Drooling is the excessive secretion of saliva in an involuntary manner, flowing outside the mouth ^[1]. The salivary glands of babies that started developing when they were in their mother’s womb advance a step further after birth causing them to drool excessively ^[2].

When do babies drool

Infants start salivating at two to four months of age that may last up to eighteen months or even two years ^{[1, 3, 7]}.

Why do babies drool

Infants drool as their mouth muscles are not yet developed in the first two years of their life, making them unable to swallow well. After their second birthday, their oral motor function gets better, gradually lessening and stopping the process of drooling ^[1,4]. Other responsible factors may include:

Mouthing: Your baby’s mouth, having a greater number of nerve endings in comparison to any other body part, leads him to put things into his mouth when he desires to get a feel of them^[5]. In this process, the amount of saliva he produces is often beyond his swallowing capacity ^[2].

Teething: Though drooling does not always indicate teething, it is one of the primary symptoms your little one shows when he is about to cut his first tooth. Other teething signs include red cheeks, ear pulling, and hand biting. ^{[6, 12]}.

Other causes for drooling

It might also result from a few health issues:

Common cold, infections of the upper respiratory tract, sore throat ^[14], and nasal allergies ^[4].
Tonsilitis (salivates a lot due to difficulty in swallowing) ^[15].
Reflux (the baby prefers throwing out the saliva as ingesting it gives a burning sensation in his throat) ^[8,9].
Oral and gum infections like thrush and gingivostomatitis ^[13,22].

If your baby continues drooling even after two years of age then it might be an indication of a neurological disorder like cerebral palsy ^[16], autism ^[17], and Bell’s palsy ^[11]or because of an undeveloped swallowing mechanism.

When to call a doctor

Apart from drooling if your baby has a fever, lessened appetite, restlessness, mouth sores and prolonged bad breath, consult your doctor as it might indicate some of the above health issues.

Can you stop drooling in babies

Though it is not possible to prevent the excessive secretion of saliva as it occurs because of a natural mechanism, you can take certain measures to maintain proper hygiene when your baby is drooling.

Ways to manage excessive salivation

Ensure cleanliness by bathing him daily and wiping the excess drool with lukewarm water. Pat his skin gently rather than rubbing it to prevent skin irritation ^[20].
Make him wear a bib to lessen possibilities of his clothes getting soiled, also reducing chances of rash formation. Do not tie the bib too tightly as it might cause discomfort to your kid, increasing the risk of strangulation.
Drooling pads can also be placed on the child’s bed or attached to a baby career to minimize chances of the baby’s and your clothes from getting stained.
Your baby’s rash from drool leading to skin irritation around his mouth, chin, neck and cheeks may be avoided by putting a cotton diaper under his chin, which helps in absorbing the saliva ^[20].
Apply a barrier cream on his chin to relieve him from skin irritation ^[19].
When your baby is drooling in sleep, keep his head slightly elevated by arranging the pillows appropriately to prevent choking. Children above one year can be made to sleep on their side as they are less prone to SIDS (Sudden Infant Death Syndrome) ^[21].
Apart from the drooling, much of the excessive saliva goes into the baby’s stomach, causing them to pass loose stools multiple times a day ^[18]. This in turn might lead to nappy rash ^[24]; so change his nappy as often as necessary to keep him dry as well as apply a barrier cream when changing him into a fresh diaper ^[23].
References +

Baby Drooling