Clinical Reference Systems: Pediatric Advisor 10.0

To say that crying is a key challenge to early parenting is an understatement, especially when it is 3 AM, you haven't gotten any sleep, and your baby is still crying!

With crying, there are no firm rules--both as to what causes it and what you can do to get your baby to stop. As you get to know your baby, however, you will get better at understanding what causes your baby to cry and what will get him to stop. Soon you will be able to distinguish hungry cries from boredom cries, hurt cries from angry cries. And then of course there are times when your baby will cry seemingly for no reason at all.

POSSIBLE CAUSES FOR CRYING

When your baby cries, first check obvious causes:

• Hunger--Short (20 minutes), frequent (every 2 hours) feedings give comfort and closeness in addition to keeping baby's tummy full.
• Pain--Check clothing to see if it is too tight or if diaper pins have become loose. Sometimes threads from the baby's clothes get wound around his fingers or toes and cut off circulation. Your baby may also be too hot or too cold. Diaper rash or an upset stomach can also cause crying. (Note: If the child is ill, there are usually other signs, such as fever, vomiting, diarrhea, decreased appetite, nasal congestion.)
• Overstimulation--Prolonged stimulation from playing and handling can often cause overtiredness, which will result in crying.
• Boredom--Crying can also indicate your baby's desire for a change in scenery or activity.

CALL YOUR PHYSICIAN IF:

• Your baby seems to be in pain
• Your baby has cried constantly for 2 hours or more
• You are feeling angry, resentful, or exhausted and you are afraid you might hurt your baby.

CRYING BECAUSE OF BOREDOM

• Babies can often be distracted by lively music, by your dancing with them in your arms, or by a noisy rattle or toy.
• Motion--Car or stroller rides often work wonders for a crying baby and for parents as well. A baby swing may also work.
• Since babies love to see the sights and to be held close in someone's arms, walking your baby from room to room is generally a good cure for crying. Hold the baby upright as you walk in case the crying is due to a gas bubble.
• Try using a front pack to free up your hands for little chores while you are walking. (While this is a good cure for crying, it can be murder on your back--don't overdo it!)

CRYING BECAUSE OF OVERSTIMULATION

• Some babies like the secure feeling of being tightly swaddled in a blanket--as in the hospital. If your baby startles and dislikes being naked, hold his arms folded up close to his body or crossed over his chest and hold him firmly.
• Place the baby on a soft blanket on top of a running clothes dryer--the warmth and vibration may calm him. (Be sure to never leave the baby where he could fall off.) A hair dryer blown on the baby may create the same effect--be careful not to burn his skin.
• Steady sound (white noise) such as a fan, a dishwasher, or a vacuum cleaner may calm your baby.
• If you know your baby is not hungry, a pacifier or a finger (his or yours) can be just the thing to relax your baby and put him to sleep.

HINTS FOR DEALING WITH CRYING:

• If there is a possibility your baby is hungry, try feeding first.
• Placing your baby across your knees and rubbing his back may bring up a gas bubble. A hot water bottle covered with a soft blanket or towel and placed under your baby's tummy may also provide comfort for an upset stomach.
• Check diapers. Unless they have been trained to cry at dirty diapers or unless they have a bad diaper rash, babies generally don't mind wet or soiled diapers.
• RELAX! As you will notice, your baby can tell when you are tense and will often also become tense and cry. Quiet music, gentle rocking, soft singing or talking often help, as do a warm bath or a gentle massage.

COLIC

Colic is a catchall word used to describe a baby who cries daily for several hours at a time, usually at the same time each day. It was originally thought that stomach cramping and an intolerance of formula was the cause; at present, however, there is no known cause and no sure cure other than time. Almost all babies outgrow colic by 3 months of age.

For further information, see Colic.

CRYING -- A LAST RESORT

If you have checked for hunger, discomfort, boredom, and overstimulation and if you have tried all the remedies you know and your baby is still crying, sometimes nothing will work and the baby will simply cry himself to sleep. In this situation it is important for YOU to get some relief. If you don't get away and somehow relax, your baby will sense your fatigue and tenseness and most likely respond with increased crying. If at all possible try to be relieved hourly by a spouse, friend, neighbor, or relative.

CRYING AS A TRIGGER FOR CHILD ABUSE

If your baby has been crying and you are getting so angry that you are afraid you might hurt your baby, call a physician, an emergency room, or a good friend and talk about the problem. You are not alone in your feelings!