Overview 

Teething is a natural stage in every baby's development, where the baby’s teeth break through the gums. This process usually begins when the baby is between the ages of 6 to 12 months. This can be a difficult time for the baby, causing restlessness, soreness, and possibly developing a mild fever.^1,2

Parents may choose to give pain relievers like ibuprofen or acetaminophen to help with the pain. However, it's important to carefully consider the potential risks and side effects of these medications, so that they are used safely. This article will look at the safe use of acetaminophen and Ibuprofen for teething, compare the two options, and find non-medical alternatives that can provide relief.

Understanding teething 

Every baby is born with a full set of teeth beneath their gums. During a baby's first year, these teeth will start to break through the gum line.³ This causes pain and discomfort for the baby, and the gum surrounding the erupting tooth tends to be swollen and tender. This is the primary symptom of early baby teething. Other symptoms include:^4,6

• Drooling more than usual
• Being fussy 
• Not wanting to eat 
• Hard time sleeping 
• Biting or chewing on objects 
• Being cranky

Safe use of acetaminophen for teething pain

Acetaminophen (a-set-a-MEE-noe-fen), also known as paracetamol, is commonly used in managing teething pain and other symptoms. Acetaminophen works by stopping the production of prostaglandin, resulting in pain signals in the brain being blocked. Because of this, the baby will feel much more relieved during teething. Acetaminophen is generally considered safe when used in the recommended dosage administration guidelines.⁵

The dosage should be based on the weight of the baby. This information is often found on the medication packaging, however, you can also ask your doctor or pharmacist to be sure. Giving your baby the correct dose of acetaminophen is crucial, as too high a dose can be dangerous, potentially causing liver damage.

Overall, acetaminophen is considered safe for use in infants who are teething when given in the right amount. However, when a baby is under three months, it's usually not recommended to give acetaminophen unless it has been recommended by your doctor. If the baby is on other medication or has liver issues, parents need to speak to a doctor before using acetaminophen.¹

Safe use of ibuprofen for teething pain

Another useful treatment for teething is ibuprofen, a non-steroidal anti-inflammatory medicine (NSAID). Acetaminophen is mainly for pain relief, but Ibuprofen has anti-inflammatory properties that make it useful for relieving inflammation or swelling in the gums. 

Ibuprofen should always be taken with food to prevent stomach irritation. When it comes to choosing what dosage to give to your infant, it's very similar to acetaminophen, as the dosage is based on the baby's weight. It's important that parents do not give more than the recommended dose.

While Ibuprofen is good for reducing swelling and discomfort, parents should be careful when administering Ibuprofen to babies with pre-existing kidney problems or babies who are dehydrated, as Ibuprofen can worsen these conditions. Babies who are older than six months are advised to take ibuprofen.

Comparing acetaminophen and ibuprofen

Both medications are useful, but there is a slight difference in how they work.²

In summary, for mild pain, acetaminophen is a more suitable option as it can provide quick relief. However, if inflammation or swelling is present, it’s better to go with Ibuprofen. If a parent is still unsure about which medication to give, it’s always best to speak to a doctor or pharmacist beforehand.

Medications to avoid for teething pain

Before considering any over-the-counter teething remedies, parents should always speak to a doctor or pharmacist first. Acetaminophen and ibuprofen are considered to be safe, however, there are other medications and items parents should avoid when managing teething pain. This may consist of:³

• Teething necklaces: This might be risky since the beads could break off and cause the infant to choke. The infant could also be strangled if the necklace gets tangled
• Teething gels (benzocaine): Children younger than two years old should not use teething gels containing benzocaine
• Teething tablets: Belladonna, which is dangerous in certain quantities, may be present in some teething medications

Non-medical alternatives for teething pain

As a parent, your first instinct may be to reach for medication to help with the pain. However, there are also home remedies available that parents could try instead.

Using chilled teething rings is one way parents can help with teething. The baby will experience some short-term relief from the sore gums when they chew on the cooled teething ring. However, freezing the chilly teething ring could be dangerous for the infant. This is because when the ring is frozen, it becomes too hard, which could hurt the baby’s gum.^2,3

Another approach is to give the infant a clean, cold washcloth to chew on. The coolness of the cloth can numb the gums, and the texture can contribute to sensory relief. Finally, parents can also use a clean finger to gently massage their gums. This can help numb the gums and help with the pain. These are some simple methods that parents can choose to add to their treatment routine for teething.^2,3

General safety tips for parents

• Correct dosing: Always use the right measurement device that is given with the medication. Never guess the dose, as that can be a danger to the baby's health¹
• Seeing a doctor: If you are unsure of which medication to give to your baby or if the teething pain lasts more than a few days, consult a doctor or a healthcare provider²
• Side effects: While it's not common, some babies can still have side effects like a bad stomach, or some may have an allergic reaction. If there is anything that is not right or strange, it's best to have it checked out by a doctor¹

Summary

Teething is a natural stage that all babies experience during their development, but it can be a difficult and painful process for the baby, as well as their parents. When a parent sees their baby in discomfort, it’s natural for the parent to make sure they can make their baby feel better. The correct use of acetaminophen or ibuprofen will provide the baby with the pain relief that they need.

The information presented in this article highlights that acetaminophen works better when fast pain relief is required. However, if the baby has a lot of swelling, a better option would be to choose ibuprofen. Whether a parent chooses acetaminophen or ibuprofen for their infant, the parent should make sure they give the correct amount. Teething gels and tablets should also be avoided as they can be dangerous if not used correctly. 

Apart from medication, parents should also consider non-medical remedies like chilled teething rings for further comfort. It’s important to always consult with your baby’s healthcare provider before using any kind of medication to minimise any potential side effects. By following these guidelines, keeping track of symptoms and having a baby-friendly routine, parents can provide their infants with the best care they need during teething.