Introduction

“My child is teething so he has been having diarrhoea for some days now.”

Does this sound familiar? Have you had this conversion before? Does teething really cause diarrhoea? Does it even have any relationship with the gastrointestinal system (also known as the digestive system)? Or is it just a coincidence?

Everyone has something to say about teething and diarrhoea. Join us in this journey as we try to unravel this dilemma in this article. We will be looking at what teething is, why diarrhoea has consistently been associated with teething, if there are other gastrointestinal symptoms associated and how to differentiate normal teething symptoms from symptoms of illness in a child.

Teething is the processing of teeth erupting from the gum, and it is a natural process that occurs between the ages of 6 months and 36 months. However, it is believed by some to be associated with several symptoms like fever, diarrhoea, drooling of saliva, irritability and many more.^1,2 This may lead to seeking medical help early or on the other hand aggressive administration of medicines that can put the child at risk of other harm.⁶ 

Understanding teething and its effects

What happens during teething?

• Eruption of teeth and irritation of gum

Teething can be very uncomfortable for a child and may result in swelling and gum irritation which may also make the child cry a lot.⁵

• Changes in behaviour such as:
  • Biting
  • Sleep disturbances
  • Increased production of saliva

While teething is a normal process, many parents have attributed these behavioural changes to teething. This is very subjective and serves only as a way of explaining these behaviours to allay the anxiety of the parents or caregivers.⁵

What are the common symptoms mothers associate with teething?

There are two main symptoms that mothers have associated with teething and they include:^1,2

• Mild fever: there may be a slight increase in temperature when a tooth is erupting However, not a high fever. High fevers are usually associated with infections
• Diarrhoea: however, we have no scientific evidence to support this

Other symptoms they have also associated are:^3,4

• Excessive salivation: this usually is seen during teething
• Vomiting
• Swelling and redness of gums: the eruption of teeth can make gum red and cause some pains as well as swelling on the gum
• Increased desire to bite: probably to reduce teeth discomfort
• Reduced sleep
• The child becomes very irritable
• Runny nose
• Loss of appetite
• Loss of weight

Is there really a link between teething and diarrhoea?

What is the common belief?

Many parents, irrespective of their educational background, socioeconomic status or even medical background believe there is a relationship between teething and diarrhoea.

What is the scientific point of view?

From several studies that have been done, there is no direct biological link to support the belief that teething and diarrhoea are linked.

However, possible explanations for the coincidence may include:²

• The fact that teeth begin to erupt at about six months of age and this is the same time children begin to build their own fighting systems that defend them against infections
• At this time, the mother’s antibodies which they have been using begin to wane off leaving them prone to infections as their own fighting systems are not fully developed yet²
• Also, it's at about the same time they begin to crawl and mouth things, therefore increasing the risk of germs/infections that may lead to diarrhoea and fever²
• Also, worthy of note is the fact that sleep disturbance or excessive night crying may be a result of attention-seeking and anxiety from parental separation⁴

Other possible reasons why teething and diarrhoea may seem to be connected

• As a result of excessive salivation and swallowing of this saliva, stool may become a little loose compared to the usual. However, this does not really cause diarrhoea
• Digestion and feeding patterns may also be affected by the discomfort from teething

How do you differentiate between teething-related changes and illness

Signs that diarrhoea may not be from teething

• Watery, frequent stools that last for more than a day

Signs of infections such as:

• Vomiting
• Dehydration
• Fever above 38°C (100.4°F)

When to see a doctor

Reach out to a doctor if:

• Diarrhoea persists and is very severe
• Additional symptoms like fever, rash, or blood in stool 

How do you comfort a baby teething without assuming illness?

These involve two methods namely: pharmacological (using drugs) and non-pharmacological which can either be by cooling or rubbing. 

The pharmacological method include:⁴

• Pain reliefs that are appropriate for age e.g., paracetamol, ibuprofen and they must be used as recommended by a doctor
• Teething remedies containing numbing agents e.g., anesthetic gels. But, lidocaine should be avoided because it can be harmful

The non-pharmacological methods include:⁴

• Cooling:
  • The use of cold washcloths and chilled teething rings
  • Chilled fruits and vegetables e.g. cucumber, carrot, apple
  • Cooling of the gingival with cold compress, frozen peas, ice
  • Wiping gingiva with alcohol

• Rubbing:
  • Massaging the gum with firm finger pressure
  • Chewing dry toasts, pacifiers, or teething biscuits

Other alternative medicines such as oil-based ointment (tea tree and cloves) and herbs have also been used by mothers but all to no avail. However, none have been scientifically proven to be of help.⁴

FAQ’s

Does teething cause diarrhoea?

No. No hard facts show teething leads directly to diarrhoea. But, diarrhoea might happen from increased mouthing of things. This happens at the same time, increasing the risk of babies catching infections.

Why do many think teething causes diarrhoea?

Teething and diarrhoea often show up at about six months when babies lose their mom's protection and begin grabbing things to chew, which increases the chance of getting infections.

What signs do you mostly see with teething?

• Gums get swollen and sore 
• Lots of biting and chewing 
• Excessive drooling 
• Fever 
• Trouble sleeping

How do I know my baby’s diarrhoea is due to an illness and not teething?

• If the watery stools are frequent and last for more than a day
• If there is an associated high fever (above 38°C/100.4°F)
• If a child is vomiting or dehydrated (dry mouth, fewer wet diapers)
• If there is blood in the tool or a severe rash

What should I do if my teething baby has diarrhoea?

• Ensure they are well hydrated with breast milk, formula, or oral rehydration solutions (ORS)
• Maintain good hygiene to prevent infections
• See a doctor if diarrhoea is severe or lasts more than 24 hours

When should I see a doctor for teething symptoms?

If your baby has a high fever, severe diarrhoea, vomiting, dehydration, or any unusual symptoms beyond typical teething discomfort.

Are the medicines that can be taken for teething pain?

Paracetamol or ibuprofen (as recommended by a doctor) can be used. Avoid teething gels with lidocaine or benzocaine due to safety concerns.

Can excessive drooling from teething cause loose stools?

Yes, swallowing large amounts of saliva might loosen stools slightly but does not cause true diarrhoea.

How can I soothe my teething baby?

Gently massaging their gum. Use cold teething rings, chilled fruits, or cold washcloths, and give a pain reliever like paracetamol approved by a doctor if needed.

Summary

Teething is normal but can make a baby's gums sore, make them drool, and feel pain. Many people think it also makes babies have diarrhoea, but science does not back this up. 

Diarrhoea when teething may be from exposure to more germs as babies grab and chew on things. Or it could be due to changes in how they fight off germs at about six months of age.

If kids really get sick, they might have a fever, throw up, or lose too much water, and they will need a doctor's help. 

To help a teething baby, cool their gums, rub their gums, or use a pain relief approved by a doctor. Knowing the real cause helps parents handle teething without too much stress.