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The Informed Parent

Why Is My Baby Fussy? A Parent’s Guide To Interpreting Babies’ Cries

by Lori A. Livingston, M.D., F.A.A.P.
Published on Jul. 09, 2012

Some parents are able to decipher the hungry cry from the tired cry; but for most of us, soothing a baby takes a bit of trial and error. Here are some guidelines to help figure out this sometimes difficult question…Why is my baby crying?

1. Hunger

Look for hunger cues such as rooting and trying to suck on everything. Most babies eat every 2 to 3 hours. However, breast fed babies sometimes eat more often (cluster feeding). Also, if your baby falls asleep before finishing a full meal, he may be hungry again quickly. A full meal may be 2 to 4 ounces, depending on the age and size of your infant. If you are breastfeeding it may take 40 minutes. When your baby is a little older it may take 10 minutes to feed. It is best to let your baby eat ON DEMAND, which means following their cues for how often and how much he wants to eat. And some babies just love to suck on something, so give the pacifier a try. Not all crying is hunger, and we should try to avoid overfeeding our infants to prevent obesity later on.

2. Dirty Diaper

Some babies could care less if they sit in a wet diaper, and others cry the second they have a pee or poop. It’s always best to try changing the diaper if your baby is crying.

3. Tired

Most babies will sleep during every feeding cycle, which means they eat, have some alert play time, and then need to sleep. Since your baby eats every 2 to 3 hours, that adds up to a lot of sleep too, usually around 16 hours a day. Most young infants don’t stay awake more than 2 hours at a time. Look for signs your baby is tired such as yawning, eye rubbing, or fussiness. If you wait too long, your baby may become overtired and be much more difficult to soothe. Help your young infant fall asleep since they are usually unable to sooth themselves until 4 to 6 months of age.

4. Temperature

In general, babies should be dressed in one layer more than an adult. Be careful not to overheat him since this is a risk factor for SIDS. If your baby is swaddled in a blanket, the best place to check temperature is by feeling his ear. If it feels very cold or hot you may want to add or remove a layer of clothing or blanket. If you are worried about a possible fever, take your baby’s temperature rectally for the most accurate number and call your pediatrician if it is over 100.4 degrees.

5. Overstimulation

Young infants can become fussy with too much attention or activity. They will usually try to avoid eye contact and interaction. If you think this is a possibility, try to find a quiet dark room. Then try using the “5 S’s” to soothe your baby. Swaddle (tight), Swing (fast), Shush (or white noise. loudly) Side lying and Sucking (try using a pacifier). Trying some or all of these techniques can be very helpful.

6. Gassiness

It is normal for babies to grunt and fuss when they have gas and poop, which is often during or after feedings. However, if your baby seems to be excessively gassy or fussy, it may be due to his diet. If you are breastfeeding, try eliminating caffeine, spicy foods and gas producing foods from your diet (cruciferous vegetables, onions, garlic, peppers , beans, dairy foods, etc). If you are formula feeding, try a different formula that is more easily digested (talk to your pediatrician about this choice). Try rubbing his belly or back or pushing his legs into his belly to help relieve the gas. It is also safe to try Simethicone which is a gas reducing over-the-counter medicine for babies.

7. Pain

Check your baby’s body for any causes of pain. Diaper rash, a hair or string wrapped around a toe or finger, or a scratch from a sharp fingernail are just a few examples. If your baby seems like he is in pain and cannot be consoled within 30-60 minutes, call your pediatrician or go to the emergency room.

8. Reflux

Gastroesophageal reflux (GER) or heartburn also affects infants. Most babies spit up milk, and this is normal in infancy. But if it causes pain or trouble gaining weight, this is a problem. Frequent spitting up, back arching with crying during and after feedings, regurgitating milk and re-swallowing, nasal congestion, and cough are common signs of GER. You can help your baby by avoiding overfeeding. Feed smaller amounts more frequently. Burp frequently during and after feedings. Keep the baby’s head elevated 30 degrees for at least 30-60 minutes after each feeding. If you think your baby has GER and pain, call your pediatrician for the possible need for medication.

9. Attention

Some babies just need more attention. They are soothed as soon as you pick them up and cry when put down. The first three months after a baby is born is a transition period, and babies often need to be held and cuddled. You cannot spoil a baby during this time. It’s okay to pick up your baby every time he cries and try to figure out what he may need. Many babies will sleep better at night if they are held all day. Baby carriers can be helpful so that you can have your hands free to do other things.

10. Colic

Doctors don’t know what causes colic, which is unexplained crying in an otherwise healthy infant. It may be one of the problems listed above. Colic typically starts around three weeks of age. Crying lasts for at least three hours a day for three or more days a week, and for at least three weeks. Crying is usually around the same time of day, typically evening. Most babies outgrow colic by three to four months of age.

If you are feeling overwhelmed and need a break from a crying baby, put your baby down and  let him cry while you go in another room for a few minutes. Even the best parents can become so upset over a crying baby that they have thoughts of hurting their child. If you feel this way, you are not alone, but you need to ask for help. Call your family or friends or your doctor. Never shake a baby since this can cause brain damage and death. 

As always, if you are unsure why your baby is crying so much or you are not sure what to do, call your pediatrician for advice.

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