Teething and Biting

by Anne Smith, IBCLC

Many new mothers tell me that they plan to nurse their babies for six months, or until they get teeth. With the AAP (American Academy of Pediatrics) now recommending nursing for at least a year, it makes sense to re-examine our ideas about breastfeeding babies with teeth. I have had two babies out of six who got teeth at four months, so if I had weaned them at that stage, they wouldn't have been able to nurse for long at all.

Most babies will cut their first teeth sometime around six months. Usually the first teeth come in fairly easily, accompanied by a lot of drooling and chewing everything he can get his hands on. Cutting teeth may make your baby's gums swollen and sore, and he may chew on the nipple just as he chews on everything else to relieve his discomfort. The first molars, cut at about a year, tend to cause the most discomfort. The very first tooth, and the second one that will follow it soon afterwards, will be bottom front teeth. It will probably be months before the matching top teeth come in, so even if he tries, he can't really bite effectively (closing the top teeth against the bottom teeth) for a while. That doesn't mean that a bite won't be uncomfortable with one or two bottom teeth, however. We'll discuss why some babies bite, how to prevent biting, and what to do if you do get bitten.

By the way, baby's teeth come in a particular order, but at widely varying ages and intervals. Early teething doesn't mean your baby will be advanced intellectually, and late teething doesn't mean he'll be slow in other areas.

Many babies never ever bite at all, and most who try it once usually respond to your startled reaction by never doing it again. With some babies, it is a little harder to break the habit, but all babies, no matter how old, can learn not to bite.

A baby who is latched on and nursing properly cannot bite the breast. If the nipple is positioned far back in his mouth, and his lips and gums are positioned about an inch behind the nipple on the areola, then his tongue will cover his gums, between his lower teeth and your breast. If he is actively nursing, he can't bite -- and if he is biting, he can't be actively nursing at the same time. He should never really close his teeth on the breast while nursing, but his upper teeth will occasionally cause an imprint on the areola due to slight pressure exerted during feedings. This usually occurs with older babies, and is seldom painful. If it is uncomfortable, you can take him off and re-latch him. That will usually take care of the problem.

Here are some tips on how to prevent biting:

• Check to see that he is latched on correctly. Make sure his mouth is open wide, and pull him in closely so the nipple is far back in his mouth. Sometimes after he has been nursing awhile, he gets sleepy and the nipple pulls back in his mouth, and he may bite reflexively as he feels the nipple slipping away.

• Biting is most likely to occur when your baby is full and loses interest in nursing, toward the end of a feeding. Watch him closely for signs that he is ready to stop the feeding, so you can take him off before he bites.

• Sometimes babies bite to get your attention. As he gets older, you tend to talk on the phone, read, or watch TV while nursing instead of focusing on your baby. Try to maintain eye contact, speak to him, and touch him while he is nursing. This way he will know he has your attention, and he will be less likely to bite. You will also be more likely to recognize signs that he is ready to end the feeding if you are paying attention to him.

• Watch closely for cues that he is done with a feeding. Some babies will start to fidget, pull off the breast and look around, or even tense their jaws right before they clamp down. Learn to read his signals.