Teething

Most babies start teething at six to seven months.  A few early birds begin at three to four months, and a few babies will begin at ten to twelve months.  Do not worry if the teeth come in late.  While the majority of babies aren’t troubled by the teething process, some get irritable, eat poorly, and have trouble sleeping when teeth begin to arrive.

If your baby seems uncomfortable while teething, they might be soothed by a soft, refrigerated teething toy.  Do not put teething toys in the freezer, as this makes the toys hard and can lead to freezer burns. Chewing on a chilled, moist rag can also soothe a teething baby.  If these measures are not working, you may wish to give Tylenol or ibuprofen. Please make sure with a thermometer that your baby does not have a fever before giving the Tylenol.  They may be fussy because they are getting sick rather than because they are teething.  Fevers over 101°F cannot be blamed on teething.

There are anesthetic topical ointments available for teething. However, we have seen little evidence that these agents relieve teething pain.  Also, there are some well-documented cases of bad side effects as a result of overuse of these agents.  Additionally, because of the constant production of saliva, much of the medication is quickly washed off and swallowed, rather than staying on the gums.  For these reasons, we recommend only using teething rings and acetaminophen (Tylenol) or ibuprofen for relief.

Brushing Teeth

For the first year of life, you can clean erupting teeth with a clean, damp cloth twice a day or more.  After your child’s first birthday, you should begin brushing your child’s teeth two times per day with a toothpaste that has a small amount of fluoride (these are 2014 recommendations).  After the second birthday (or when your child no longer swallows the majority of their toothpaste) you can switch to an adult toothpaste.  The first dental visit can wait until your child has turned two.

Bathing

For the first few days after your baby comes home, bath time can consist of a gentle once-over with a soft, damp, warm wash cloth and a mild soap.  If a soap seems to irritate your baby’s skin, try using a bland bar soap such as unscented Dove, Aveeno, or Aquaphor, as the liquid soaps often have scents and emulsifiers in them that irritate the skin.  Regular baths should wait until what’s left of the umbilical cord has come off, and, for boys, until the circumcision heals as well.  This is to prevent an infection of the umbilical cord or circumcision.  Once your baby is ready for full-fledged baths, be sure the room is warm with no drafts and the water is about 85º F.  When you stick your elbow in the water, it should feel warmer than your skin but not actually hot.

Your baby will find bath time the highlight of their day as long as you take a few precautionary measures like keeping soap out of their eyes and mouth and making them comfortable by bathing them on a towel or foam pad in the sink or tub.  Wash your baby’s face with plain water, a soft cloth and mild soap (most infant’s brands are fine).  Wash your baby’s head gently, working from front to back to keep the soap out of their eyes.

To clean the area around the eyes, use cotton dipped in cool, clear water.  Clean the outer areas of the nose and ear, using a moist washcloth or cotton ball dipped in water.  With a cotton ball, wipe away any yellow-orange earwax that has collected in the visible part of their ear.  It’s important not to poke anything (including Q-tips) inside the ear; it’s risky for your baby, painful, and you may end up pushing the ear wax further into the canal.

It is perfectly fine to get water inside the ear.  The outer ear canal is sealed off from the rest of the inner head by the tympanic membrane (ear drum).  In fact, a little water in the ear with each bath can help soften the ear wax helping it work its way out of the ear.