The Eruption Sequence — How Each Stage Affects Feeding Differently
Not all teething is the same — and not all teething disrupts feeding in the same way. The type of feeding difficulty a parent sees depends almost entirely on which teeth are erupting. Understanding this makes the disruption predictable rather than alarming.
| Teeth | Typical Age | Specific Feeding Impact | What Helps Most |
|---|---|---|---|
| Lower central incisors (2 teeth) | 6–7 months | Often the first disruption; gum discomfort before the teeth erupt; drooling increases; may pull off the breast more frequently during nursing as the erupting lower gum pressure activates during suckling; solid food at this stage is just beginning — purées usually tolerated well | Cold teething ring before feeds; chilled cucumber sticks if solids have started; calm, shorter breastfeeding sessions with more frequent breaks |
| Upper central incisors (2 teeth) | 8–12 months | Often the stage where biting during breastfeeding first appears — the upper teeth alter the jaw mechanics during nursing; baby is also at peak solid food introduction; upper gum discomfort during nursing and during chewing acidic or textured foods | Cold teether before breastfeeding; biting management protocol (see below); avoid acidic first foods (tomato, citrus) temporarily; offer cold food temperatures |
| Lateral incisors (4 teeth, upper + lower) | 9–16 months | Fills in the sides of the front teeth; discomfort is usually less acute than central incisors for most babies; some disruption to breastfeeding mechanics as the lateral jaw position shifts; biting risk continues; solid food at this age is well established — most lateral incisor teething has modest feeding impact compared to molars | Cold teething ring; chilled food; topical teething gel if needed; continue standard latch management |
| First molars (4 teeth) | 13–19 months | The most acutely painful and feeding-disruptive eruption for most babies. First molars have a large, flat eruption surface — the entire broad crown must push through the gum simultaneously. The gum pressure is distributed across a wide area. Most babies experience significant discomfort for 3 to 7 days before each molar breaks through. Typical effects: dramatic reduction in solid food intake; regression to preferring purées or refusing solids almost entirely; increased demand for breast or bottle; increased night waking; irritability specifically around meals | Cold foods (yoghurt, chilled mango, cold cucumber); accommodate texture regression fully — offer smooth purées of usual foods; paracetamol or ibuprofen for significant pain; sugar-free teething gel on the molar gum area; chilled (not frozen) firm teething ring for counter-pressure |
| Canines (4 teeth) | 16–22 months | Positioned laterally, canine eruption creates side gum discomfort and sometimes referred pain along the jaw; may affect chewing on one or both sides; solid food acceptance often partially disrupted — softer textures and preferred foods are better tolerated; the pointed canine shape means eruption is usually less prolonged than molars | Cold foods; accommodate food preferences; topical gel on lateral gum; paracetamol or ibuprofen if needed |
| Second molars (4 teeth) | 23–33 months | The final and often the most disruptive molar eruption; same large-surface-area mechanism as first molars but at the back of the jaw; by this age toddlers can often communicate discomfort verbally (pointing to their mouth, saying "ow", refusing food and explaining why) which can reduce guesswork; texture regression may occur again; may appear to relapse into feeding patterns of 12 months earlier temporarily | Same as first molars; at this age toddlers can use cold ice packs wrapped in cloth on the outside of the cheek; cold drinks; paracetamol or ibuprofen by weight |
Biting During Breastfeeding — Why It Happens and How to Stop It
For breastfeeding mothers, the moment a baby gets lower teeth is often accompanied by the fear — or the reality — of biting during nursing. Understanding why biting happens makes it far less alarming and makes the management protocol make sense.
The Physiology: Why Biting Cannot Happen During Active Nursing
This is the single most reassuring piece of information for nursing mothers facing teething: it is anatomically impossible to bite during active suckling with an effective latch.
During active breastfeeding, the baby's tongue is extended over the lower gum and lower teeth, cupped around the breast. The lower jaw is in a position of maximum extension (dropped down) to accommodate the breast in a wide, deep latch. To bite — to close the jaw — the baby must raise the lower jaw, which terminates the suction and de-latches the breast. Active suckling and biting are mechanically mutually exclusive.
This means: if a baby is biting during nursing, they are not actively feeding at the moment of the bite. The bite occurs at a transition point — most commonly:
End-of-feed biting
As milk flow slows at the end of a feed,
the baby's swallowing rhythm changes —
fewer swallows per suck. When there is
little milk flowing, the baby's jaw
gradually relaxes into a position that
is closer to biting than feeding. The
latch subtly shifts. The lower jaw
closes slightly, and the teeth make
contact with the breast.
This is by far the most common pattern.
It is not intentional. The baby's jaw
is responding to the reduced milk flow
by gradually readjusting its position.
Learning to recognise the end-of-feed
signs (swallowing slows, the baby becomes
distracted, the jaw relaxes slightly)
and de-latching proactively — before
the bite occurs — is the most effective
preventive strategy.
Start-of-feed biting / latching exploration
Some babies use their lips and gums to
explore the nipple area at the beginning
of a feed before latching — or bite
briefly during latching as the jaw
position is being established. This
is more common in younger babies whose
latch is still developing, and in babies
who are distracted or not deeply hungry.
Additionally, some babies — particularly
during active teething — experiment with
biting as a way to apply counter-pressure
to their sore gums. They are not trying
to bite their mother; they are gnawing
on what is available for relief.
This pattern does not make the bite
less painful, but understanding it
shapes the response.
The Biting Management Protocol
- Before the feed: Offer a cold teething ring for 3 to 5 minutes. This reduces acute gum inflammation and slightly numbs the area — reducing the urge to use the breast as a teether during feeding
- During the feed: Watch for end-of-feed signals — swallowing becoming less frequent, the baby becoming visually distracted, a slight relaxation of the jaw. De-latch gently before the jaw fully closes using a clean finger inserted at the corner of the mouth to break the suction
- At the bite: De-latch immediately and calmly. Say "we don't bite" in a matter-of-fact tone. Do not shout, gasp dramatically, or react with strong emotion — dramatic reactions are stimulating to a baby and can turn biting into a game that gets a big response
- After the bite: End the feed briefly — 30 seconds to 1 minute; place the baby down, offer the cold teether. Then offer the breast again if the feed was not complete
- Consistency: The same calm de-latch every single time, for every bite. Inconsistency (sometimes a dramatic reaction, sometimes calm) is more reinforcing of the behaviour than a consistently calm response. Most babies respond to this protocol within 3 to 7 days
Food Choices During Teething — What Helps, What Hurts, and the Texture Regression
Foods That Help
Cold foods — the most effective relief
Cold reduces gum inflammation and provides
brief topical numbing via vasoconstriction.
It is the most effective and evidence-aligned
food-based teething intervention. Never
frozen — frozen food or freezer-cold surfaces
can damage delicate infant gum tissue.
The goal is food that is fridge-cold.
Options by age:
From 6 months: Cold cucumber
sticks (cut as batons not rounds — aspiration
risk with circular shapes), chilled mango
slices, cold plain full-fat yoghurt, chilled
puréed apple or pear, chilled breast milk or
formula in a sippy cup.
From 8–9 months: Cold watermelon
pieces (large enough not to be a choking risk),
chilled strawberry halves (one of the few
exceptions to the "avoid acidic during teething"
rule — the cold outweighs the mild acidity),
cold cheese cubes, chilled cooked vegetables.
From 12 months: Cold smoothies,
cold fruit pouches, chilled banana slices.
Firm chewing foods — counterstimulation
Counter-pressure on an erupting tooth
reduces pain through counterstimulation —
the same physiological mechanism that makes
rubbing an injury feel better (competing
sensory input in the same nerve pathway
reduces the perception of the painful
stimulus). This is why babies gnaw on
everything when teething — the gnawing
pressure provides relief.
Appropriate firm foods for counterstimulation:
Age-appropriate firm (not hard) options:
Firm bread crust; unsweetened rice cakes;
a carrot stick (supervision required — raw
hard vegetables have aspiration risk; a stick
the baby can gnaw but not break pieces from
is the goal); firm apple with skin removed;
firm melon with skin removed.
The food should be firm enough to provide
resistance but not so hard that pieces break
off — breaking pieces are a choking risk.
Always supervise gnawing on firm foods.
Foods to Avoid During Active Teething
| Food Type | Why to Avoid During Active Teething | Return When |
|---|---|---|
| Acidic fruits and juices (tomato, citrus, pineapple, kiwi) | Acidity directly irritates inflamed, broken gum tissue that is erupting; the same foods that cause contact redness around the mouth in general can cause significant discomfort on actively erupting gum tissue; a baby who previously accepted tomato-based sauces may suddenly reject them during active teething | Once the teeth have broken through and the acute gum inflammation has settled — usually within 1 to 2 weeks of eruption |
| Very salty foods (salted crackers, processed snacks) | Salt on inflamed gum tissue stings — the same mechanism as salt in a mouth ulcer; inflamed erupting gum tissue is vulnerable to salt irritation | Once acute inflammation has settled; note that high-salt foods should generally be limited in infants and toddlers regardless of teething |
| Very hard foods (raw carrot rounds, whole nuts, popcorn) | Hard, sharp-edged, or brittle foods can injure inflamed, raised gum tissue; additionally, the choking risk of these foods is independent of teething and applies at all times | After teething for age-appropriate hard foods; whole nuts, popcorn, and round raw hard vegetables remain choking risks regardless of teething status and should not be given until appropriate age |
| Hot or very warm foods | Heat increases vasodilation and gum inflammation; hot foods on an already inflamed erupting gum increase discomfort; a baby who previously accepted warm porridge may reject it temporarily | Serve food lukewarm or at room temperature during acute teething; return to preferred temperature preferences once eruption is complete |
| Chewy, sticky foods (dried fruit, toffee, sticky rice) | Sticky foods that adhere to teeth and gum tissue can be painful to detach from inflamed gum surfaces; they also pose a dental hygiene concern for newly erupted teeth | After teeth have broken through; dental hygiene considerations around sticky/chewy foods remain relevant beyond teething |
Texture Regression During Molar Teething — Normal and Temporary
First molar teething (typically 13–19 months) is the teething episode that most surprises parents — because by this age, many babies are eating a wide variety of textures, and the sudden regression to wanting purées or refusing solid food looks alarming in a toddler who has been eating well for months.
Accommodate it. Offer softer, cooler versions of their usual foods. Do not pressure them to eat textures that cause pain. The regression is temporary — it resolves within 1 to 2 weeks of the molar breaking through, and the previous texture tolerance returns. Do not interpret this as new picky eating or a developmental regression.
Breastfeeding and Bottle Feeding Adjustments — Practical Changes That Help
Breastfeeding Adjustments
- Cold teether before feeding: 3 to 5 minutes on a fridge-cold (not frozen) teething ring reduces acute gum inflammation and slightly numbs the area before nursing; this is the single most effective pre-feed intervention for reducing biting and discomfort during nursing
- Adjust position to reduce pressure on erupting teeth: Experiment with different nursing positions during specific eruption stages; during lower incisor eruption, a position where the lower jaw is less extended may be more comfortable; during upper molar eruption, lying-down nursing may reduce gravity-related pressure on the upper gum
- Shorter, more frequent feeds: Brief, frequent feeds are often better tolerated than long sessions during active teething — the baby gets nutrition and comfort without the extended jaw position that builds discomfort over a long feed
- Apply counter-pressure before and after feeding: Gently rubbing a clean finger along the erupting gum before latching provides counter-pressure that reduces discomfort and can calm a distressed teething baby enough to latch
- Ensure a deep latch every time: A shallow latch during teething increases the risk of biting and increases the baby's gum discomfort during nursing; a deep, wide latch with as much breast tissue as possible in the baby's mouth distributes jaw pressure more widely and reduces the contact with the erupting area
Bottle Feeding Adjustments
Teething affects bottle feeding too — particularly during molar eruption, when the jaw movement involved in bottle suckling activates the molar gum area. Less dramatically than for breastfeeding, but meaningfully.
Flow rate adjustment
A faster-flow teat reduces the amount of
sucking effort — and therefore the jaw
pressure — required to get milk. During
teething, moving up one teat flow rate
temporarily can make bottle feeding
noticeably more comfortable and reduce
the frequency of feed refusals.
This is a temporary adjustment — once
the tooth has broken through and the
acute discomfort settles, return to
the previous flow rate to maintain
appropriate feeding pace and satiety
cue responsiveness.
Cool the bottle and teat
Formula should never be given cold
from safety and palatability perspectives
— but offering formula at room temperature
(rather than warm) during teething reduces
the vasodilatory effect that warm milk
has on gum tissue. The difference between
body temperature and room temperature
formula is modest but can help.
Alternatively, offering a cold teether
for 3 to 5 minutes before a bottle feed
reduces the gum inflammation that makes
suckling uncomfortable — the same
pre-feed principle as for breastfeeding.
Teething Products — What Works, What Doesn't, and What Is Dangerous
| Product | Evidence and Safety | Recommendation |
|---|---|---|
| Chilled (fridge-cold) silicone teething ring | The most evidence-aligned teething comfort measure; cold reduces gum inflammation and provides brief vasoconstriction-mediated numbness; silicone rings are non-toxic, easy to clean, and durable; widely recommended by NHS, RCPCH, and dental professionals | ✓ Recommended. Never freeze — frozen surfaces can damage delicate infant gum tissue. Clean and refrigerate between uses. |
| Sugar-free teething gel (Dentinox, Bonjela Baby) | Contains a mild topical anaesthetic (lidocaine or similar) that provides brief localised gum numbing (15–30 minutes); relief is real but short-lived; NHS acknowledges as a reasonable comfort measure for significant discomfort. Critical: only use products labelled for infant teething; adult Bonjela contains choline salicylate which is contraindicated in children under 16; only Bonjela Baby or equivalent infant-specific formulations are appropriate | ✓ Acceptable from 5 months for significant discomfort. Use sparingly. Always check the product is infant-specific. Do not exceed stated dose frequency. |
| Paracetamol (Calpol/infant paracetamol) | Appropriate for genuine teething pain that is causing significant distress — particularly during molar teething. Age-appropriate paracetamol from 2 months (with medical guidance) or from 3 months without prescription. Dose by current weight. Minimum 4-hour intervals. Maximum 3 doses in 24 hours for teething without medical supervision. | ✓ Appropriate for significant teething pain. Not needed for mild discomfort. Always dose by weight. |
| Ibuprofen (Nurofen for Children, Calprofen) | Has anti-inflammatory properties in addition to analgesia — making it particularly suited to teething pain (which has an inflammatory component). From 3 months and over 5kg. Dose by weight. 6 to 8-hour intervals. Can be alternated with paracetamol for significant pain. | ✓ Appropriate from 3 months/5kg. Anti-inflammatory action makes it well-suited to teething. Dose by weight. Not on an empty stomach. |
| Amber teething necklaces | No credible clinical evidence of efficacy. The proposed mechanism (succinic acid absorbed through skin reducing inflammation) has no pharmacological basis at the concentrations that amber could possibly release through skin contact. Documented strangulation and choking deaths in the UK and internationally. RCPCH, Trading Standards, BSPED, and NHS all explicitly warn against them. | ✗ Do not use. Ever. The risk of strangulation or choking is real and documented. No evidence of benefit. |
| Homeopathic teething powders / granules | No clinical evidence of efficacy beyond placebo. Some products investigated by Trading Standards were found to contain unexpected active ingredients not listed on the label. Not regulated as medicines in the UK. Not recommended by NHS, RCPCH, or dental professional bodies. | ✗ Not recommended. No evidence of efficacy; variable composition. |
| Frozen teething items (frozen rings, frozen flannel, frozen fruit) | Frozen surfaces are too cold for infant gum tissue — temperatures below approximately 5°C can cause tissue damage to the delicate gum mucosa of a young infant. Fridge-cold is the appropriate temperature range; freezer-cold is not. | ✗ Do not freeze teething items intended for infant gum contact. Fridge-cold only. |
| Clove oil / natural oils applied to gums | Clove oil (eugenol) can be toxic to infant gum tissue at concentrations that are easy to inadvertently apply; it is not formulated or licensed for infant gum use; dilution to safe levels is difficult to control at home; not recommended for infants. | ✗ Do not apply to infant gums. Use licensed infant teething products only. |
Frequently Asked Questions
Teething disrupts feeding through gum pain and altered jaw mechanics. The type of disruption depends on which teeth are erupting — incisors primarily affect breastfeeding mechanics via altered jaw pressure; first molars (13–19 months) cause the most dramatic eating disruption because the large flat molar surface creates pressure across a wide gum area and chewing solid food activates exactly the inflamed tissue that is erupting. Short-term feeding reduction during active teething is normal and temporary. Milk is usually better tolerated than solids during the most acute phase — offer more breast or formula, soft cold foods, and allow texture preferences to guide which foods to offer.
Biting is almost always mechanical, not intentional. During active suckling with an effective latch, the tongue covers the lower gum — it is anatomically impossible to bite while actively nursing. Biting happens at the end of a feed when milk flow slows and the jaw relaxes, or at the start when latching. The management protocol: offer a cold teether for 3–5 minutes before feeding; watch for end-of-feed signals and de-latch proactively before the jaw closes; de-latch immediately and calmly at any bite — no dramatic reaction; end the feed briefly; offer the cold teether. Consistent calm de-latch resolves biting for most babies within 3–7 days.
Cold foods are the most effective food-based comfort — chilled cucumber sticks, cold mango slices, yoghurt from the fridge, chilled puréed fruit. Cold reduces gum inflammation and provides brief topical numbing. Firm foods that require gentle gnawing pressure provide counterstimulation — competing sensory input that reduces pain perception. Avoid acidic foods (tomato, citrus) that irritate inflamed gum tissue, very salty foods, very hot foods, and sticky chewy foods during the most acute period. Cold teething rings (fridge-cold, never frozen) before meals reduce gum inflammation enough to make feeding more comfortable.
Yes — entirely normal and expected. First molars (13–19 months) are the most painful teething episode for most babies. A toddler who was happily eating lumpy mashed or soft finger foods may temporarily want only smooth purées or refuse solids almost entirely. Chewing activates the inflamed molar gum — the regression is a rational pain-avoidance response. Accommodate it fully: offer softer, cooler versions of usual foods. Do not pressure the child to eat painful textures. The regression resolves within 1 to 2 weeks of the molar breaking through and the previous texture tolerance returns. This is not picky eating.
No. There have been documented strangulation and choking deaths associated with amber teething necklaces in the UK and internationally. The RCPCH, Trading Standards, BSPED, and NHS all explicitly warn against them. Beyond the safety risk, there is no credible clinical evidence that amber reduces teething pain — the proposed mechanism (succinic acid absorbed through skin) has no pharmacological basis at the concentrations possible through skin contact. Do not use amber teething necklaces. Safe alternatives: chilled teething rings, cold foods, sugar-free infant teething gel, and age-appropriate paracetamol or ibuprofen for significant pain.
Use a sugar-free gel formulated specifically for infant teething — Dentinox Teething Gel or Bonjela Baby Teething Gel are the most widely available in the UK and are licensed from 5 months. Both contain a mild topical anaesthetic providing brief, localised numbing. Critical: do not use adult Bonjela on children — adult Bonjela contains choline salicylate which is contraindicated in children under 16. Always check the product label confirms it is for infants. Homeopathic teething powders and granules have no clinical evidence of efficacy and are not recommended.
No. Teething does not cause fever above 38°C. Clinical studies consistently find that teething produces at most a very slight elevation in baseline temperature (0.2–0.5°C) — not a clinically significant fever. A temperature of 38°C or above must always be investigated as possible infection. In a baby under 3 months: any fever of 38°C or above = seek immediate medical assessment. In older babies: a fever at or above 38°C alongside teething symptoms requires assessment as infection, not attribution to teething.
Not necessarily — biting during teething usually resolves with consistent management within 3 to 7 days of applying the calm de-latch protocol. Most babies go through a biting phase and then stop. If biting is causing significant pain, injury, or anxiety around nursing — the decision to wean is yours to make and is entirely valid. There is no correct point at which to wean. Contact the National Breastfeeding Helpline (0300 100 0212, free, 9:30am–9:30pm daily) for support from a trained counsellor if you want help managing biting without weaning.
The World Health Organization recommends exclusive breastfeeding for the first 6 months, then continued breastfeeding alongside iron-rich complementary foods up to 2 years of age or beyond — timing that lines up closely with when teething typically begins. WHO's complementary feeding guidance is explicitly responsive: following the child's cues on amount and pace rather than a fixed schedule. This is why a temporary dip in intake or a return to softer textures during a teething flare should be accommodated, not fought — it's the same responsive-feeding principle applied to a short-term discomfort, not a reason to withdraw foods or pause complementary feeding progress.
Log teething symptoms, feeding changes, and milestone dates —
so you always know which phase you're in.
Teething runs for two and a half years across multiple eruption stages — each with its own feeding disruption pattern. Lunara lets you log milestone dates (including first tooth!), note feeding changes, and track which symptoms correlate with which stage — giving you a clear picture of your baby's pattern and the information you need for health visitor and GP conversations. Free to start.