Teething or Growth Spurt?

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.

I 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,
S

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.

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