Infant Crying: Causes, Soothing and When to Worry

How much crying is normal

All babies cry, and crying follows a predictable curve. It increases from about 2 weeks, peaks at around 6 to 8 weeks, and is much less by 3 to 4 months. It is often worst in the late afternoon and evening. Some experts call this the Period of PURPLE Crying:

• Peak pattern: crying peaks around 2 months
• Unexpected: comes and goes without reason
• Resists soothing
• Pain-like face, even when not in pain
• Long-lasting: can last hours
• Evening: happens more in late afternoon and evening

Common reasons babies cry

• Hunger: the most common reason in newborns. Early hunger cues are rooting, lip-smacking and hand-to-mouth before crying starts.
• Tiredness: overtired babies find it harder to settle. Newborns can usually stay awake only 45 to 90 minutes.
• Discomfort: a wet or dirty diaper, being too hot or cold, tight clothing.
• Wind and swallowed air: burping during and after feeds helps.
• Overstimulation: noise, light, visitors and handling.
• Wanting closeness: being held is a genuine need, and responding does not "spoil" a young baby.
• Growth spurts: cluster feeding and fussiness for a few days around 2 to 3 weeks, 6 weeks and 3 months.

Colic

Colic is defined as crying for more than 3 hours a day, on more than 3 days a week, for more than 3 weeks in a baby who is otherwise healthy and growing well. The cause is unknown. It may reflect an immature gut and nervous system and normal developmental crying at the far end of the range. Colic is not harmful to the baby and goes away on its own by 3 to 4 months in most babies, but it is exhausting for parents.

Medical causes of crying

Fewer than 5% of babies who cry excessively have an underlying illness. Clues that point to one:

How a doctor assesses a crying baby

A doctor will ask about the pattern of crying, feeding, vomiting, stools, sleep, weight gain and how you are coping. They will undress the baby fully and check temperature, heart rate, weight, the soft spot, eyes, ears, mouth, belly, groin, hips, skin, and fingers and toes for hair tourniquets. Most babies need no tests. A urine test is common if the baby has a fever.

Soothing a crying baby

Try one thing at a time, for a few minutes each:

1. Check basics: feed, diaper, temperature, burp.
2. Hold close: skin-to-skin contact or a baby carrier.
3. Swaddle snugly around the arms but loosely at the hips. Stop swaddling once your baby shows signs of rolling.
4. Side or stomach hold while you are holding and watching them. Always place your baby on their back to sleep.
5. Shush: white noise or a steady "shhh" sound.
6. Swing gently: rocking, walking or a slow rhythmic sway. Never shake.
7. Suck: a pacifier or feeding.
8. Change the scene: a walk outside in a stroller or a drive in a properly fitted car seat.
9. Reduce stimulation: a dim, quiet room.

Gripe water and simethicone drops have little evidence of benefit. Some breastfed babies with colic may improve if the mother removes cow's milk from her diet for 2 weeks, but discuss this with your pediatrician first. Probiotic drops (L. reuteri) may reduce crying in some breastfed babies.

When you feel overwhelmed

Persistent crying is one of the main triggers for abusive head trauma (shaken baby syndrome), which can cause brain damage or death. If you feel frustrated or angry:

• put your baby on their back in a safe crib
• close the door and step away for 10 to 15 minutes
• call a partner, friend, relative or your pediatrician
• check on the baby every 5 to 10 minutes

It is okay to let a safe baby cry while you calm down. Persistent low mood, anxiety or thoughts of harming yourself or your baby can be signs of postpartum depression. Tell your doctor, and call or text 988 (US) if you are in crisis.

Frequently asked questions

Why is my baby crying so much?

Most crying is due to hunger, tiredness, discomfort, wind or the need for closeness. Crying normally increases until about 6 to 8 weeks and then eases. If your baby is feeding and growing well and settles at times, it is likely normal crying or colic. Unusual crying, fever or poor feeding need a doctor.

When should I worry about my baby crying?

Seek urgent care if the cry is weak, high-pitched or unusual, if your baby is under 3 months with a fever of 100.4 °F (38 °C) or higher, or if crying comes with vomiting, poor feeding, floppiness, breathing problems, a rash that does not fade or a bulging soft spot.

How long does colic last?

Colic usually starts at around 2 to 3 weeks of age, peaks at about 6 weeks and improves by 3 to 4 months. In a small number of babies it lasts until about 5 or 6 months. It does not cause long-term harm.

Is it okay to let a baby cry?

Responding to a young baby's cries helps them feel secure and does not create bad habits. However, if you are overwhelmed, it is safe to put your baby on their back in a crib and take a short break. A brief cry in a safe place is far better than shaking or harming a baby.

Can a baby cry because of what I eat while breastfeeding?

Occasionally. A small number of breastfed babies react to cow's milk protein in the mother's diet, causing crying with vomiting, eczema or mucus in stools. Other foods are rarely the cause. Talk to your pediatrician before cutting out foods so your diet stays nutritious.