Published: 2026-08-25 | Category: Teething, Baby Health

Your baby is fussy. Chewing on everything. Slightly warm. A little runny nose.

Teething or a cold? Every parent has stood in this exact spot, squinting at a red-faced baby and trying to decide whether to call the pediatrician.

Here's the truth: teething and illness can look frustratingly similar — but there are real, evidence-based differences. Knowing them can save you from unnecessary worry and from missing a genuine illness.

First, What the Experts Say

The American Academy of Pediatrics (AAP) is clear: teething does not cause high fever, diarrhea, vomiting, or a serious runny nose. Studies tracking teething babies found only mild symptoms — slight temperature elevation, increased drooling, irritability, and chewing — that typically appear a few days before a tooth erupts and fade quickly after.

If your baby has a fever above 100.4°F (38°C) or symptoms that last more than a few days, that's not "just teething." That's illness — most commonly a viral infection.

The 8 Signs to Compare

1. Temperature: The Most Reliable Clue

Teething can cause a slight temperature bump as gums become inflamed. But a true fever — over 100.4°F — points to infection. If the fever lasts more than 24–48 hours, call your pediatrician.

2. Runny Nose: Clear vs. Persistent

A mild, clear runny nose can appear with teething (excess saliva irritates the nasal passages). But:

• Teething: Clear, light, short-lived
• Illness: Persistent congestion, thicker discharge, lasting several days, often with sneezing and coughing

3. The Chewing Test

Teething babies chew constantly — hands, toys, crib rails, anything. The behavior is driven by the pressure needed to help the tooth break through the gum.

Sick babies may chew a little, but they're usually more lethargic, clingy, and uninterested in play. A baby who's actively chewing is more likely teething than sick.

4. Drooling & Chin Rash

Excessive drooling is a classic teething sign — expect up to 3–5× the normal saliva. This often causes a mild chin or cheek rash.

Illness doesn't typically cause sudden excessive drooling unless there's a sore throat or mouth issue (like hand, foot, and mouth disease — which comes with telltale blisters).

5. Appetite: Picky vs. Refusing

• Teething: Babies often eat a little less (sore gums make chewing uncomfortable), but they still drink and take some food. Offer soft, cool foods like yogurt, applesauce, or chilled purees.
• Illness: A sick baby may refuse all fluids — which is a bigger concern. Dehydration risk is real, especially with fever, vomiting, or diarrhea.

Red flag: If your baby refuses fluids for more than a few hours, or shows fewer wet diapers than usual, call your pediatrician.

6. Ear Pulling: Context Matters

Ear pulling is one of the most confusing signs — it happens with both teething and ear infections.

• Teething: The pain radiates from the jaw/cheek area, so babies tug at their ears or cheeks. Usually intermittent, and the baby otherwise seems fine.
• Ear infection: Ear pulling plus fever, fussiness that worsens when lying down, trouble sleeping, and sometimes fluid draining from the ear. If ear pulling persists more than a day or comes with a fever, get it checked.

7. Sleep Disruption Patterns

Teething often causes brief night wakings and early-morning fussiness — usually a few days before the tooth erupts, then it settles.

Illness disrupts sleep more severely and continuously, often with cough, congestion, or fever keeping the baby awake through the night for multiple nights in a row.

8. Duration: Days vs. Weeks

Teething symptoms come in waves: a few rough days, then relief, repeating as each tooth arrives. Most symptoms resolve within 3–5 days per tooth.

Illness typically follows its own course — colds last 7–10 days, and if symptoms persist beyond that or keep getting worse, it's time for a doctor visit.

When to Call the Doctor Right Away

Don't wait if your baby shows any of these:

• 🔴 Temperature over 100.4°F (38°C) for a baby under 3 months — call immediately
• 🔴 Fever lasting more than 48 hours
• 🔴 Refusing fluids or fewer wet diapers (dehydration)
• 🔴 Diarrhea or vomiting lasting more than 24 hours
• 🔴 Blisters, sores, or rash in or around the mouth
• 🔴 Difficulty breathing, lethargy, or unresponsiveness
• 🔴 Ear pulling with fever lasting more than a day

Trust your gut. You know your baby best — if something feels off, a quick call to the pediatrician is always the right move.

How to Soothe True Teething Discomfort

If it is teething, these are the safest, most effective comfort strategies:

1. Chilled (not frozen) silicone teethers. The Mombella Mimi Mushroom Teether and 3-in-1 Clownfish Teether provide the firm-yet-gentle pressure babies crave. Refrigerate for 15–20 minutes before use.
2. A clean, cool washcloth — wet, wrung out, and chilled. Old-school and effective.
3. Gentle gum massage with a clean finger or a silicone finger toothbrush.
4. Extra cuddles and distraction — often the most underrated tool of all.
5. Pediatrician-approved pain relief — age-appropriate acetaminophen or ibuprofen only with your doctor's guidance.

What to Avoid

• ❌ Teething gels with benzocaine (FDA warning: risk of methemoglobinemia in babies under 2)
• ❌ Amber teething necklaces (choking/strangulation hazard, no proven benefit — AAP advises against them)
• ❌ Frozen-solid teethers (too hard for tender gums)
• ❌ Homeopathic teething tablets with belladonna (FDA warning)

Frequently Asked Questions

Can teething cause a fever?

Teething may cause a slight temperature rise — usually under 100.4°F (38°C). A true fever above that is a sign of illness, not teething. The AAP is clear on this point.

Can teething cause diarrhea?

Research hasn't confirmed a direct link. If your baby has diarrhea, treat it as a separate issue, watch for dehydration, and contact your pediatrician if it lasts more than 24 hours.

Can teething cause a runny nose?

A mild, clear runny nose can happen due to increased drooling. Persistent congestion with coughing or sneezing over multiple days is more likely a cold.

How long do teething symptoms last?

Typically 3–5 days around each tooth eruption — coming in waves as different teeth arrive.

My baby is 6 months old and has a fever of 101°F. Teething or sick?

Almost certainly sick. 101°F is above the teething range. Contact your pediatrician, especially if the fever persists.

When do babies typically start teething?

Most babies cut their first tooth between 6 and 12 months, though some start as early as 3–4 months. See our full teething timeline for what to expect month by month.

This article is for informational purposes only and is not a substitute for professional medical advice. If you're concerned about your baby's health, contact your pediatrician.

Products mentioned: Mimi Mushroom Teether · 3-in-1 Clownfish Teether · Baby Finger Toothbrush