Why Won’t My Baby Stop Crying?
by Mommy MD Guide Stacey Ann Weiland, MD
A crying baby can be very stressful to new and seasoned parents, alike. We worry about our baby’s health, and want to make sure we are not causing any harm.
We check to see if our baby is hungry, needs to be changed, is too cold, too hot, or otherwise uncomfortable. Once we are out of ideas, and our baby continues to cry, the most likely cause is a condition called colic.
Colic is the most common cause of unexplained crying in an otherwise healthy infant. It affects anywhere from 10 to 30 percent of infants worldwide, occurs equally in boys and girls, and is generally seen in children between the ages of 2 weeks and 4 months. Its incidence is similar in breastfed and bottle-fed infants.
Colic can be defined by the “Rule of Three”:
- Paroxysms of excessive crying in an otherwise healthy baby lasting more than 3 hours per day.
- Crying occurring more than 3 days in any week
- Crying episodes span for a period of at least 3 weeks.
Crying generally begins around the same time every day. For my son, Andrew, this was generally around 7:00 pm (right when we were trying to get my older two children bathed and to bed!). Episodes usually begin suddenly and for no clear reason. Crying can be intense and high pitched. The baby’s face may flush, she may curl up her legs, clench her fists, and tense up her abdominal muscles.
While these episodes are unbelievably distressing to the baby and the parents, crying of this nature has been found to be attributable to “organic” causes in less than 5 percent of cases!
Warning signs that may indicate that your baby is suffering from something more than simple colic may include fever, breathing difficulties, poor weight gain, or abnormal findings on a neurologic exam.
Laboratory tests and x-rays are usually unnecessary if your child is gaining weight normally and has a normal physical exam.
Gastrointestinal symptoms such as frequent regurgitation of more than 28 g (1oz) may indicate reflux. Diarrhea or watery stools may indicate signs of lactose intolerance or a cow’s milk allergy.
Sometimes, physicians suggest medication treatments to parents in an effort to treat a colicky baby. One of the most popular, simethicone, is a safe, over-the-counter drug used for decreasing intestinal gas. While some parents swear by its benefit, randomized controlled studies with simethicone have actually demonstrated no benefit compared with placebo.
If a cow’s milk allergy is suspected, a protein hydolysate formula is indicated. Soy-based formulas are generally not recommended to infants allergic to cow’s milk, because these infants are at an increased risk of developing an intolerance to soy protein, as well. If the crying is related to a cow’s milk allergy, benefits should be observed within the first 2 to 7 days of making the switch.
In breastfed colicky infants, mothers are sometimes encouraged to systematically eliminate certain allergenic foods, including dairy, nuts, soy, and citrus. If an allergy exists, changes in the baby’s behavior should be seen within a week.
Other treatments that may prove beneficial in a colicky baby include probiotics, oral glucose and sterile water, and several herbal tea remedies.
The “5S” approach consists of a set of rhythmic calming techniques that have also been found to be effective in calming a colicky baby:
- Side or stomach (the baby is held on its side or stomach) Note: A baby must always be placed on its back for sleep
- Shhh sound
- Swinging the baby with tiny 1-inch jiggly movements back and forth (care must be made to support the head and neck)
- Sucking (let the baby suckle on the breast or pacifier)
If all else fails, play soothing music, make eye contact, talk to and touch your baby, rock her, and walk. Be assured that colic is just a phase, that you are doing everything right, and that you are being a good parent.
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