It so often happens that just when a baby starts to sleep through the night, you hit the dreaded “teething troubles” or your baby gets poorly with a bug. You might need to give a bit more TLC during the night at these times, but that doesn’t mean that any progress your baby has made with independent sleeping has to go out of the window.

For many babies this period of extra need is temporary, and the time spent helping your baby to feel comfortable is well invested – as they’ll ultimately sleep better. You should not feel bad about giving your baby lots of attention if they are poorly in the night, as really you have little choice in the matter! Babies will simply not sleep if left in discomfort, and leaving them to cry is not only unkind but is also unsafe and will lead to them developing an unhappy association with the cot.

The most common baby ailment is teething. Although a natural process and not an illness, teething can cause pain and general discomfort. Babies typically cut their first tooth at around 6 months old, but for some this might not happen until much later. Some babies cut their teeth earlier than this, and some are even born with some teeth. If you are not sure whether your baby is teething, the symptoms are; red and sore looking gums, your baby wanting to chew on everything, excessive dribbling, red cheeks, diarrhoea/loose stools, ear pulling, blocked nose, and babies being generally quite irritable.

Please note that some of these symptoms can be indicators of more serious illnesses, so if your baby has a temperature [above 38C or 100F] or seems very unwell or has a different cry, you should always seek medical advice.

Not all babies suffer during teething, but many do, and the discomfort of teething is invariably much worse during the night.

It’s important to realise that there are measures which you can take during the day, which will help your baby with night time teething. First of all, make sure that they have lots of opportunity to bite and chew. Then if you baby is old enough, encourage them with finger foods, such as crusty bread, bagel and toast which has been allowed to cool and go soft but tough. Because the cold has a numbing effect, keep a teething ring as well as whole peeled or scrubbed carrots in the fridge [never the freezer!] for them to chew on. Do not discourage your baby from putting safe toys etc. into their mouths, as any kind of biting is helpful with teething.

When babies are teething they tend to drool and this often leads to the skin around the chin and neck to become very chapped and sore. To help with this you should change bibs frequently, or use soft dry muslin cloths. After meals and drinks use warm water and soft dry cotton cloths to clean them rather than wipes that might sting. Don’t forget to clean and dry in the soft skin folds under the chin, where food and moisture can easily become trapped, and use a gentle barrier cream here to protect them even further.

If you notice that your baby is pulling at their ears, this is often a sign of discomfort and can indicate inflammation within the ear. This is common during teething, but to be safe, you will need to visit your GP who will establish the cause of the pain and then recommend a suitable painkiller. If the pain is cause by bacterial infection and not just teething, they may prescribe an antibiotic.
 
If your baby is unwell at bedtime and is old enough to have medication, you should follow your normal bedtime routine as closely as possible, being aware that your baby may be irritated at being handled. Before bath time you might consider giving a dose of infant Paracetamol or Ibuprofen to ensure that they are pain free and have no raised body temperature as they go to sleep. Many parents prefer to give Ibuprofen at bedtime, as it is long acting but needs to be taken when there is something in baby’s tummy and then if a second dose of painkiller is needed during the night; give Paracetamol, which is gentler on an emptier stomach. If you are intending to give your baby medication of any kind, you should always discuss it beforehand with a pharmacist, doctor or health visitor.

After bath time, offer a bedtime feed but do not be too stressed if your baby refuses it or doesn’t take it all. If they are poorly, they are unlikely to wake up hungry – especially if they are over 6 months old. If your baby usually self settles, you should allow them to go to sleep without help, as usual. Unnecessarily rocking them to sleep can become a difficult habit to break once they are better.

If your baby wakes in the night and is clearly unwell, you should go to them and pick them up and offer a drink of water [not milk if they’ve already dropped their night feeds.] These actions alone can help to unblock the nose and the tiny tubes connecting the back of the nose to the ears, thus helping your baby to feel more comfortable. If he or she continues crying, and/or feels hot, you should offer a dose of infant painkiller. You then need to remain close by until your baby is calm and settled. You should avoid bringing your baby into bed with you if they are poorly and especially if they have a high temperature. It is much safer for you to go and sleep in their bedroom instead.
It usually takes two or three consecutive nights of your baby coming into your bed; being given a night feed again or being rocked to sleep, for instance, for this behaviour to become a habit again.

It will do no harm to relax the usual rules around bedtime when babies are genuinely unwell. As soon as they are better however, you need to allow them to self settle again at the start of the night, drop the night cuddles and let them get back to sleeping as they did before the illness.