Why Babies Cry at Nappy Changes, Baths and in the Car

A father leaning into a car to fasten the harness on his daughter's car seat while she smiles up at him

Three moments in the day reliably produced screaming in our house, and for a long time I filed all three under the same heading, which was that Shan disliked being messed about with. That was lazy of me. They have three different causes, they respond to three different things, and once I worked that out two of them stopped almost immediately.

What they share is that each involves a sudden change to what a baby can feel on her skin. That's the thread running through all of it, and the one I was slowest to pick up.

Nappy changes

The mistake almost everyone makes, myself very much included, is assuming the objection is to the nappy. It's usually the surface, the temperature and the position.

A baby laid flat on her back on a wipe-clean changing mat has gone, in one movement, from warm and held to cold, exposed and unable to see your face properly. Add a wipe that's been sitting in air-conditioning and you have a fairly reasonable complaint on your hands.

Cold, in every form. A cold mat, a cold wipe, cold hands, cold air on a bare tummy. Warm water on a soft cloth at home solves most of this and costs nothing.
The surface itself. A slick vinyl mat feels quite unlike anything else a newborn touches. A folded muslin or a soft cover over the top changes the whole experience, and for some babies it is the entire problem.
Being flat on the back, which from around four months is simply boring and from around eight months is an outrage, because there are places to be.
Losing sight of you. Talk continuously, keep your face close and in view, and give her something to look at above her.
Genuine soreness. If she cries specifically when you clean her and the skin is red or broken, that's nappy rash and it needs treating, not distracting.
Hunger or tiredness arriving at exactly the wrong moment, which isn't really about the nappy at all.

From four months onwards, speed beats technique. Have everything within reach before you start, give her something interesting to hold, and accept that you're working to a short deadline.

Bath time

Newborns very often dislike baths. The surprising part is that the water is rarely the problem, I think, though I never tested it properly, because by the time I'd worked it out she had stopped minding.

The undressing is the problem. Being stripped, held bare in moving air, then lowered into water is a great deal of sensory change in about forty seconds, and the crying frequently starts before anybody has got anywhere near the bath.

Temperature is the first thing to check, and it should be around 37°C. Test it with your elbow or your wrist, which feel temperature far better than your hands. Bathrooms here are often air-conditioned or draughty, so the room counts as much as the water.
Try a swaddled bath. Wrap her loosely in a thin muslin and lower her in still wrapped, unwrapping one limb at a time. This is well known among midwives and almost unknown among parents, and it works on a great many babies who scream at every other approach.
Get in with her. Skin-to-skin in the bath is calming, safe with a second adult on hand to take her out, and by far the easiest fix for a baby who hates being put down in water.
Keep her covered. A warm flannel laid over her tummy while she's in the water removes the exposed feeling entirely.
Go shorter. Five minutes is a complete bath for a newborn, and there's no obligation to bath daily at all.
Warm the towel first, and have it open and waiting, because the exit is where a good bath most often falls apart.

The situations themselves

The car seat

This is the one I never solved as a newborn problem.

Shan screamed in the car seat from birth. The interesting part, which took me two years to notice, is that she screamed when the car was stationary and settled when it was moving. Once I'd seen it I couldn't unsee it: the crying started at every red light and stopped when we pulled away. By the time she was one I was using the same fact, driving up and down the highway at one in the morning because motion was the only thing that would put her out.

What's behind it is a combination of things, and all of them are worse when the car is parked.

Being restrained, semi-reclined and unable to move, which is a great deal to ask of a newborn with no compensating motion to make up for it.
Heat. A car parked in the sun in Singapore becomes brutal within minutes, and a baby strapped into a padded seat can't do a single thing about it. Cool the car before she goes in.
The straps themselves. Over-tightening, twisted webbing, or a thick jacket or blanket underneath the harness. Nothing bulky goes between a baby and the straps, and this is a safety rule as well as a comfort one.
Not being able to see anybody. A mirror or an adult in the back changes some babies completely.
Motion sickness, which appears later, usually after the first year.
Reflux, which being semi-reclined after a feed makes a good deal worse.

The rule that overrides all of this: never unclip a crying baby while the car is moving, and never leave her sleeping in the car seat outside the car. Pull over and stop if you need to. I've done it on the Pan Island Expressway more than once and I'd do it again.

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If a baby cries at all three of these and at getting dressed and at having her hair washed, step back and ask whether the thread is the activity or the sensation, which is a question I didn't ask for years. Shan is ten now, and it's obvious she's sensitive to materials. She sleeps badly in anything thick, stiff or synthetic and well in soft, breathable cloth. As a baby that showed up exactly here, at the changing mat, at the moment of undressing, against the padding of a car seat, and I read every one of those as bad temper. I'm not suggesting every baby who hates the changing mat has a sensory difference, since most of them are simply cold. What I'd say is that if the pattern is consistent across every situation involving her skin, notice it instead of explaining it away, and raise it with a doctor if it persists alongside anything else that concerns you. The free version of acting on it is soft, thin, breathable fabric everywhere it touches her, and a check for labels and seams. It cost me nothing when I finally tried it, and it was the answer.

When it isn't the activity

All of the above assumes an otherwise contented, well baby who objects to specific moments. These are the signs of something else, and they're good to know.

Crying that has spread across the day and no longer belongs to particular situations.
Crying with a fever, poor feeding, vomiting, or unusual sleepiness.
Distress on being handled or moved generally, or when a particular limb is touched, which needs same-day assessment.
Screaming episodes with the legs drawn up and vomiting, which need immediate attention.
Skin that is red, broken or blistered anywhere the crying is concentrated.
A cry that is high-pitched, weak or unlike her normal one, or a temperature of 38°C or above under three months.

Where this comes from

This guide is general information, written to help you understand a topic and ask better questions. It is not medical advice and does not replace your own doctor, midwife or paediatrician. Anything that worries you about your baby belongs with them.

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