleep advice sounds great.