NURSING
MOTHERS, INC.
When Baby Cries
Factsheet 10
Ever since you brought your baby home from the hospital or birth place, you have been waiting for her to behave the way "normal" babies do. You thought she would sleep 20 hours a day and eat, bathe, or play for brief intervals, and smile contentedly in response to your loving care for the other 4 hours. Your baby, however, seems to cry much of the time. Your day consists of efforts to solve the mystery, and you alternate between frustration and a sense you are doing something wrong.
All healthy babies, no matter how they are fed, cry. Breastfed babies do tend to cry much less, particularly if they are fed on cue. But few babies just eat and sleep. Many have a regular fussy period that typically starts in the late afternoon or early evening and can last several hours.
You may worry that your breastfed baby is crying from hunger, or that you are not producing enough milk to satisfy her needs. If your newborn nurses well 8 to 12 times in a 24 hour period, has 6-8 wet diapers a day, produces 2 to 5 bowel movements a day, and appears to be filling out, you are producing enough milk to satisfy her hunger. A trip to the baby's doctor to have her weighed and check for any problems should reassure you that she is healthy.
It can help to consider the profound changes your baby is experiencing outside the womb. She spent the first 9 months of her life never knowing hunger or cold. She had no experience of different textures on her skin. Her movements were in a fluid world; outside the uterus she is weak muscled and bound by gravity. She continually heard the sound of your heartbeat, the digestion of your stomach; your movements gently rocked her. Now all that has changed for her.
We respond with uncanny distress at the sound of a baby's cry. That cry is intended to motivate us to care for the baby. In trying to track down the reasons for your baby's wails, it can help to go over the obvious:
· Offer the breast -- she may be hungry, even though you started the last feeding an hour and a half ago. Some babies feed very frequently in the first several weeks.
· Change her diaper -- it may be soiled, wet, or too tight.
· Take her clothes off and check for anything that could be poking her and for abrasive tags or constrictions.
· Try burping her -- make sure however you hold her to burp, you are applying gentle pressure to her stomach (lifting her higher on your shoulder or laying her face down across your lap may help).
· Check if she seems too warm or too cold and add or remove layers as appropriate.
· Determine if your baby is over stimulated. Too much noise or visual stimulation can make a baby fretful. Turning off a loud TV, darkening the room, or simplifying what your baby looks at may help calm her. Newborns are rarely bored, but if under-stimulation is frustrating your baby, try talking with her and bringing baby toys one by one into her range of vision.
· If her crying spells are not regular, but seem intense or caused by gas, she may be reacting to something in your diet. Talk with your Nursing Mothers counselor about how to determine if your baby has a food sensitivity and how you should handle it. See Factsheet #13 on Nutrition for more information about food sensitivities.
Comfort measures for crying
Once you have covered the obvious possibilities and found nothing amiss, you can only offer your comfort. There are numerous ways to comfort a crying baby. You may find that one strategy will always work for you. Most likely you will find that no one strategy works every time. Through trial and error, and with some creativity on your part, you will probably hit upon several that work for your baby. Here are some suggestions parents have found helpful:
· Let him suck. Some babies have very strong sucking needs. If he doesn't seem hungry, but wants to continue to suck on the breast, you can fulfill his need for non-nutritive sucking that way. Alternatively, clean one of your fingers and offer that as a pacifier (your fingers never get lost, and using a finger rather than a rubber-nippled pacifier helps prevent nipple preference problems from developing).
· Hold him close and tightly to provide warmth and security. Skin-to-skin contact may be particularly helpful.
· Rock him in a rocking chair (babies seem to respond better to quick time rocking rather than slow rocking).
· Break out the stroller and go for a walk.
· Dance with your baby cheek to cheek, either to slow music or rock-and-roll.
· Shush softly but persistently in his ear.
· Tell him a story in a calm, gentle voice, or sing him a song.
· Put him in a sling or carrier and "wear" him. (One study found that young babies who were carried for at least three hours a day reduced the amount of their crying by 45%).
· Try using a baby swing for 20 minute intervals. Some babies love the motion a swing generates; it helps them nod right off. The swing can truly terrify other babies. It is best to borrow a swing and see if it works for you before you go out and spend money on it.
· Swaddle him tightly in a light blanket. Some babies like their arms free while others like their arms secured against their bodies. Try it both ways.
· Take all his clothes off and give him an "air bath". There are babies who love this freedom.
· Take him into a warm bath with you (once the umbilicus has healed). Keep his body fully supported with his head above water and gently sway back and forth to let the water wash over him.
· Go for a car ride together, making sure he is properly secured in an infant car seat.
· Settle him near machines that hum constantly or vibrate. White noise can help calm a fussy baby.
· If he seems to do most of his crying when you put him down to sleep, look for ways to make his bed feel smaller. Many babies are calmed in be when they feel firm pressure on top of their heads (many catalogs offer a pillow like device to cushion and put pressure on the head, simulating the baby's experience in the womb). Try warming his bed with a heating pad or hot water bottle (which you then remove) before putting him down to nap.
· Give him a massage. You can find books to instruct you in infant massage techniques. Or you can lay him on his tummy on your bed and pat firmly on his back.
· Lay him face down on your lap and gently rub his back as you lift and lower your heels. Try other forms of gentle bouncing and swaying.
· Carry him in the "colic hold": tummy down, lying along the length of your forearm, with your hand supporting his chest.
· Take him to bed with you for naps and through the night. There is no danger that you will spoil your baby by letting him sleep with you. In fact, during the early months sleeping with your baby makes nighttime feedings much easier. If you are spending the bulk of your day coping with a fussy baby, you are going to need your sleep at night.
· A friend or family member who is already calm may be willing to take over for a little while to give you a break.
· Have the father take over. Many men have a wonderful ability to soothe irritable infants.
· Dr. Harvey Karp, author of The Happiest Baby on the Block, recommends using the “Five S’s” as one way to calm almost any baby: the simple steps (swaddling, side/stomach position, shushing, swinging and sucking) done all at the same time, trigger the infant’s calming reflex.
Colic
Most parents blanche at the mention of colic, and for good reason. Colic is a parent's worst nightmare. Dr. William Sears states in his book, The Fussy Baby, "If you are wondering whether or not you have a colicky baby, you probably don't have one. The colicky baby leaves no doubt in the minds of sympathetic caregivers that he is truly in agony." Colicky babies can cry for hours on end, sometimes without tiring. Very little the parent does seems to help. Few things can so successfully undermine a parent's patience.
Typically, colic starts to appear sometime after the first four weeks of life. It usually lasts, with varying degrees of severity, until the baby is three months old. The colic may gradually taper off, however many parents report that one day their baby was howling like crazy and the next day he just stopped. While the majority of colic cases are over by the fourth month, some persist through the first year.
Defining colic and finding its cause has so far proved impossible. No one seems to know why one out of five babies develop this unnerving behavior. The incessant, pained crying seems to stem from extreme physical discomfort. Colicky babies have tensed bodies, clenched fists and frequently draw their legs toward their chests. This has led some researchers to assume the pain is caused by persistent gas. Certainly, a baby who constantly cries is going to swallow a lot of excess air, which can lead to intestinal distress. If you suspect your baby has this problem, discuss remedies for relieving gas with your doctor. Sometimes massage or gentle body manipulation can help your baby relieve stubborn gas.
But the gas theory doesn't explain it all. Some babies come into this world temperamentally predisposed to colic. These babies seem to be neurologically hypersensitive. They respond with extreme reactions to sound, texture, taste, visual stimulation, and odor. It is almost as if they take in more of the world than their systems are able to process. "High needs" babies easily become over stimulated. Everything seems an assault to their senses.
You will find that many of the comfort measures above, and those you devise in desperation, will help relieve your baby's distress. Parents of colicky infants may find Snugly-type carriers or slings of special help. These cocoon the baby, shielding him from the environmental stimulations that seem to bother him. Many mothers report that breastfeeding a colicky baby was their best strategy for helping him disengage from the world and calm down. And a baby who is nursing well or comfort sucking at the breast isn't crying.
If you and your baby are suffering from colic, you will need to find time to take care of yourself. Ask an understanding friend to watch your baby for a couple of hours so you can have a break. Use every available opportunity to rest and relax -- colic creates intense stress for all members of the family. If you fear you will physically harm your baby, put him down in a safe place, and remove yourself to a place where you cannot hear his crying. Give yourself 10 to 20 minutes to calm down and regain your composure before you return to him.
Colic sorely tests the patience of the most saintly parent. It is important that you not blame yourself for what is happening. If the situation becomes overwhelming, if you feel child abuse is distinctly possible, if you become severely despondent or depressed, see professional help. Contact your local Department of Human Services for recommendations, or talk with your doctor. Your Nursing Mothers counselor can help you get in touch with people who understand your situation.
On the bright side, colic does go away. Things really do get better. And when you are in the midst of these days, it may comfort you to know that many children who experience colic turn out to be very bright. They are particularly good at problem solving. And they tend to demonstrate a sensitivity we wish more children could cultivate. As difficult as it may seem, you will find ways to enjoy your baby through these trying times. Look for those moments, and keep your sense of humor!
Original: Andrea Vapaa and Gail Timm
Rev. 2/95 Lisa Davis; 1/03 Megan Allen
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