Why Is My Newborn Crying?

An exhausted mother resting in an armchair with her baby asleep against her chest while her partner brings her a mug of tea

There's a particular hour, somewhere between three and four in the morning, when you've fed her, changed her, checked she isn't too warm and winded her twice, and she's still crying, and you begin to suspect that the problem is you.

I spent a good deal of Shan's first months in that hour, working through a mental list that got shorter and more desperate each time round. What nobody told me, and what I'd put on the first page of every discharge folder if it were up to me, is that the list is short, that most crying has a cause you can find in about ninety seconds, and that a real amount of it has no findable cause at all.

That last part sounds like a defeat, though it arrives as a reprieve. Unexplained crying is a documented feature of the first months, and knowing it in advance turns a frightening night into merely a hard one.

The eight, in order

Work down this list in order. The first four take about ninety seconds between them and account for most crying in the early weeks, which on a good night means you're back in bed before you've properly woken up.

Hunger. Most common by a distance in the early weeks. Rooting, hands to mouth and stirring all come before crying, which is a late signal.
Nappy. Not every baby minds, but some mind a great deal.
Temperature. Feel the chest or the back of the neck, never the hands. Too warm is the more common error and the more dangerous one.
Wind, or needing to be upright. Hold them against your shoulder for a few minutes before concluding anything, the burping guides below cover the positions that work.
Tiredness. An overtired newborn cries harder and settles worse. Awake windows in the first six weeks are only about 45 to 60 minutes.
Overstimulation. Too much light, noise, handling or company. The answer is fewer inputs, not another technique.
Wanting contact. Being held is a genuine need at this age, and no amount of it'll spoil her.
Pain or illness, the smallest category, and the one the last section of this post is about.

The ones people forget

Then there's the category nobody covers in an antenatal class, which I now mention to most new parents I meet, generally to their alarm.

A hair tourniquet is a single strand of hair, yours in all likelihood, since you're shedding a remarkable quantity of it, wound tightly enough around a toe, a finger or, in boys, the penis to cut off the circulation. It hurts a great deal, producing exactly the sustained, inconsolable, nothing-is-working crying that sends people to A&E at midnight, and unless you go looking for it it stays invisible.

Go looking. Count the toes and the fingers on any baby crying for no reason you can find. Twenty seconds.

A scratched cornea, often from their own nails. Suspect it if they're crying with one eye closed or watering.
Clothing: a tag, a seam, a thread wound round a toe inside a sleepsuit.
A limb caught awkwardly, or an arm trapped in a sleeve.
Constipation, particularly in formula-fed babies.
Something the feeding parent has eaten, in a small number of babies. Investigate properly, with guidance, before you cut anything out.

By situation

I had assumed, in the way you do at six weeks, that a baby crying more than she had at three weeks was a baby getting worse, and that the getting worse was in some fashion my doing. A reasonable inference and hopelessly wrong, in a way that one diagram and thirty seconds of somebody's time would have corrected. Infant crying follows a shape, the same shape across cultures, across feeding methods and, as far as anyone can tell, across centuries. It climbs from around two weeks, peaks somewhere between six and eight, and falls away between three and four months. There are numbers attached, which I find far more comforting than reassurance. A meta-analysis pooling 28 diary studies and 8,690 infants put average fussing and crying at 117 to 133 minutes a day through the first six weeks, dropping to about 68 minutes by ten to twelve weeks. Two hours a day at the peak. Roughly an hour by three months.

Two things follow. A baby crying more at six weeks than she did at two isn't deteriorating, she's on the curve, doing what almost every baby does. And the worst fortnight has a known end, which is an entirely different thing to endure than a fortnight that might go on indefinitely.

The week I learned this was the week the nights stopped frightening me. Nothing about Shan's crying changed in the slightest. What changed was that I knew where on the graph the two of us were standing.

Colic sounds like a diagnosis and describes rather more than it explains, which I'd hold on to when somebody applies the word to your baby.

The definition is pure arithmetic: crying for more than three hours a day, more than three days a week, for more than three weeks, in a baby who's otherwise well and growing. It affects roughly one in five, it has no established single cause, and it resolves on its own by three or four months. Nobody is going to find the thing that's wrong, because there's no thing.

Which moves the question along to what doesn't work, since that list is shorter and better evidenced.

Most over-the-counter colic remedies have weak evidence behind them or none at all. The single exception deserves its full name, because the vague version will send you to the wrong shelf: Sung and colleagues pooled the raw participant data from four double-blind trials covering 345 infants, and found that Lactobacillus reuteri DSM 17938 cut crying and fussing by around 25 minutes a day by day 21, with a confidence interval running from 47 minutes down to three. I can't remember which brand we bought, though I'm not sure it did anything for Shan.

Twenty-five minutes is a real effect and a modest one, and it held for breastfed infants only. Take the strain name to your doctor. The evidence attaches to that strain alone and the pharmacy will happily sell you six others.

As for cutting foods out of your own diet, do it with guidance or not at all. Eliminating dairy on a hunch for six weeks while running on four hours' sleep makes a difficult period harder, and it very rarely produces a clear answer. I know because I tried it, for a fortnight, and learned nothing.

What soothes

They're all versions of the same two ideas, less input and more contact, and the one that works tonight stands a fair chance of failing tomorrow for reasons you'll never establish.

Skin-to-skin contact. The most reliable single intervention, and it does more than settling. It regulates temperature and supports feeding.
Movement, slow and rhythmic. Walking, rocking, a pram over uneven ground.
Steady low sound. The household hum they were used to before birth, not silence and not loud.
Sucking, at the breast or on a dummy once feeding is established.
Swaddling, for babies who take to it, with the arms in and the hips loose.
A change of scene. Stepping outside resets a lot of evening crying.
Fewer inputs. Dim the room, stop talking, stop bouncing. An overstimulated baby needs less, not more.

Never shake a baby

There's a part of this subject that most pages imply and very few say outright.

Mentioned above

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Shaking a baby causes serious and usually permanent brain injury. The circumstances are almost never the ones people picture on reading that sentence.

Decide what you'll do now, while you're reading this calmly, and have the decision already made when the moment arrives.

If the crying has taken you past what you can hold, put her down somewhere safe, a cot, on her back, walk out of the room, and take a few minutes. A baby crying alone in a cot for five minutes is perfectly safe. Leaving the room is the right thing to do, and there's nothing whatever to feel guilty about afterwards.

Tell everyone else who looks after her the same, and mean it.

When it isn't ordinary crying

Everything above assumes a well baby having a hard time, which is overwhelmingly the likeliest explanation. These are the signs of something else, and they want attention today.

A temperature of 38°C or above in a baby under three months.
A cry that is high-pitched, weak, continuous or unlike their usual one.
Floppiness, unusual drowsiness, or being difficult to wake.
Difficulty breathing, grunting, or pauses in breathing.
A rash that doesn't fade when pressed with the side of a glass.
A bulging or sunken soft spot on the head.
Green or bile-stained vomit, blood in the stool, or a swollen hard tummy.
Inconsolable crying in episodes with the legs drawn up, particularly with vomiting. This pattern needs immediate assessment.
Refusing feeds, or no wet nappy for 12 hours.
Any sense that this isn't your baby's normal cry. Parental concern is treated as a warning sign in clinical guidance for good reason.

The last item on that list earns its place. Paediatric guidance treats parental concern as a warning sign in its own right, which is a formal way of saying that your sense something is wrong counts as evidence, and you're entitled to act on it.

What I read

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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