Chances are if you are reading this article, you are dealing with a fussy baby. Welcome to the world of parenthood! And there is nothing like dealing with a fussy baby to introduce you to the challenges of becoming a parent! We should know; we have dealt with them as parents and as pediatricians. In a typical day, we field numerous calls from stressed out and exhausted parents regarding questions and concerns about their new fussy baby. We wish we had the magic button to turn off the fussiness. But we don’t; no one does. First and foremost, know that all babies fuss and cry. Crying is a protective mechanism that alerts us when something may be wrong with the infant. Also, it is one of the main ways that infants communicate with us. On average, newborns cry for 1-4 hours a day. Yikes! Studies by Dr. T. Berry Brazelton, a well-known developmental pediatrician, have shown that infant fussiness peaks around week six and declines thereafter. Around three to four months of life, fussiness dramatically decreases so hang in there. It does get better!
Sometimes there is a reason behind this intense crying. More often than not, there isn’t. When your baby is crying, go through a mental checklist of the obvious causes. Is my baby hungry or lonely, does he need a diaper change, is she cold or in pain, is she over-tired, does he have a fever? Some of these will have simple solutions but we know that dealing with a fussy baby is often quite complex and requires a great deal of insight and patience. Let’s further discuss some of the less obvious causes of crying….
Another common cause of intense bouts of crying is the age-old phenomenon of colic. So what exactly is colic? Colic is defined as crying for more than 3 hours/day for more than 3 days/week and for more than 3 weeks. Basically, it is unexplained crying. It usually starts around 2 weeks of life, peaks at 6 weeks of life, improves at 8 weeks of life and resolves around 16 weeks of life. These crying spells are often not related to feedings or hunger and usually peak in the evening. No one knows the cause of colic but we see it in patients of all backgrounds. One interesting theory behind the cause of colic involves the use of the term, ‘the fourth trimester’. According to this theory, babies are born immature and extremely fragile. Back when we were cavemen and we learned to walk upright, the pelvis became narrower. Babies are born 3-4 months early so as to allow the developing brain a safe passage way through the woman’s small pelvis. It is during these first few months outside the womb that the infant learns to interact with this loud, bright and complex world. This can be overwhelming to the baby (and to the parents). This is why the treatment of colic involves recreating a womb-like atmosphere. These techniques involve the popular “S’s” that you may have read about. They are:
This is an extremely soothing and natural reflex for all infants. We know that babies that nurse or suck on the pacifier during vaccines or circumcision have lower pain scores. Sucking can involve nursing or the pacifier. Please don’t be afraid to offer your baby a pacifier. Most would agree that the use of pacifiers does not interfere with nursing. However, most would agree that the best time to break your baby of the pacifier habit is around 4 months of life.
Allowing an infant to feel contained takes them back to the time they spent growing in your small uterus. Also, when their arms and legs are still, they can better focus on the other “S” techniques. Don’t be afraid of the swaddle!
Based on studies, we know that the uterus was a loud environment for your baby given all of the blood flowing through the large arteries. A loud “Shah” into the baby’s ear can be comforting. Also, white noise like the vacuum or washing machine may be comforting.
Remember, for 9 months, your baby was used to being in constant motion as you went through your day. Your baby may not prefer to be still. If the baby is fussy, try putting her in the swing or taking her on a drive. However, please do not allow your infant to sleep for long periods in their swing and ALWAYS buckle them in.
Every newborn experiences gas but some babies are more sensitive to it. Gassy babies will draw up their legs during a fussy period and parents often describe their bellies as being ‘tense.’ The more crying that the baby does, the more air they swallow which in turn leads to more gas! Gas is also the result of the developing intestinal tract of the infant and the digestive process. Breastmilk is often better than formula for a gassy baby. Some foods in the maternal diet can trigger excessive gassiness. These foods may include: dairy, acidic foods (OJ, tomato-based foods), root vegetables, and spicy foods. This is often discovered by trial and error on the mom’s part. Other ways that may help relieve your baby’s gas include:
* Placing your baby on their tummy during periods of wakefulness
* Pumping their legs or moving them in a bicycle-like motion
* Frequent burps to get rid of air pockets that were swallowed during a feeding or a crying episode
* Using OTC products like Mylicon drops. Both products can be found easily at your local pharmacy.
Mylicon drops can be given (0.3 ml every 6 hrs WITH meals) to help bust up gas bubbles that form in