Is Your Baby Fussy?
You are Not Alone
It is commonly assumed that babies "cry for a reason", so it is not surprising then that "all babies cry". Both new and experienced parents are, however, often perplexed by their infant's cry. About 1 in 5 babies born in the United States cries excessively during the first months of life. These babies fuss more than most babies and have longer bouts of unsoothable crying. Excessive crying is not correlated with parental age, education, or the child's birth order. Commonly called colic, excessive infant crying typically subsides in the first 3 months. Nevertheless, parents rarely forget the experience of colic, which often becomes part of the family story.
While excessive crying has been defined in various ways, the one common theme is that parents view it as distressful and work to stop it. For "typical babies", new parents can expect an increase in crying over the first few weeks of life, which typically peaks at 2 and half hours per day at 6-8 weeks of age. For "excessive criers", these crying episodes last longer and tend to cluster in the evening, and the total crying is typically greater than 3 hours per day. For "colicky babies", many parents report that their infants have a higher pitched cry, grimace and draw-up their legs. They may also have abdominal distention, pass gas, or clench their fists. Parents report this crying behavior is typically resistant to soothing. Thankfully, for most babies and their parents, this high level of crying or crying associated with these behaviors decreases by 3–4 months of age.
Medical causes of excessive crying account for 5% or less of the babies with excessive crying. For most infants, this excessive crying is part of learning to soothe themselves. All parents learn that "common things happen commonly" and first check to see if their crying infant is tired, wet, or hungry. However, for some families and their child care providers, medical reasons for excessive crying must be ruled out. These rare but diagnosable conditions include cow's milk protein intolerance, fructose intolerance, infantile migraine, and gastroesophageal reflux.
For most babies, excessive crying resolves by 3-4 months of age; however, a small proportion of these babies continue to cry excessively beyond 4 months. Parents of babies for whom the crying does not resolve should be in contact with their health care provider to watch their babies‘ development and to talk about the stress related to caring for the baby and support services that can help. Excessive infant crying causes tremendous parental and family stress. Families need a team of providers that can collaborate and work together to reduce stress and promote the healthy development of their infant. The joy of bringing a new baby into any family need not be diminished by excessive crying.
