Health Education

Fussy Baby

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Why do babies cry in the first few months of life?

In the first 3 months of life, crying is a baby’s primary form of communication. Babies cry when something is wrong or when they are wet or hungry. Sometimes, however, crying is just a means of identifying a need. As adults, when our nose itches, we scratch it but when a baby’s nose itches, he or she cries. When our clothes are too tight, we loosen them but when a baby’s clothes are too tight, he or she cries. It is important then, to view crying as a baby’s most primary means of communication, rather than always signifying a problem.

How many hours a day does a baby cry?

The secret that no one reveals in a Lamaze childbirth class is that the average infant cries over 2–4 hours every day during the first two months. First-born children tend to cry more than others because we, as parents, are not as proficient in interpreting the reason for crying and often respond in ways that are out of sync with the baby’s needs.

At what age do fussy periods begin?

As early as 2 to 3 weeks of age, you may notice your infant has a “fussy period,” which is typically in late afternoons and evenings. During these times, your baby may not be as consolable as other times. The period of most intense crying tends to peak by 6 weeks, remains stable until about 8 weeks and disappears between 10–12 weeks. The bad news is that this seems to occur in almost all children, but the good news is that it also disappears on cue by 3 months in almost all children.

What is the mechanism behind fussiness in babies?

No one really knows for sure. Most experts believe that it is because babies have an immature nervous system, which easily becomes over stimulated. As adults, there are many times that we become overly stressed and no matter what we do, our nerves feel on edge and even a hot shower or backrub doesn’t seem to relax us. That wound up, stressed out period then just slowly passes. Imagine how we would feel if someone started jiggling us around, slapping us on the back or force feeding us. This is how many children feel during the first few months.

How does overfeeding contribute to fussiness?

If someone placed a garden hose in your mouth and left the faucet on for six weeks, imagine how bloated, gassy and fussy you would feel. This phenomenon occurs quite often in infants because we misinterpret the cries as hunger and end up overfeeding. This causes the gut to be over stimulated which causes it to move more rapidly, causing more spitting and more expulsion of gas.

What about food intolerance or gas?

In our society, fussiness in infants is most often attributed to food intolerance and gas. Studies show that fewer than 5% of fussy periods can be attributed to food intolerance. For some children, no matter what they eat or no matter what their breastfeeding mothers eat, there will still be a level of fussiness. As for gas, there is no evidence that infants produce more gas than older children. Moreover, the normal crying positions for babies include knees pulled to the chest and tightened stomach muscles, so this is not a good indicator of gas. And since the theory behind fussiness relates to an over stimulated nervous system, it makes no sense for gas medicines to work. In multiple studies, so-called gas medications containing simethicone (such as Mylicon) have been shown to function only as placebos (in other words, no better than sugar water). We often encourage parents to wait out this normal fussy period before blaming food, changing diets, or taking unnecessary medications unless of course there are other accompanying issues such as very dry, scaly skin which may suggest other causes.

Does personality play a role?

T Berry Brazelton, in his landmark book, Infants and Mothers, describes 3 types of infants. Active children cry with gusto, eat with gusto but later, giggle with gusto and take on the world with gusto. Active, extroverted infants who are paired with quiet, introverted parents seem to be diagnosed with fussiness more commonly. Quiet children don’t respond much at all. They don’t cry much but they also don’t move much and the most common question about those children is are they quite normal or do they hear well. They are very normal and hear just fine but they respond quietly to newborn stimuli and later in life, tend to be quieter adults. Average children are somewhere in between. Personality plays a huge role in how a child responds to his/her environment in the first few months and this can be particularly acute if the parents are quieter in personality. Understanding personality differences between parents and children is one area that is a major focus of interest in this practice.

Is there such a thing as colic?

We don’t like using the term ‘colic’ because it turns what is really a normal condition into a disease. And then rather than confronting the issue and problem solving, we, as parents, tend to look for a ‘medicine’ to deal with the disease.

So what can you do if you have a fussy baby?

Every child is different and different techniques may work better at different times. Look through the following suggestions and try various combinations (i.e. changing position, adding motion and increasing non-nutritive sucking) to help your new baby. Try a selected pattern for 15 minutes before trying another. Rapid switching can also over stimulate baby and lead to more crying.

  1. Positioning
    • Lay your baby face down over your forearm or seat your baby on your hand or arm, with the back to your chest, and lean forward on the other forearm.
    • Try to place your baby high on your shoulder.
    • Cradle your baby in your arms, across your stomach.
  2. Motion
    • Keep motion gentle and rhythmic. DO NOT shake your baby.
    • Walk slowly, with or without deep knee bends.
    • Sway back and forth.
    • Sit in a rocking chair or glider.
    • Use an infant swing with a battery or crank- swings do not cause Shaken Baby Syndrome.
    • Use a vibrating infant seat.
  3. Non-Nutritive Sucking
    • Promote pacifier use in first 2 months. Try introducing the pacifier after a feeding; your child is more likely to accept it when quiet than when wailing. Don’t worry — we will help you eliminate the pacifier by three months of life when it is no longer physiologically necessary.
    • Some children will not take a pacifier. Try swaddling tightly and putting the fleshy part of your finger on the roof of the palate to stimulate a sucking reflex.
  4. Massage
    • Gently, but firmly, massage the torso, arms, legs and try rhythmic patting of the back and bottom (“butt pats”).
  5. Warmth
    • Always check that items are not too hot — your child should be comfortably warm. Swaddle him in a blanket. Swaddling tightly is often the best approach especially in combination with a swing.
    • Cuddle against your body. If you find yourself tensing because of the crying, this approach often makes it worse.
    • It is helpful to pass the baby to another parent or use a swing.
    • Put a hot water (lukewarm) bottle on the tummy.
  6. Sounds
    • Speak in a low gentle voice, hum or sing.
    • Provide gentle, rhythmic clicking or whispering sounds.
    • Try the dishwasher, vacuum, fan, clothes washer or dryer.
    • Try music — classical, soft jazz, new age.
    • There are a number of devices available that play natural sounds such as rain, oceans, birds, and heartbeats. These mimic the sounds of the uterine artery in utero and have been shown to be very effective in preventing and treating fussiness in the newborn period.
  7. Car Ride
    • It combines motion and gentle sounds as well as the secure feeling of the car seat!
  8. Read
    • Read Brazelton’s book, Infants and Mothers. Brazelton traces active, quiet and average children through the first year and it is fascinating to watch the active child laugh with gusto at four months, roll with gusto at 5 months and crawl with gusto at 6 months. The point is that your fussy baby may simply be a more intense, active child who will turn out to be a real go-getter in life but at this stage, can only communicate by crying and so, he or she cries with gusto.
  9. Do things for yourself
    • Most importantly, parents must take care of themselves first! If a mother is not relaxed, well hydrated, well rested, and well nourished, she’s not well equipped to care for baby!
    • Try to nap when your child is napping; turn off the phone and make sure that you get some sleep.
    • If the crying becomes overwhelming, get help! Babies know when you are upset. Leave your baby with someone you trust and take a break. Not all crying can be easily fixed, and it is not a reflection of your parenting ability!
    • Remember, this is not about you but rather about a particular stage in your child’s life. At about 6 weeks, your child will begin to smile and often, that first smile is enough to lift the cloud.