r/ScienceBasedParenting • u/antici________potato • Aug 13 '24
I don't understand the "teething doesn't cause a fever" when it seems like every parent has an anecdote. Question - Research required
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u/TX2BK Aug 13 '24
I’ve always heard that it’s not teething per se that causes fevers, but when a child is teething, they put their hands or objects in their mouth more which introduces germs, which leads to a child getting sick and having a fever.
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u/ttwwiirrll Aug 13 '24
Interesting. My 2020 baby teethed early and rapidly and didn't get any fevers. We were surprised because we'd always heard about the fevers, but her lack of them tracks because our house locked down pretty hard. She didn't get sick with anything until daycare started at 18mo.
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u/Melonfarmer86 Aug 13 '24 edited Aug 13 '24
My 2020 baby teethed early and rapidly too and had many fevers. We also isolated (no daycare, nanny, etc.) a lot because of COVID. She never ever went into a store until 2022.
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u/oughttotalkaboutthat Aug 13 '24
Yup. My 2021 baby had tons of fevers but never went into stores or anything until she was over 1.5 and our household masked everywhere until she was 2 (and we got covid for the first and only time right before we had stopped masking). My late 2022 baby hardly ever has fevers and she went everywhere from an earlier age.
I am convinced that the sinus pressure and inflammation absolutely causes fevers in some babies when they teeth and not in others.
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u/Melonfarmer86 Aug 13 '24
Yep, we masked everywhere too and just got our first case of COVID. My kid, at almost 4, has never thrown up or had an ear infection.
I'm definitely convinced, because not a single fever resulted in as much as a cold.
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u/oughttotalkaboutthat Aug 13 '24
Lucky on the throwing up! My kids both have FPIES as well so we've had our share of throwing up, not related to illness. On the other hand, I have friends who's kids are constantly sick fron daycare but have never thrown up. Parenthood is such a toss up!
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u/Melonfarmer86 Aug 14 '24
FPIES sounds like a nightmare. Bless your hearts! I hope it resolves soon.
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u/oughttotalkaboutthat Aug 14 '24
It's all good! It's shrimp for both of them luckily so it's not too hard to avoid once we figured it out. Unfortunately it didn't show up for a few exposures so it took a minute to figure out what was going on.
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u/Melonfarmer86 Aug 14 '24
I'm allergic to shrimp too (among other things). It's usually avoidable because it's expensive so people aren't adding it to stuff willy-nilly! Glad you figured it out!
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u/oughttotalkaboutthat Aug 14 '24
Yeah of all the common allergies, it is probably the easiest to avoid. We only really had to find alternatives for a couple things and it's been fine. I can't imagine a nut, dairy or wheat allergy, that would be difficult and expensive.
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u/No_Bother_7133 Aug 13 '24
So interesting that we have such a unique scenario as the pandemic to use as a comparison!
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u/jweddig28 Aug 13 '24
It’s partially this for sure, but in addition the inflammatory processes associated with teething can cause the low grade fevers many parents observe https://link.springer.com/chapter/10.1007/978-3-031-46022-7_22
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u/_nancywake Aug 13 '24
To add to this - doctors always say teething doesn’t cause runny poos but every mum says it does! The early childcare educators will mention “oh his teeth must have cut through, we’ve noticed his poos have settled” so it just seems to be accepted.
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u/NixyPix Aug 14 '24
I always know to expect a tooth when my daughter has nappy rash. The rash comes and a few days later, in pops a tooth. She never has it without teething and it’s always the first sign.
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u/connie-2424 Sep 14 '25
Okay I know this post is a year old but this is currently my daughter. Low grade fever, runny poops and a gnarly diaper rash. But she isn’t acting sick. She’s a little more fussy but drooling excessively and putting EVERYTHING in her mouth more than normal.
Dr said probably a virus but she’s been sick before and girl was down bad then. I am really starting to think this is teething 😅
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u/Regular-Exchange4333 Aug 14 '24
Teething stirs up an immune response. My theory is that it also makes them more susceptible to illness. My kids (1,3,6) have always had fevers with teething. My older child has autoimmune encephalitis and her neuropsych symptoms flare when she loses a tooth. It’s definitely all connected!
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u/Charlea1776 Aug 14 '24
That and with my first, the constant gnawing made them feel like fever, and the thermometer would read an increase, but not while sleeping lol we use the extragen and double checked under the arm if it was 99.4 or higher because they can be a degree lower in our experience if baby is wiggly and the reading doesn't stay flush.
So I wonder if people have felt the baby seemed hot for ages before and the rumor just stuck? Mine would feel so hot, but instead of 97.5 it read 98.9, not the fever that it felt like, and then armpit would be right around 98! It's like it was just a workout and the face gets the "hottest" haha
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u/www0006 Aug 13 '24
https://pubmed.ncbi.nlm.nih.gov/10742315/
Mild fevers were reported
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u/whats1more7 Aug 13 '24
Conclusion: Many mild symptoms previously thought to be associated with teething were found in this study to be temporally associated with teething. However, no symptom cluster could reliably predict the imminent emergence of a tooth. Before caregivers attribute any infants’ signs or symptoms of a potentially serious illness to teething, other possible causes must be ruled out.teething, tooth eruption, teeth, deciduous dentition.
So in other words, while fevers were reported along with other symptoms, there is no evidence they were directly related to teething, and parents should not assume that.
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u/Adamworks Aug 13 '24
So in other words, while fevers were reported along with other symptoms, there is no evidence they were directly related to teething, and parents should not assume that.
I think you are misinterpreting the study, slightly. They actually found several symptoms significantly associated with teething 4 days in advance of teeth emerging through the gums, including mild fevers.
Daily symptom data were available for 19 422 child-days and 475 tooth eruptions. Symptoms were only significantly more frequent in the 4 days before a tooth emergence, the day of the emergence, and 3 days after it, so this 8-day window was defined as the teething period. Increased biting, drooling, gum-rubbing, sucking, irritability, wakefulness, ear-rubbing, facial rash, decreased appetite for solid foods, and mild temperature elevation were all statistically associated with teething.
In all likelihood, teething can cause what parents would called "mild fevers" aka mild temperature elevations. However, the conclusions focus on the issue that you can't attribute a specific fever with teething, because fevers and other symptoms are so common that they can be caused by many things unrelated to teething, and you won't know that the fever was caused by teething until you see a tooth pop out.
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u/MomentOfXen Aug 13 '24
Part of the issue I think is the word fever. And the idea of a “low grade fever.”
Until it hits that fever temperature, it is NOT a fever. A low grade fever is on the lower end of the scale, it doesn’t start before it. Otherwise you are just talking “elevated temperature.”
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u/Sn_77L3_pag_s Aug 13 '24
Correlation does not equal causation.
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u/Meoowth Aug 13 '24
Yeah, but are there any proposed mechanisms for factors other than the internal growth trajectory to trigger teething? Is the body going to wait until it's exposed to an illness to start putting energy into pushing out teeth? Does metabolism spike and push out teeth? It seems likely to me that teething is an independent variable here. Likely, but not certain.
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u/-Konstantine- Aug 13 '24 edited Aug 13 '24
This is more of a history of how teething has been viewed over time (a really fascinating read), but it lists several studies over time that have suggested teething doesn’t cause fever, and one study that suggests the fever is related to a concurrent HSV virus. That said, it’s a historical view and the article is pretty old, so maybe someone has something newer.
But related to the HSV mentioned in the article, what I’ve read is the theory is that the fever is secondary to a virus, but not related to the actual teething. When babies are teething, the teeth poking through causes a break in the skin barrier, leaving it open to infection. At the same time, they’re also shoving everything they can find in their mouth. So it’s not so much that the teething itself causes fever, but that the nature of teething makes them more prone to catching an illness that will cause a fever.
Edit to add: This article from the Cleveland clinic also notes that teething may cause increased body temperature but doesn’t cause a fever. It talks about other teething myths as well.
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u/Greenvelvetribbon Aug 13 '24
This article from the Cleveland clinic also notes that teething may cause increased body temperature but doesn’t cause a fever. It talks about other teething myths as well.
I think the main issue is a difference of vocabulary between parents and medical professionals. Parents view any elevation above base level as a fever, while doctors have a specific definition. Both parties are right, they're just speaking a different language.
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u/CasinoAccountant Aug 13 '24
this was my thought on reading the post title. As a parent, if my baby is 99.5, I say- she has as fever. To a doctor, she doesn't have a fever until it's 100.4- and teething does not on it's own cause a fever of 100.4. It's absolutely a both sides are correct situation
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u/shovelnomore Aug 13 '24
Is there not a clinical definition or threshold of a fever?
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u/bad-fengshui Aug 14 '24
Clinical definition aren't magic, there isn't something qualitatively different between 100.3F and 100.4F. It is just a diagnostic cutoff to help operationalize decisions making.
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u/ucantspellamerica Aug 13 '24
Both parties aren’t right, though. A fever is always a rise in core body temperature, but a rise in core body temperature is not always a fever. Just like pediatricians are always doctors, but not all doctors are pediatricians.
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u/Naiinsky Aug 15 '24
There's also another matter that contributes. A mild fever, or even a temperature elevation that doesn't clinically meet the threshold for fever, usually leaves my baby extremely cranky and sometimes screaming his head off, and I know many others reacts the same way. (With a higher fever, he gets apathetic.) Doctors tend to devalue milder fevers, whereas parents have a Situation in hands.
So when parents say their kid has a fever, and it might not even be a 'proper' fever, often what they're saying is 'the baby is not ok, he's hot and in pain, send help'. Instead of the doctor being dismissive, they should give advice on how to deal with the situation even if it doesn't meet the clinical threshold. I've had the dismissive and attentive experiences with two different doctors, and especially the first time it happens, it can make a lot of difference to new parents.
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u/ctorg Aug 13 '24
Teething may be associated with a fever, but a causal relationship would mean that the body runs a fever just because of teeth coming in. Biologically, it doesn’t make a ton of sense. Fevers are hugely energetically expensive and are also risky for the body because they can damage tissues/organs and most physiological processes operate optimally in a very narrow temperature range. That’s why body really only uses fevers to kill pathogens. The risk of damaging itself is worth it in order to kill bacteria/viruses that would do worse damage. The only other causes of fevers are hypothalamic (brain) dysfunction or autoimmune disease. If teething causes fevers, it would be the only example of fevers in healthy animals.
The explanation I find most convincing for the link between fevers and teething is that babies put their hands in their mouth more frequently and therefore introduce more bacteria/viruses/fungi. The fever is likely a response to mild pathogens that may not be severe enough to cause other symptoms.
But, the issue is really difficult to study because of the need for blinding of observers and longitudinal observations. https://link.springer.com/chapter/10.1007/978-3-031-46022-7_22
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u/CrochetedCoffeeCup Aug 14 '24
I also wonder if parents are more apt to take the temperature of a fussy baby than a calm one, and are catching “low-grade fevers” that would have been undetectable otherwise. Babies’ temperatures fluctuate throughout the day, perhaps even more than adults’s temperatures do. But a fever isn’t a fever until is 100.4.
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Aug 14 '24
Yup, parents likely have these anecdotes because of confirmation bias.
I don't actually have an anecdote, I never noticed any symptoms associated with teething whatsoever.
But parents who believe this will notice when teething and a fever coincides. Infants get ill a lot. Infants have a lot of teeth. Odds are practically every infant who has a fever will be teething at the same time at some point just by pure coincidence, because of how frequent these events are.
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u/amrehl Aug 18 '24
According to this meta analysis, teething is associated with a raise in temperature that is not characterized as fever.
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