Teething is a normal developmental milestone when an infant’s first teeth begin to push through the gums. Parents often notice an overlap between this process and common symptoms like congestion and coughing, leading to questions about a direct link. This article clarifies the relationship between teething and respiratory symptoms, providing guidance on how to distinguish between them and when to seek professional medical advice.
The Direct Answer: Teething and Respiratory Symptoms
Teething is a localized process involving inflammation of the gums and does not directly cause systemic symptoms. The physical act of a tooth erupting does not trigger a respiratory illness, such as a cold or the flu. Therefore, a persistent cough or significant nasal congestion is unlikely to be a direct result of teething alone.
The confusion arises because teething involves excessive salivation, commonly known as drooling. The substantial increase in saliva production means a large portion of this fluid is swallowed throughout the day and night. This surplus of saliva can accumulate at the back of the throat, triggering a mild post-nasal drip.
This irritation from the constant trickle of drool can lead to a slight, wet cough as the infant attempts to clear the sensation. The cough is usually temporary, intermittent, and tends to be more noticeable when the baby is lying down, especially during sleep or naps. This mechanism can mimic mild cold symptoms but does not involve the infection or inflammation of the respiratory tract seen in a true illness.
Differentiating Teething Symptoms from Illness
Distinguishing between a mild, drool-related symptom and a genuine infection requires careful observation of the nature and severity of the symptoms.
Fever
Teething may cause a slight elevation in body temperature, but this is typically a low-grade temperature below 100.4°F (38.0°C). A true fever, defined as a temperature at or above this threshold, should not be attributed to teething and usually indicates an infection.
Cough Quality
The quality of the cough provides another clue for differentiation. A teething cough is generally wet, mild, and shallow, caused by the throat clearing reflex due to swallowed saliva. In contrast, a respiratory illness often produces a more persistent, deep, or chesty cough, which may be accompanied by sounds like wheezing or a harsh barking sound.
Nasal Discharge
Nasal discharge also differs between the two causes. Teething may involve a minimal amount of clear, thin mucus related to the irritation caused by excess drool. A common cold or viral infection typically presents with sustained nasal congestion and a discharge that often becomes thick or changes color (yellow or green) as the illness progresses.
Demeanor and Duration
The baby’s overall demeanor and the duration of the symptoms are also telling indicators. Teething discomfort is usually short-lived, often lasting only a few days around the time a tooth breaks through the gum. While a teething baby may be irritable and fussy, they are usually still able to be comforted, will play, and maintain typical feeding patterns. Conversely, a baby with a true illness is often lethargic, difficult to console, may refuse to feed, and shows symptoms that persist beyond a few days.
Managing Teething-Related Congestion and Cough
Management focuses on simple, non-medicinal comfort measures, as the mild cough and congestion are caused by excess drool and minor throat irritation. Increasing the moisture content in the air can soothe irritated airways and help thin minor secretions. Using a cool-mist humidifier in the infant’s room, especially at night, is a safe and effective strategy.
For mild nasal congestion, parents can use a saline nasal spray or drops to help loosen mucus. Following the application of saline, a bulb syringe or nasal aspirator can be used to gently clear the nasal passages, particularly before feeding or sleeping. Keeping the infant well-hydrated with formula or breast milk is also helpful, as increased fluid intake naturally thins secretions and eases post-nasal drip.
It is important to keep the baby upright, especially during and immediately after feedings, to prevent the accumulation of swallowed saliva and mucus in the throat. Parents should avoid giving infants over-the-counter cold and cough medications, as these are not recommended for young children and will not address the underlying cause of a drool-induced cough.
Warning Signs Requiring Medical Attention
While mild, temporary symptoms are often related to teething, certain warning signs indicate the baby’s condition requires a medical evaluation.
Fever and Duration
A temperature of 102°F (38.9°C) or higher, or a fever of any degree lasting longer than 24 hours, suggests an infection unrelated to teething. Such a sustained fever requires prompt consultation with a pediatrician to determine the cause.
Immediate Concerns
Any signs of respiratory distress represent a medical emergency and should be addressed immediately. This includes difficulty breathing, characterized by:
- Fast breathing
- Wheezing sounds
- Flaring of the nostrils
- Retractions (where the skin visibly pulls in between the ribs or at the neck during inhalation)
A cough that is persistent, severe, or causes the baby trouble sleeping or feeding is also a cause for concern.
Other Red Flags
Other red flag symptoms include a consistent refusal to eat or drink, which can lead to dehydration. Unsoothable, high-pitched crying or extreme lethargy, where the baby is unusually sleepy or unresponsive, should prompt an immediate call to the healthcare provider. If symptoms like a cough, congestion, or fever last for more than a few days without improvement, seek professional medical guidance to rule out a more serious illness.