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How can babies get relief when teething?
Q: My 5-month-old twins are now teething. They have small mouths so the chew-teething toys are big for them. We have tried gum-soothing gel and infant pain reliever, but there has been very little relief. We do rub their gums, but they'd rather keep their own hands in their mouths. Any suggestions?
A: Teething can make babies quite fussy. Babies typically start teething between 4 and 7 months with the first bottom two teeth, followed four to eight weeks later by the first top four teeth. On it goes until 3 years of age, when most children have all 20 baby teeth. With twins, that's a lot of teething for you over the next couple of years!

Typical symptoms of teething include drooling, chewing on toys and hands, fussiness and loss of appetite. You're already taking most of the recommended steps to relieve your babies' discomfort. Letting them chew on things can help relieve their discomfort and help the teeth erupt through their gums. Chewing on their own hands is fine, as long as you wash them frequently. Rubbing their gums with your finger is OK if you wash your hands well. Pacifiers and teething toys are good, too. For safety, be sure they're one piece to prevent choking on detachable parts. And don't tie them around your babies' necks, which could strangle them.

Some babies prefer the pacifier or teething toy cooled in the refrigerator. A clean damp washcloth placed in the freezer for about 30 minutes can also be a good teether. Once their teeth have erupted, don't use the fluid-filled teething rings; the teeth can puncture them and the liquid may not be safe. You can also give your babies hard food to chew on, such as teething biscuits or frozen bagel wedges. Just watch them very closely to make sure they don't choke on any pieces that may break off. It's usually a matter of trial and error to figure out what works best.

If your babies are still uncomfortable with teething, you can use an over-the-counter teething gel that numbs their gums when you rub it on. Pain medication such as acetaminophen or ibuprofen (after 6 months of age) may also be helpful. Consult your pediatrician about the right dose. Don't give your baby aspirin because it can cause Reye Syndrome and brain damage. Also, if your babies are drooling a lot, clean their faces often to prevent a rash.

Many parents believe that teething causes fevers and diarrhea, but studies have shown this is generally not the case. If your babies develop a fever, diarrhea or other signs of illness, be sure to contact their doctor to evaluate them for a possible illness.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician