Describing crying

What should I know about crying?

Crying is one of the ways a baby communicates. Normal babies cry from time to time, usually for short periods and for clear reasons. They may be hungry, thirsty, cold, tired, lonely, or in pain. Whatever the reason, it is important to meet the needs of the baby. It reduces the crying, promotes health, and limits stress on the parents and the baby. It is not spoiling the baby to meet the baby’s needs. Breastfeeding can calm the baby. It provides milk to relieve hunger and thirst and places the baby in a familiar, comfortable, and safe place. Crying usually decreases around 8 to 12 weeks of age. If the baby is hungry and angry, mothers may need to settle the baby before breastfeeding. Mothers can try speaking softly, stroking the baby’s head or mouth area, or gently rocking or bouncing the baby. On-going crying can happen if the baby is underfed, sick, in pain, or has other needs that are not met.

A) Crying is a type of communication

Babies produce their first words between 8 and 12 months. Before this, they use body language, facial expression, and sounds to communicate how they feel (Scheiner 2002). Communication starts with birth, even if babies are born very premature (André 2020; Caskey 2011). Crying is a type of communication that indicates distress.

Our approach to crying is based on the following principles:

  1. Babies who cry are in need of help. 
  2. Babies cry when they:
    1. Are behaving normally: Normal, healthy babies cry from time to time for short periods and for mostly clear reasons.
    2. Are underfed: Hungry babies may cry frequently.
    3. Are sick: Some sick babies cry frequently. If they suddenly face a health crisis, they may start screaming in an uncharacteristic way.
    4. Have other needs that are not met.  
  3. Meeting the baby’s needs reduces crying and supports the baby's healthy development.
  4. Colic is just another way of saying that the baby is crying. It is not a diagnosis or a reason for crying. We do not refer to babies as colicky.

Babies cry in different ways and at different times, depending on the cause (Parga 2019). When parents see crying together with other signs and situations, they can usually figure out what is bothering their baby. Crying generally decreases around 8 to 12 weeks of age (Wolke 2017).

Meeting the needs of a baby is important. It:

If parents understand what bothers babies, they can help to fix the problem and stop the crying. One study showed that babies had better language and brain development at 18 months when their mothers were helped to understand their babies’ problems (Lester 1995).

B) How breastfeeding settles an upset baby

Breastfeeding is a very effective way to settle an unhappy baby as it provides both milk and comfort. Normal babies ask to breastfeed not only when they are hungry but also when they are:

  • Thirsty.
  • Tired.
  • In pain or not feeling well.
  • Cold.
  • Anxious, scared, or stressed.
  • Lonely.
  • Bored.

Breastfeeding quickly calms these babies because:

  • The baby quickly gets milk to settle hunger and thirst.
  • Breastfeeding is a familiar environment and the baby recognizes the:
    • Mother’s smells, voice, and heartbeat.
    • Position at the breast.
    • Temperature of the milk.
    • Smell and flavour of the milk.
  • Breast milk has special chemicals known to calm babies (Gaitán 2018).
  • The baby feels protected in the mother’s arms.
  • The temperature of the mother’s body can warm a cold baby.
  • Their mothers may be more responsive to their hunger cues (Whitfield 2019).

C) How to settle an upset, hungry baby

The most frequent cause of unhappiness in babies is hunger. Most babies give clear signs when they are hungry. If they are not then fed, they become increasingly unhappy and start to cry. They will generally not latch if crying and may need to be calmed a little before they will breastfeed.

You can try the following to settle an angry, hungry baby who is unwilling to latch:

  1. Take the baby away from the breast and gently rock or bounce the baby for a few seconds.
  2. Using a gentle, sing-song voice as you put the baby into a breastfeeding position.
  3. Gently stroke the baby’s face and head.
  4. Stroke the area around the mouth with your finger.
  5. Let the baby suck on your clean finger or pacifier for a few seconds.
  6. Squirt a bit of breast milk into the baby’s mouth by using manual expression.

As soon as the baby calms down, the baby will give hunger signs and latching can resume.

If the baby still does not settle, mothers:

  • Can give the baby a little bit of milk to calm the baby down, if the baby is already being supplemented with milk.
  • Should ensure the baby does not have a latching problem.
  • Should ensure that the baby is growing well.

D) Calming the baby if you aren’t sure of the cause of the crying

If the baby is not hungry and you are not sure of the cause of the crying consider:

  • Watching the baby for clues to the problem. 
  • Holding and rocking the baby gently.
  • Change the baby’s position.
  • Keeping the baby close to your skin.
  • Using sounds such as a gentle voice or white noise.
  • Offering the breast periodically.
  • Using a pacifier for a few minutes until the baby is calm.
  • Ensuring that the baby is not screaming because something is wrong.

Your baby may be sick or not getting enough milk if while being held, the baby:

  • Is usually unhappy.
  • Will only settle when:

E) The effect of crying on parents

When babies are bothered, they nearly always let you know. Sometimes this means crying, a very effective tool to get your attention.

Pregnancy, labour, and breastfeeding cause radical changes in hormones that trigger adaptations in the mother’s body and brain, which makes caring for and protecting a baby easier (Hoekzema 2019). For example, breastfeeding mothers respond to hearing their babies cry with a complex series of neural and hormonal responses and can result in a her breasts warming, a milk let-down, and leaking (Swain 2011; Vuorenkoski 1969). Brain scans have shown that breastfeeding mothers appear to be more responsive to their baby's cries compared to infant formula-feeding mothers (Kim 2018).

Still, listening to a crying baby can be very stressful for parents and can lead to:

  • Unnecessary supplementation with infant formula and early weaning (Kent 2020; Mohebati 2021).
  • Loneliness and depression.
  • Worry and exhaustion.
  • Frustration, anger, a breakdown in family relationships, and even violence (Barr 2012; Botha 2019; Fairbrother 2018).

It is not uncommon for parents to visit hospital emergency departments over concerns about their baby’s crying and possible illness (Barr 2015; Calado 2009; Dudek 2016).

Parents’ attitudes about crying depend on their culture. In one study, 18% of the parents studied in the U.K. reported that their babies had colic, but only 7% of the parents studied in Denmark did so (Wolke 2017). The parents’ view of crying can also be affected by their own stress levels and emotions (Li 2017; Radesky 2013).

Many of the parents in our clinic report that their babies cry all the time. Once we describe the causes of normal crying, parents are able to prevent or fix most of the problems that lead to crying and view their child as much more contented.

F) Health-care providers’ approaches to crying

Many health-care providers do not feel comfortable dealing with crying. In a survey of 168 Australian pediatricians, only 1 in 3 (53) felt very confident in managing crying. They used approaches that were not always based on research and did not follow established guidelines (Rimer and Hiscock 2014).

This is not surprising given that:

  • Studies often have a different definition of crying which makes the research less useful (Gabrieli 2019). 
  • The term colic can further confuse the issue. 
  • The perception of crying is influenced by culture
  • The management of babies is fad-prone. 

For example, recently an increasing number of babies have been diagnosed with reflux and treated with acid-blocking medication. However these medications (Salvatore 2018):

  • Are not generally effective for treating crying.
  • Can have significant side-effects.
  • Do not fix the real reason the baby is crying.

References

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