Babies are supposed to cry, right? I mean, isn’t that just what they do?
So why does it seem like your baby is crying more than he should? What is considered excessive crying, anyway? And if your baby is crying more than normal, why? Is something wrong? Is he uncomfortable? In pain? Hungry? Angry? Hangry? Or just simply hating life and you?
It can be stressful and frustrating when your baby won’t stop crying regardless of what you do.
First off, it’s important to consult with your pediatrician to ensure your baby does not have a medical problem causing her crying. Don’t be ashamed to bring it up. Excessive crying is the primary reason for all parents’ visits to their pediatrician during their child’s first year of life.
To help you prepare, here is information on some of the possible medical issues to rule out with your pediatrician.
Baby got gas?
For a long time, most people believed that excessive crying in babies was simply a sign of gas, and assumed that all bawling babies just needed a better burping. (Grandmothers and Aunts even prided themselves on their superior baby burping techniques and abilities.) This can be highly annoying to us parents of excessively crying infants who are afraid we are going to dislodge a lung from how much we are pummeling the backs of our shrieking babies on a daily basis.) Yet excess gas has never been proven to be a cause for infant colic – a common cause of excessive infant crying during the first few months of life.
Further, studies have shown that although safe, treatment of gas with simethicone is not particularly effective in reducing crying. (See more on treating infant gas.)
Despite this fact, the old wives’ tale that gassiness causes colic persists. This is why Great Aunt Sally fruitlessly tries to burp the heck out of your crying baby every time she comes by for a visit.
Imbalance of gut bacteria
Scientists hypothesize that an imbalance of gut microflora (the normal bacteria that live in our intestines) can open the door to bad bacteria and environmental or food antigens (potential allergens). You could say that presence of the normal strains of bacteria appear more protective against crying behavior in babies, while other not-so- good bacteria appear to cause irritability.
And some of the “beneficial” bacteria, are known to be the most common species present in breast milk. Talk to your pediatrician about trying a probiotic designed for fussy infants. The one with the most proven benefit thus far is called Lactobacillus reuteri. Researchers recommend trying it for at least a week before deciding whether it is effective in reducing your baby’s crying time.
Acid reflux
Gastro-esophageal reflux disease (GERD), or what most of us refer to simply as ‘acid reflux’, is another disorder commonly linked to excessive infant crying. As anyone who has suffered from acid reflux can attest, GERD is a painful condition resulting from the backward leakage of acid from the stomach (where it belongs) into the esophagus (where it does not belong). Between 2000 and 2003, when the presumed link was made between excessive infant crying and GERD, there was a 400 percent increase in the number of infants treated with antacid medications, and this has continued to be a prominent treatment modality today for reflux.
However, according to the peer-reviewed medical literature, GERD represents a small percentage of crying cases. Best to let your pediatrician explore whether reflux is affecting your baby.
Food Allergies and Sensitivities
Cow’s milk protein allergy is believed to occur in roughly 2 to 7 percent of all infants and can lead to increased fussiness, diarrhea and abdominal discomfort, vomiting, and skin inflammation, among other symptoms. Dietary sensitivities (as opposed to allergies) may also be the culprit for fussiness. Some studies have shown that infant irritability may be in response to cruciferous vegetables such as broccoli, cauliflower, and Brussels sprouts. Trials have shown that irritability in infants improves when these items are avoided. Consumption of foods containing soy, wheat, and eggs by the mother also may be culprits for discomfort in breastfed infants, suggesting they may merely be sensitive to these foods. Food trials are the only way to diagnose these sensitivities, which are no fun for the breastfeeding mom.
Colic
If your doctor has run through all the possible medical causes of excessive crying and given your baby a clean bill of health, she may label your baby’s chronic displeasure as “colic”.
What is colic, really?
Well, most doctors accept the relatively arbitrary “rule of three” definition derived from Dr. Morris Wessel’s research back in the early 1950’s, which described colic as ‘unexplained, paroxysmal bouts of fussing and crying that last for more than three hours per day, for more than three days per week, for longer than three weeks’. But this definition
But this definition is actually pretty vague and could potentially describe most infants on the planet around six weeks of age. However, researchers disagree on how to refine the definition for colic. Studies vary widely in their reported incidence rates, as well as in the suspected causes of and proposed treatments for the condition. If your doc has diagnosed your baby with colic, or you suspect your infant has colic, I highly recommend The Essential Crying Baby Book: Support and Resources to Help You Cope With Colic and Calm Your Fussy Baby.
Maybe it’s normal?
In general, most healthy babies display a fairly consistent “crying curve” that begins shortly after birth, peaks around six to eight weeks of age, and decreases to baseline at three to four months. In other words, the crying of a normal baby increases in frequency until the baby reaches six to eight weeks old, then it peters off. For whatever reason, most of the crying during this peak period takes place in the evenings around dinner time. Many moms affectionately refer to this unpleasant time of day as the “witching hour.” It just happens to coincide with arriving home from work and struggling to get dinner on the table. It is not pleasant to deal with but it is manageable for a while.
Some researchers have called this peak period of crying in normal infants “the PURPLE period” [PURPLE: Peak (two months of age), Unexpected, Resistant (to soothing), Painful, Lasting (a long time), and occurring mainly in the Evening. Those behind the PURPLE theory understand the importance of educating parents on the fact they are not alone in dealing with this period; crying happens in all babies, and parents can get through it.
Inadequate rest
Linda Weissbluth suggested in her research that colic may be associated with inadequate sleep and elevated serotonin levels in the first few months of life. She noted that serotonin stimulates intestinal contraction and can be countered by melatonin, which relaxes the smooth muscles in our gut and supports sleep. However, an infant’s ability to produce melatonin does not develop until after three months of age, so until that time, levels of serotonin are unimpeded, resulting in potentially painful intestinal contractions and interference with the baby’s ability to rest. And we all get cranky with too little sleep.
Summary
The difficulty researchers and doctors face in finding a cause for excessive crying partly stems from the challenge of weeding out medical conditions that may cause discomfort, excessive crying, or colic in each individual baby. Some doctors consider conditions such as milk allergies and gastroesophageal reflux disease (also known as GERD) as causes of colic (as these conditions often result in more than three hours of crying a day for more than three days a week) while other researchers argue that cases of infant crying that can be attributed to known medical illnesses are separate from colic. If there is an underlying medical condition to your baby’s crying, it typically resolves with the appropriate treatment.
Many experts agree that colic and the normal PURPLE period should be considered as separate entities from the relatively small percentage of cases of excessive crying for which there is an identifiable medical cause. The reason for this is because these causes (e.g., allergies, reflux, etc.) have been shown to be absent in most babies with colic, and to also be present in infants without colic.
Despite the fact that food trials and other treatments may not help in the majority of excessive crying cases, it’s important to keep in mind that for a small number of babies, intense, prolonged crying may be a sign of a medical condition, some severe such as gastrointestinal intussusception, which can be life-threatening. Thus, it’s important never to make a diagnosis yourself or assume your child needs no further medical testing; Talk to your pediatrician.
