If your baby or toddler has disrupted sleep you may be tempted to blame teething – and you may be right. There’s no question that for some babies, teething involves discomfort. But studies suggest that teething may not be the huge sleep wrecker that parents assume it to be – and that many of the common symptoms that parents blame on teething may actually have nothing to do with those emerging pearly whites.

Here’s how to determine if teething is the real culprit, or if there are other causes for your baby’s sleepless nights.

Most babies begin teething between four and eight months of age, but order and timing are variable. Genetics and gender play a role in teething – early teething parents tend to have early teething children, and girls tend to teethe earlier than boys. Teeth usually emerge in pairs on the left and right side of the mouth, starting with the two bottom front teeth and proceeding from front to back, alternating between lower and upper jaws. Most children get four new teeth every four months and have all 20 of their baby teeth – 10 on top and 10 on the bottom – by the time they’re 2 ½ to 3 years of age.

There’s a common misconception that teeth actually “cut” through the gums as they emerge, but teeth don’t pierce or puncture the flesh at all. Gums actually move out of the way and create a pathway for new teeth as they push up – which is why there’s no bleeding

Studies on teething have yet to find a causal relationship between any specific cluster of symptoms and the emergence of teeth. Symptoms like drooling, gum rubbing, fussiness, decreased appetite for solids, mild temperature increases and wakefulness can sometimes be associated with the eruption of teeth but congestion, high fever, loose stools, cough, body rashes and decreased interest in liquids are not. Studies do suggest that teething related symptoms, if they are truly related to an emerging tooth will only appear for a few days prior to the tooth’s eruption, and for a few days afterwards. That means that if your child has symptoms for more than a few days and a tooth doesn’t appear it’s unlikely that teething is the problem.

If your child is clearly bothered by teething, of course you’ll want to do whatever it takes to comfort them and help them to get the rest they need. Offer cool teething rings and avoid choking hazards like frozen bagels and teething necklaces. Check with your pediatrician before giving your child over the counter pain medications, and call them if your child develops a fever or exhibits other symptoms of illness that could be unrelated to the teething.

If you’re not sure, start by assessing their daytime behavior. If your baby is behaving normally during the day, even if they’re drooling like a faucet or chewing everything in sight, it’s unlikely that teething is suddenly an issue at night. If you need more convincing look for red, swollen gums or the tip of a tooth. If you don’t see anything but are still not convinced, use the pick up test. If your child stops crying the second you lift them out of the crib they’re probably not in discomfort or pain.

Looking for changes in sleep patterns can also help you determine if teething is to blame for your child’s wake ups. Discomfort and pain causes wake ups at unusual times. Think about your child’s typical sleep patterns and compare them to what’s going on now. Does your child typically sleep for three hours at a stretch but is suddenly waking up every 20 minutes? If so, teething may be disrupting their sleep. If, on the other hand, your child has ingrained sleep associations like rocking or nursing to sleep and is waking up at the same predictable times or the same time frames (for example, every 60 to 90 minutes) you may be blaming teething when it’s actually the sleep association that’s waking them up. If the disruption lasts for more than three or four days you can bet that that’s the case, and you may want to work on gently teaching your child learn how to put themselves to sleep and back to sleep without your help.

Sweet dreams!

While your breasts were likely growing throughout your pregnancy, you will notice a dramatic shift in the two-to-three days following giving birth. Specifically, your breasts will likely grow another one-to-two cup sizes as they become engorged with milk.

Your breasts will potentially start to feel sore, swollen, and flushed. You will also likely begin to experience milk leakage for several weeks following your pregnancy, even if you’ve decided that breastfeeding is not right for you.

The size of your breasts will often go back down to what you were used to pre-pregnancy (or even smaller sometimes), assuming that you go back to your pre-pregnancy weight – which, remember, takes TIME.

While a baby pushing on your bladder in utero typically makes you feel like you need to go to the bathroom more frequently during pregnancy, the opposite can be true once you baby is born. Additionally, the large amount of pressure on a woman’s urethra during delivery can make going to the bathroom more difficult post-birth.

However, on the opposite side of the spectrum, a pregnant woman’s Pelvic Floor muscles have largely weakened throughout her pregnancy (unless you’ve been actively strengthening your pelvic floor muscles like I mentioned in this blog post). Weak pelvic floor muscles can lead to urinary incontinence and/or leakage because your body is no longer trained to stay “tight” in your lower half.

No matter what, it’s really important in the postpartum period to focus specifically on strengthening your pelvic floor muscles (again see this blog post for details), especially if you didn’t do so during pregnancy. Also, be on the lookout for a potential urinary tract infection (UTI), which many women notice after birth, and can cause a burning sensation when you’re going to the bathroom.

Thanks to the extra hormones that flow through our bodies during pregnancy, our skin can have a myriad of reactions. Some women experience heavy acne, while others may have the “pregnancy glow” with a pinkish tone appearing on our skin, especially around the eyes.

Right after we give birth, our skin can go through a massive adjustment period. If you experienced acne or other skin irritations during pregnancy, typically this will start to clear up quickly and go back to normal. Those women that experienced the pregnancy glow thanks to estrogen creating more collagen and elastin in the body, thus making our skin more youthful looking, will also experience their skin going back to normal … which can look like dry, lackluster skin.

Due to the massive drop in estrogen that occurs when a woman gives birth, many women notice that their skin starts to look and feel much more dry than it may have been when they were pregnant. This can appear as a red rash around their mouth and chin.

To combat dry skin, be sure to stock up on clean, organic face oils to help your skin during this transition period. My favorite oil to use is Living Libations Best Skin Ever Sea Buckthorne Face Oil. It’s amazing, and can be used for cleaning your face too which can also help tremendously if you’re struggling with dry skin. Remember that all lotion-based moisturizers will have unnecessary (often toxic) ingredients added, so it’s best to stick to one ingredient face oils instead.

Unfortunately, many pregnant women tend to have bad posture, especially in their third trimester. While this can lead to severe headaches – as I discussed in my most recent newsletter – this can also be a cause for uncomfortable back pain both during and following pregnancy.

On top of that, our core muscles are often significantly weakened post-pregnancy, which leaves our back muscles to do most of the work in carrying our body weight (and the extra weight of your new little one).

Just like your pelvic floor muscles, it’s important to focus on re-strengthening your core muscles post-pregnancy. But be careful what kind of exercises you’re doing. If your back pain is hindering your day-to-day activities or continues after several weeks, you may want to consider acupuncture or massage therapy to decrease pain.

While it’s not fun to talk about, constipation is quite often a part of the pregnancy journey for many women. Pregnancy hormones slow down the gastrointestinal system, as do many pain medications given to new mothers during birth. On top of that, an episiotomy or hemorrhoids that can develop during delivery may make bowel movements painful. Combine these all together and going to the bathroom can be no fun at all.

If constipation is something that you are experiencing following birth, it’s best to start using magnesium ASAP. Magnesium helps to naturally draw water into the colon, which can make bowel movements easier to pass. Also be sure you’re eating plenty of fiber-rich whole foods such as sweet potatoes, winter squash, fruit, chia & flax seeds, and whole non-gluten grains (like quinoa, buckwheat or rice). And be sure to keep your water intake high. Aim for at least half your body weight in ounces of clean, filtered water per day.

As I mentioned earlier, your body tends to take on a lot more water and blood than normal throughout pregnancy. This means your body will need to flush out this excess fluid following birth, which it typically tries to do fairly quickly.

Unfortunately, this can tend to take the form of excessive sweating in the days following birth. If this is something you’re experiencing, it tends to stop within a few weeks as your body begins to normalize, but I’d suggest keeping a fan nearby or leave your bedroom windows open to help you get a good night’s sleep.

Whether you work out regularly throughout your pregnancy or not, your body will likely feel weaker than it did prior to getting pregnant. During pregnancy a woman’s body creates more of the hormone relaxin to help relax the intrauterine ligaments and give baby a bit more space to live while in your growing belly. However, post-pregnancy often these ligaments are still in the relaxed/loose form which can result in weaker joints following pregnancy.

If your postnatal body is feeling weak, and your doctor has given you the go-ahead, start focusing on gently and slowly incorporating strength training and toning exercises to improve overall body strength and stability. This will also go a long way in protecting your structure as your baby grows heavier and you’re still carrying them around!

Sarah Jane Sandy is a functional nutritionist and women’s health expert. As a hormone imbalance survivor herself, Sarah is passionate about helping women fix their hormonal chaos, get pregnant, grow a healthy baby, and feel happy and content in their bodies. For over a decade she has been researching and studying how the food we eat and the way we live affects our fertility, pregnancy, hormones and post-birth. Sarah works with women all over the world remotely through her 1:1 consultations and online programs. You can read more about Sarah on her website, and find more information about she works with women to optimize health in all phases of life.