The evening fussies

Why is my baby fussy every evening?

Many healthy babies become fussy in the evening. Typically, they are unsettled for two to three hours. They feed frequently during this time but only for short periods. Eventually, after loading up on milk and tiring themselves out, they may sleep for up to five hours. Babies usually outgrow the fussies by about four months. The cause of the fussies is unknown. Some mothers think they are caused by a declining milk supply. In fact, that rarely happens. Other mothers worry that their baby is sick. The best way to handle them is to settle in on the couch and breastfeed and support the baby. There is little evidence that medications or milk supplements are effective. If a baby is fussy outside of these times, the baby may not be getting enough milk or may be sick.

A) Describing the evening fussies

1) The baby's behaviour during the evening fussies

Many babies become fussy in the evening even though they are generally happy during the rest of the day (Barr 1990). Typically, babies are unsettled for two to three hours during the evening or at night. Rarely the fussies continue for four hours.

Babies feed frequently but for short periods. Every solution caregivers try, such as breastfeeding, rocking, bouncing, burping, more feeding, and so on, seems to settle the baby only for a few minutes.

The evening fussies are one of the most common causes of concern for mothers.

After loading up on milk and tiring themselves out, babies often sleep for up to five hours.

2) Other names for the evening fussies

We call this behaviour the evening fussies, as this best describes the behaviour - babies are fussy in the evening! There are several other terms for this but they don't describe the behaviour as well:

  • Cluster feeding: Babies aren’t just feeding more during this time; they are also a little unhappy. 
  • Mild colic: We do not like this term because it suggests something is medically wrong and doesn’t describe what is happening.
  • Purple crying: During this time, babies don’t usually scream so hard that they turn purple. Indeed, hard screaming can be a sign of a major problem and should not be dismissed.
  • The witching hours: This doesn't describe the bevariour.

3) Causes of the evening fussies

The cause of the evening fussies is not known. One study identified immature development of the stress (cortisol) and sleep (melatonin) hormone rhythms (Ince et al. 2018).

B) Evening fussy patterns

1) How many babies are affected

One study (Wessel 1954) found that half of the babies studied had a fussy period in the evening and we have found similar numbers in our clinic. 

2) Ages of the babies affected

One study (Wessel 1954) looked at 98 babies and found that the evening fussies could start as early as the second week after birth and tended to last about eight weeks.

We have found that the onset of the evening fussies can occur as early as the second night after birth or as late as three weeks of age.

Once babies outgrow the fussies and are no longer loading up on milk before sleeping, usually by four months, they may start waking more at night.  

3) Timing of the evening fussies

A baby will usually start fussing at the same time every evening and the fussies happen most evenings. The most common times for the fussies to occur are between 7 and 10 p.m. or between 9 p.m. and midnight.

Premature babies tend to fuss between midnight and 3 a.m. or between 3 and 6 a.m. Once past their due date, however, the fussing usually moves to the evening.

Some young babies have a shorter morning fuss as well as an evening fuss. The morning fuss usually disappears within two weeks of starting, leaving only the evening fuss. The fuss is regularly followed by a good sleep. 

C) How to deal with the evening fussies

The best way to handle the evening fussies is to settle in on the sofa or a comfortable chair with your baby, breastfeed whenever the baby is interested, and support the baby with movement (rocking, bouncing, or walking) and burping. Change the approach if it no longer settles the baby and this may mean changing as often as every few minutes.

Ask others to handle the evening household chores and prepare other children for bed. If you find yourself stressed, you can distract yourself with music, movies, television, podcasts, or an audiobook. 

Bottle-feeding rarely relieves the fussies. There is no evidence that over-the-counter medications are effective, and some can even be dangerous. Similarly, prescription medication will not fix the evening fussies.

Remember that the evening fussies:

  • Are normal.
  • Are common.
  • Will only last for about three hours.
  • Will increase the chances of the baby sleeping up to five hours.
  • Will stop after the first few months after birth.

D) Worries about milk supply

Many mothers mistake the evening fussies for “losing their milk” because their breasts feel soft and empty at this time of day. The baby’s frequent breastfeeding to load up for the night’s sleep prevents the mother from storing milk and her breasts stay soft. Breasts don’t just stop making milk. Rather they make it continuously.

It is very rare for mothers to have a decrease in milk supply. Most breastfed babies get lots of milk. Unfortunately, some mothers start unnecessarily supplementing their baby with infant formula or expressed breast milk because of this confusion over the cause of the evening fussies. Before choosing to supplement, remember that the evening fussies are normal. You do, however, need to ensure that your baby is getting enough milk and growing well.

If you have started to unnecessarily supplement your baby, you may be able to stop the supplements and return to full breastfeeding.

E) Worries about illness in the baby

The evening fussies have a clear start and end, happen around the same time each day, and typically last 2 to 3 hours.  Away from this time, the baby should be mostly happy when fed and held and the baby should show all the signs of growing well. When healthy babies have the evening fussies, some mothers unnecessarily worry that their babies are suffering from:

Crying caused by illness may happen whenever the baby is awake and not just in the evening. A baby who is fussy for longer than 3 hours, fussy outside of the evening hours, or is always fussy is likely not getting enough milk or is sick. This is not the evening fussies. Please see your health-care provider if you notice these behaviours.

References

Barr RG. The normal crying curve: what do we really know? Dev Med Child Neurol. 1990 Apr;32(4):356-62.
 
İnce T, Akman H, Çimrin D, et al. The role of melatonin and cortisol circadian rhythms in the pathogenesis of infantile colic. World J Pediatr. 2018 Mar 5
 
Wessel MA, Cobb JC, Jackson EB, et al. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954 Nov;14(5):421-35