There is nothing more stressful than a crying baby. In fact, humans have similar physiologic responses (elevated heart rate, increased alertness) when they hear a baby cry as when faced with a physical threat. This reaction seems designed to prepare us to help the otherwise helpless baby. Yet many parents, especially brand new parents, feel ill-equipped to comfort their fussy baby. This brief article is designed to help parents and other caregivers respond to a crying baby with confidence and compassion.
When a baby cries, she is trying to communicate a need to us. The cry may be an alert to hunger, discomfort from a wet or soiled diaper, feeling cold, feeling lonely, or it might be a sign of pain or illness. Initially your baby has only one "word" in her vocabulary and this is her cry. She will use this frequently to communicate her various feelings. As time goes on, parents often notice subtle differences in the sound of a baby's cry to distinguish what the baby is trying to communicate. Until that happens, parents should consider the common complaints a baby has and use a "mental checklist" to see what the baby is trying to say. For example:
Parent: [thinking out loud] Is she hungry? Probably not, since she just ate an hour ago. Does she need a new diaper? Well, I don't smell anything and I don't see or feel anything on the outside of the diaper. I don't think she's too cold or too warm since she's adequately dressed. She was alone in this room sleeping, so maybe she's lonely. I'll pick her up and rock her so she'll calm down.
Baby: [stops crying]
Usually, a "simple" intervention such as feeding, changing a diaper or clothing, or holding or rocking the baby is all that the baby is requesting. The crying stops quickly after the appropriate need is addressed. Of course, when the baby cries again, you'll need to repeat the mental checklist to determine your baby's new message.
If the crying persists, however, you should look for symptoms that your baby is sick or in pain. These warning signs include a fever, recent poor feedings, persistent coughing or trouble breathing, persistent vomiting (not just spitting up), or evidence of an injury (arm caught in sleeve, swollen belly, hair wrapped around a digit, etc). Contact your pediatrician immediately if any of these symptoms accompany your newborn baby's crying.
By now, you've probably figured out what's making your baby fussy and have responded to her cry for help. If you haven't and your baby is still crying, don't panic! From 2 weeks of age until 12 weeks (peaking at 6-8 weeks of age), a healthy baby cries for an average of 2 hours per day. Some babies cry more than that and we describe them as having colic. Despite its name, colic is not an intestinal disorder - it seems to be an exaggerated response to the developmental crying that all babies experience. Whether your baby has colic or not, it's time to review the DOs and DON'Ts to calm a fussy baby.
DO swaddle your baby snugly. A tight swaddle will remind her of the peace and comfort of her mother's womb.
DO place your fussy baby in a side- or stomach-stimulating position. Babies will calm when in "fetal" position. Laying flat on her back is the opposite of how she wants to be when she's crying. Remember, this only applies to soothing a crying baby that is awake. Babies should always sleep on their backs to reduce the risk of Sudden Infant Death Syndrome.
DO rock or jiggle your baby. She may also enjoy being patted firmly or being placed in a vibrating bouncy seat or a swing. These movements remind her of the gentle but constant motion she experienced in mom's fluid-filled womb.
DO shush your baby loudly. White noise from fans or appliances also works. Make sure your noise is at least as loud as a vacuum cleaner (75 decibels) -- that's how loud it is right under mom's heart when she was in the womb.
DO let her suck on something, such as the mom's breast, a pacifier, a clean, dry finger, her own hand or finger. Babies feel soothed when sucking -- it's a reflex. This doesn't mean you should feed your baby every time she cries, only when she's hungry.
DON'T ignore a crying baby. She's trying to tell you something and needs your help. Remember, a newborn baby has almost no other way to communicate they have a need than to cry.
DON'T let her cry it out. A baby does not develop any self-soothing techniques until she is about 4 months old. Until then, she needs your help to settle down.
DON'T give your baby any medication for colic or fussiness unless instructed by a pediatrician. Some remedies, including over-the-counter or folk remedies are ineffective and some can be dangerous.
DON'T shake a baby. Ever. If you ever feel this urge, put the baby down in a safe place, move yourself away from the crying baby and call someone to help you.
Calming a fussy baby often takes a team approach. Moms, dads and other caregivers each have a role to play. The primary caregiver (usually mom) should get a break from the fussy baby (at least an hour a day away) to relax from the stress of the crying infant. It is never anyone's fault that a baby is fussy. Guilt and blame are counterproductive. Don't forget to include your pediatrician on your team, especially if your baby remains fussy in spite of these suggested techniques.
A baby will not remain fussy forever. After 8 weeks of age, the amount of fussiness per day will decrease and by 3 to 4 months of age, infant fussiness will be gone. At this age your infant will be much more interactive - smiling at everyone and everything and laughing with delight. By 4 months of age, babies have developed self-soothing techniques and are more adaptable, being able to adjust to a regular schedule of feeding, sleeping and playing. Until then, use the tips listed here to respond to your baby's needs and to magically transform your crying, screaming baby into an angel of peace and comfort. For more information, visit www.EsseHealth.com.
By Dr. Peter Putnam, Pediatrician at Esse Health Pediatric & Adolescent Medicine at Watson Road
9930 Watson Road, Suite 100
St. Louis, MO 63126