If you’ve ever stared at your baby at 2 a.m. thinking, “Are you teething… or are you actually getting sick?” you’re in good company. The tricky part is that early illness symptoms and teething discomfort can look surprisingly similar: fussiness, sleep disruption, extra drool, and a sudden refusal to eat like they did yesterday.
And because babies can’t exactly point to their gums and say, “Hey, this molar is coming in,” you’re left playing detective. The good news is that there are patterns you can learn to recognize—little clues that help you decide whether you’re dealing with normal tooth eruption, a minor bug, or something that deserves a call to your pediatrician.
This guide breaks down what’s typical for teething, what’s more suggestive of illness, and how to respond in a way that keeps your baby comfortable without overreacting. We’ll also talk about when it’s time to trust your gut and get medical advice.
Why teething and illness get mixed up so often
Teething often starts right around the same age that babies begin exploring the world with their mouths, meeting more people, and (if they have older siblings) being lovingly “gifted” every daycare cold known to humanity. So timing alone can be confusing—teeth and viruses can overlap.
There’s also a common myth that teething causes high fevers and serious diarrhea. While mild temperature changes and looser stools can happen for some babies, significant symptoms are more likely to signal an illness. The overlap is real, but the intensity and combination of symptoms usually tells the story.
Finally, a baby in discomfort—whether from gums or a sore throat—often acts the same: clingy, cranky, and not sleeping well. That’s why it helps to look beyond mood and focus on measurable signs like temperature, hydration, breathing, and feeding patterns.
Teething basics: what’s normal and what’s not
Most babies get their first tooth somewhere between 4 and 7 months, but there’s a wide range. Some pop a tooth at 3 months, others not until after their first birthday. Teething also doesn’t happen in a neat, predictable schedule. You might get a week of symptoms, then nothing, then another wave.
Normal teething symptoms tend to be localized to the mouth and behavior—think drooling, gum swelling, chewing, and irritability. When symptoms move into “whole body” territory (high fever, persistent vomiting, labored breathing), it’s time to consider illness.
One helpful mindset: teething is uncomfortable, but it shouldn’t make your baby truly unwell. If your baby seems sick—weak, unusually sleepy, hard to console in a different way than usual—treat that as a separate issue until proven otherwise.
Common teething signs you can usually manage at home
Extra drool is a big one. You may notice soaked bibs, a shiny chin, and little drool bubbles. Some babies also get a mild drool rash on the face, neck, or chest. Keeping the area dry and using a gentle barrier cream can help.
Chewing and gnawing often ramps up. Babies may chomp on their hands, toys, your shoulder—anything. This pressure can feel soothing on sore gums, especially when the tooth is close to breaking through.
Fussiness and sleep changes are also common. A baby who was sleeping well may suddenly wake more frequently or have trouble settling. You might see more clinginess, shorter naps, or a baby who needs extra comfort to fall asleep.
Less common teething symptoms that still can be normal
Reduced appetite can happen, especially for solids. Some babies don’t want anything near their mouth when their gums are tender. Others prefer cool foods or nursing/bottle feeding more frequently but for shorter periods.
Mild temperature elevation can occur, but it’s typically low-grade. If your baby feels warm but doesn’t have a true fever, teething could be the culprit. (More on what counts as a real fever in a bit.)
Ear pulling can be confusing. Pain from teething can radiate, and babies may tug at their ears. But ear pulling plus fever, poor sleep, and significant irritability can also point to an ear infection—so context matters.
Teething myths worth letting go of
“Teething causes high fever.” A high fever is more consistent with infection than teething. If your baby has a higher temperature, treat it as illness and check with your healthcare provider.
“Teething causes severe diarrhea.” Some babies have slightly looser stools due to extra saliva, but watery diarrhea, frequent stools, or signs of dehydration deserve medical attention.
“Teething explains everything.” It’s tempting to blame teething for any rough patch, especially when you’re tired. But if symptoms are intense, persistent, or unusual for your baby, it’s safer to investigate illness rather than assume it’s teeth.
What illness looks like in babies (and why it can feel sudden)
Illness in babies can escalate quickly. One day they’re fine, the next they’re fussy with a runny nose—and by nighttime you’re dealing with a fever and a baby who won’t settle. That fast shift is common because babies’ immune systems are still developing.
Unlike teething, illness often comes with systemic signs: fever, congestion, cough, vomiting, diarrhea, unusual sleepiness, or changes in breathing. The key is not just “Is my baby cranky?” but “Is my baby functioning like themselves?”
Another clue: teething discomfort usually comes and goes, and your baby may have happy breaks between cranky moments. With illness, babies are often consistently uncomfortable, with fewer periods of normal play and engagement.
Fever: the biggest differentiator
A true fever is one of the clearest signs you’re dealing with sickness rather than teething. Temperature thresholds vary by age and by how you take it (rectal is the most accurate for infants). If your baby has a fever, especially if they’re under 3 months, it’s important to seek medical advice promptly.
Teething may cause a slight temperature bump, but it generally doesn’t cause a sustained fever. If you’re seeing a higher reading, or if the temperature keeps returning after medication wears off, treat it like an illness until your pediatrician says otherwise.
Also pay attention to your baby’s overall presentation: Are they alert? Making eye contact? Drinking fluids? Wetting diapers? A number on a thermometer matters, but the full picture matters more.
Respiratory symptoms: congestion, cough, and breathing changes
Teething doesn’t cause a true cough or thick congestion. Babies may gag or cough a little on extra drool, but that’s different from a persistent cough, wheezing, or labored breathing.
If your baby has a runny nose, sneezing, a wet cough, or noisy breathing, think virus or allergy rather than teeth. Watch for signs of increased work of breathing: flaring nostrils, ribs pulling in with breaths, grunting, or rapid breathing.
When in doubt, it’s okay to call your healthcare provider or local nurse line. Breathing concerns are always worth checking, even if everything turns out fine.
Stomach symptoms: vomiting and diarrhea
Spit-up is common in babies, but repeated vomiting—especially if it’s forceful, frequent, or paired with lethargy—suggests illness. Similarly, one slightly looser stool could be incidental, but ongoing watery diarrhea is more concerning.
Hydration is the priority. Fewer wet diapers, a dry mouth, sunken soft spot, or no tears when crying can indicate dehydration. If you see these, seek medical care.
Sometimes teething coincides with new foods, which can also change stool patterns. If you’ve recently introduced solids, consider whether a new food might be contributing. Still, if symptoms are significant, don’t chalk it up to teeth alone.
A practical “teething vs sick” checklist you can use today
When you’re tired, it helps to have a quick mental checklist. Think of it as sorting symptoms into two buckets: mouth-focused (more likely teething) and whole-body (more likely illness).
No checklist replaces medical advice, but it can help you decide what to do next: comfort measures at home, monitor closely, or call your pediatrician.
Here’s a simple way to walk through it.
More likely teething if you see this pattern
Drool + chewing + mild irritability is the classic combo. If your baby is cranky but still has stretches of normal play, and symptoms are mostly centered around the mouth, teething is a strong possibility.
Swollen gums or a visible tooth ridge can be a giveaway. Wash your hands and gently feel along the gumline. You may notice a firm bump or see a little white line under the gums.
Symptoms that come in waves also fit teething. Many babies have worse evenings and nights, then seem more comfortable during the day.
More likely illness if you see this pattern
Fever, especially sustained or high, points toward infection. If your baby’s temperature is elevated beyond a mild bump, don’t assume teething is the cause.
Congestion, cough, or breathing changes are not typical teething symptoms. If your baby is struggling to feed because they can’t breathe through their nose, that’s a strong sign of a cold or other respiratory issue.
Vomiting, watery diarrhea, or unusual sleepiness also suggest illness. A baby who is hard to wake, unusually floppy, or not interested in feeding needs medical attention.
When it could be both (yes, that happens)
It’s completely possible for a baby to be teething and catch a cold at the same time. In those cases, you might see drooling and chewing plus congestion and a clear fever.
If you suspect overlap, prioritize the illness symptoms first—especially fever, hydration, and breathing. Teething discomfort can be managed alongside, but it shouldn’t distract from monitoring the more serious signs.
In mixed cases, tracking symptoms over 24–48 hours can help. Teething discomfort often stays fairly consistent or improves after a tooth breaks through. Illness usually follows a more recognizable arc (worsening, peak, gradual improvement).
Comfort strategies for teething that actually help
Teething can be rough, but you don’t have to just “power through.” Small comfort measures can make a big difference, especially during bedtime. The goal is to reduce gum inflammation and give your baby safe things to chew.
Keep it simple and safe: clean hands, age-appropriate teethers, and soothing routines. If you’re considering medication, it’s best to consult your pediatrician for dosing and timing.
Here are a few parent-tested options that are generally helpful.
Cold pressure: the go-to for sore gums
A chilled (not frozen solid) teether can provide relief by reducing inflammation and giving your baby something satisfying to gnaw on. Some babies prefer soft silicone, others like firmer textures—there’s no one perfect teether.
You can also try a cold washcloth. Wet a clean washcloth, twist it into a rope shape, and chill it in the fridge. Many babies love the texture and the cold.
If your baby is eating solids, cool foods like yogurt or purées (age-appropriate and allergen-aware) can sometimes help. Always supervise closely, especially with anything that could pose a choking risk.
Gum massage and connection (yes, comfort counts)
With clean hands, gently rub your baby’s gums using a finger. Some babies relax immediately; others don’t want their mouth touched at all. If they resist, don’t force it—try again later.
Extra cuddles are not “creating bad habits.” When babies are uncomfortable, they need more reassurance. Comforting now doesn’t mean you’ll never sleep again; it means you’re meeting a real need.
Sometimes the best teething strategy is simply a calmer day: fewer errands, more downtime, and earlier bedtime if your baby seems worn out.
Medication: what to consider and what to avoid
If your baby is truly uncomfortable, your pediatrician may recommend an age-appropriate pain reliever. Always follow professional guidance for dosing—especially for infants.
Avoid numbing gels with ingredients that aren’t recommended for babies (your pharmacist or pediatrician can clarify what’s safe). Also avoid teething necklaces or bracelets; they can be choking or strangulation hazards.
If you find yourself needing medication around the clock for multiple days, that’s a sign to reassess. Either the teething is particularly intense, or something else (like illness) may be going on.
If it’s sickness: supportive care that makes a real difference
Most baby colds are viral and improve with time, but supportive care can make those days much more manageable. The priorities are hydration, comfortable breathing, and rest.
Babies can’t blow their noses, and congestion can make feeding harder. Small interventions—saline drops, suction, humidified air—can change everything, especially at night.
If symptoms are severe or your baby is very young, don’t hesitate to seek medical advice early. It’s always better to ask than to worry alone.
Hydration and feeding when your baby isn’t into it
When babies are sick, they may eat less. That’s common. Focus on keeping fluids going, even if it’s more frequent smaller feeds. Wet diapers are one of the best indicators that hydration is okay.
If your baby is breastfeeding, nursing can be both hydration and comfort. If bottle-feeding, you may find your baby does better in a more upright position to reduce congestion-related frustration.
For older babies on solids, it’s okay if solids drop off temporarily. Fluids matter more than food during short illnesses.
Making breathing easier (especially for sleep)
Saline drops followed by gentle suction can help clear nasal passages before feeds and sleep. Many parents find this is the single most effective trick for a congested baby.
A cool-mist humidifier can also help, particularly in dry winter air. Just be sure to clean it regularly to prevent mold buildup.
If you notice persistent wheezing, fast breathing, or your baby seems to be working hard to breathe, seek medical care right away.
When you’re not sure: track symptoms like a pro
When you’re on the fence between teething and illness, tracking can clarify things. Note temperature readings, diaper counts, feeding amounts, sleep patterns, and any new symptoms (rash, cough, vomiting).
Patterns matter: teething often peaks in the evening; viral illness may worsen over 24–72 hours. If you’re seeing escalation rather than fluctuation, that leans toward sickness.
Having notes also helps if you call your pediatrician—you’ll be able to share specific details instead of trying to remember everything while your baby cries in the background.
Red flags that mean “call a professional now”
Some symptoms should never be attributed to teething. If you see these, get medical advice right away, even if a tooth is visibly coming in.
Trust your instincts here. You know your baby’s normal. If something feels off in a bigger way, it’s okay to seek help quickly.
Here are common red flags to watch for.
Breathing, dehydration, and extreme lethargy
Any signs of breathing trouble—rapid breathing, rib retractions, grunting, blue lips, or persistent wheezing—warrant urgent care.
Dehydration signs include significantly fewer wet diapers, no tears when crying, dry mouth, and sunken eyes or soft spot. Babies can dehydrate faster than you might expect.
Extreme sleepiness (hard to wake), limpness, or a baby who seems “not themselves” in a concerning way should be evaluated promptly.
High fever or fever in very young infants
Fever in newborns and young infants is taken very seriously. If your baby is under 3 months and has a fever, contact a healthcare provider immediately.
For older babies, a high fever, a fever that persists, or fever paired with other concerning symptoms should prompt a call as well.
Even if you suspect teething, fever is one of those symptoms that deserves a real medical check-in.
Rashes, ear infections, and pain that doesn’t fit teething
A new rash with fever, a rapidly spreading rash, or any rash that looks like bruising or doesn’t blanch when pressed should be assessed.
Ear infections can mimic teething because babies tug their ears, but ear infection pain often comes with fever, worsening night waking, and intense fussiness. If you suspect it, call your pediatrician—ear infections are treatable and babies feel better quickly once managed.
If your baby’s crying is high-pitched, constant, or seems like severe pain, don’t wait it out as “just teething.”
How to support your baby’s overall resilience during teething season
Teething can feel like a months-long phase, and it often overlaps with developmental leaps, sleep changes, and new foods. While you can’t prevent teeth from coming in, you can support your baby’s baseline comfort and routine so the rough days don’t hit quite as hard.
This doesn’t mean chasing perfection. It’s more about stacking small, practical habits that keep your baby regulated: consistent sleep cues, gentle nutrition, and a calm approach to new symptoms.
Think of it as building a “buffer” so teething discomfort doesn’t derail everything at once.
Sleep routines that flex without falling apart
During teething, sleep can get choppy. Instead of trying to enforce a rigid schedule, focus on consistent cues: dim lights, a familiar song, a short cuddle, and the same sleep space. Those cues help your baby settle even when they’re uncomfortable.
If your baby needs extra comfort for a few nights, that’s okay. You can return to your usual routine once the worst passes. Many parents find that responsiveness during discomfort actually helps babies feel secure long-term.
Also, don’t underestimate daytime sleep. An overtired baby often experiences teething pain more intensely, so protecting naps (when possible) can improve nights too.
Food, fluids, and gentle digestion support
Teething can disrupt feeding. Some babies snack more often; others refuse solids. Keeping hydration steady and offering soft, cool foods can help. If your baby is on solids, watch for constipation too—routine changes and reduced intake can slow things down.
Some families also think about broader gut comfort during fussy phases. If you’re exploring options in that area, you can clinical digestion support resources to see what’s available and discuss any questions with your pediatric provider, especially for infants.
As always, introduce anything new thoughtfully and with professional guidance when needed—babies’ systems are sensitive, and “gentle” is the right pace.
Skin, drool rash, and the little things that add up
Drool rash can make a teething baby even more miserable. Pat (don’t rub) drool away, use soft bibs, and consider a simple barrier cream around the mouth and chin. If the rash looks angry, cracked, or infected, ask your healthcare provider.
Keep teethers clean and rotate them. Sometimes babies get bored of one texture, and a different shape can make chewing more satisfying.
And if you’re feeling overwhelmed, simplify. A calmer caregiver helps a baby regulate. It’s not selfish to take turns, ask for help, or lower expectations for a few days.
Smart shopping without getting lost in the teething aisle
There’s no shortage of products marketed to teething parents—some helpful, some unnecessary, and a few that are truly unsafe. The best approach is to focus on basics: safe teethers, simple skincare for drool rash, and a thermometer you trust.
If you like having a curated place to browse baby-focused options (rather than wandering through endless listings), a dedicated baby wellness shop can make it easier to compare products and read details in one place.
Whatever you buy, prioritize safety: avoid choking hazards, skip amber necklaces, and be cautious with anything that promises instant “numbing.” When you’re unsure, your pharmacist and pediatrician are great resources.
When you want to go deeper: antioxidants, immunity talk, and what matters most
Parents often start thinking about immune support right around the time babies begin teething—partly because that’s when colds start showing up more often. It’s natural to wonder if there’s something you can do to help your baby (and your household) get through the season with fewer rough weeks.
The most proven “immune supports” for babies are still the fundamentals: adequate sleep, good hand hygiene in the household, staying up to date on recommended vaccines, and keeping feeding/hydration steady. Beyond that, parents may explore nutrition topics and ask their healthcare provider about what’s appropriate for their child’s age and situation.
If you’re the type who likes to research categories and understand what’s out there, you can view here for a look at professional antioxidant options—then use that information as a starting point for a conversation with a qualified clinician about what’s relevant (or not) for your family.
Putting it all together on a rough day
On the days when your baby is drooling, refusing the bottle, and crying in a way that makes you second-guess everything, it helps to zoom out. Start with the basics: take a temperature, check breathing, count wet diapers, and look for mouth clues like swollen gums or chewing.
If symptoms are mild and mouth-focused, treat it like teething: cold teethers, cuddles, and a slightly easier schedule. If symptoms are systemic—fever, cough, vomiting, diarrhea, unusual sleepiness—treat it like illness and contact your healthcare provider as needed.
And if it’s both, you’re not failing. Babies can stack discomforts like pros. Your job isn’t to guess perfectly every time; it’s to notice patterns, respond safely, and reach out for help when the signs point beyond normal teething.
With time, you’ll get better at reading your baby’s signals. The first couple of teeth can feel like a mystery. By the time the next ones arrive, you’ll likely find yourself thinking, “Ah—this again,” and you’ll have a plan ready.
