Crying by Dr Kiran Rahim
Paediatrician and mother of three, Dr Kiran Rahim has spoken to us sharing her advice about baby crying, tips on how to soothe them and reassuring words for all parents who might be going through a crying stage with their baby.
Whether you are a first time parent or it’s your 4th or 5th rodeo, a crying baby is a universally stressful experience for all. Many of us have googled “why is my baby crying”, “how to make baby stop crying” well into the wee hours of the night. Even as a Children’s Doctor I am guilty of this and I too struggle with the cries of the babies I care for. So when parents come in with a ‘crying baby’ to A&E, I get it and I’m ready to help. Part of that help is helping parents understand why crying happens, what they can do and when to worry.
Why? Because research shows that persistent crying is related to significant parental anxiety, parental mental health and poor establishment of breastfeeding. Sadly in some cases persistent crying can lead to harm to the infant and some studies suggest that inconsolable crying is a trigger for baby shaking leading to trauma and brain damage. The purpose of this blog is to help you understand infant crying, reassure you that you aren’t alone AND to equip you with some evidence based tips and tricks to soothe a crying baby.
What is ‘normal crying’?
On average, babies cry for up to 5hours a day in the first few months of life, so it’s easy to see why it can be stressful. Normal crying follows a circadian rhythm meaning it is often worse in late evenings and early morning. 70% of the crying happens between noon and midnight, and is often associated with inconsolable bouts, where nothing you try seems to work.
The most important take home message from this blog is that ALL babies cry. Some cry more than others but they all do it albeit in different patterns. Crying is an EXPECTED part of a baby's development and it’s important that we normalise this for parents. Research shows that all babies go through a developmental phase of crying known as PURPLE crying. Even in animal studies there is evidence of this period of crying which I find strangely reassuring.
PURPLE crying is an acronym for a period in your baby’s life where they are likely to cry more; sometimes known as the developmental curve of crying.
The letters in PURPLE stand for…
Peak of crying. Your baby may cry more each week, the most in month 2, then less in months 3–5.
Unexpected. Crying can come and go and you don't know why.
Resists soothing. Your baby may not stop crying no matter what you try.
Pain-like face. A crying baby may look like they are in pain, even when they are not.
Long-lasting. Crying can last as much as 5 hours a day, or more.
Evening. Your baby may cry more in the late afternoon and evening.
The word “period” means that the crying has a beginning and an end.
Isn’t this just Colic?
Yes! Traditionally the term colic was used by healthcare professionals to describe babies that displayed excess crying or fussiness without an obvious cause. Most professionals use “rule of 3,” which diagnoses a baby with colic if they are “otherwise healthy and well-fed,” but has bouts of “irritability, fussiness, or crying” that last more than 3 hours each day for more than 3 days each week. The problem with the term Colic is that it implies some babies have it and some don’t which isn’t true. I always tell parents that in my experience, all babies have ‘colic’ in that they ALL have periods where they cry a lot, are usually inconsolable at some points and that colic is a bit like a spectrum meaning some babies cry more than others on this spectrum, and others less. It’s important to understand that Colic isn’t a disease or something that needs fixing.
So what should I DO?!
Now that we’ve normalised the big bouts of crying let’s talk about some of the things you can do to minimise it. Firstly check the basics; is your baby hungry, wet/dirty or poorly? If they aren’t then it’s time to try some of these soothing methods.
- Swaying/Swinging: gentle rocking movements that mimic what baby would have experienced in the womb have been shown to calm babies down. If you can go outside with baby in a pram, then that’s great for them and you!
- Sling: evidence shows that carrying babies for three or more hours a day and keeping them close to you reduces crying by about an hour! If you can, do as much skin too skin as possible.
- Sucking: this is a normal infant reflex and many babies suck their fingers and thumbs in the womb! If you are breastfeeding, let your baby suckle as often as they would like or offer a pacifier/dummy once breastfeeding has established. If you are bottle feeding, then offer a dummy at any time
- Shushing/Humming/Singing: mimics the muffled noises baby would have heard in the womb. You can also sing or use white noise to create a similar effects. Constant repeating sounds, such as classical music, have also been shown to soothe babies.
- Swaddling: provides the security and confinement baby had in the womb. Please ensure you know how to safely swaddle a baby!
- Massage: There is emerging evidence that regular infant massage is associated with less crying
Remember that these are just some of the ways that you can soothe your baby. Some may work for you, some may not and what worked yesterday may not today. This is all normal. What’s important is to stay calm. It is incredibly frustrating to have a constantly crying baby. If its getting to you, please remember that its OKAY to put your baby down in a safe place and walk away. Take a few minutes to calm down and then go back and check on your baby. Remember to reach out for support from a trusted family member/friend. Whilst crying is incredibly stressful, remember, no matter how frustrated you get, never shake your baby.
Babies cry, Mums cry AND Dads cry, but nobody needs to cry alone.
Parenting an infant that cries a lot is draining and can be emotionally exhausting. It’s always important to remember to trust your parenting instinct and seek medical help if you are worried about something. In 98% of cases with ‘crying babies; there is nothing wrong. Very occasionally there are some serious medical causes for crying and parents should ALWAYS see a doctor if their baby has any of the following:
- Fever >38°C
- Rash that does not fade
- Reduced wet nappies (<2 a day)
- Feeding <50% of normal
- Persistent or projectile vomiting
- Blood in nappy
- Sleepy/lethargic baby
If you think there is something else the matter, such as reflux or an allergy, please discuss this with your Doctor BEFORE you buy any over the counter medications or make changes to your diet.
I hope you’ve enjoyed reading this blog post! If you have any questions please feel free to reach out to me on my Instagram page TheMunchingMedic. If you would like to read more about crying and how to understand your baby, these are some excellent resources: Iconcope, Cry-Sis, PurpleCrying, Cry-sis telephone helpline 0845 122 8669.
Sending you love and solidarity!
Kiran
Dr Kiran Rahim
Paediatrician
Mama to two boys and little lady
