Babies have an amazing ability to communicate without words, through their delightful expressions, sounds and body language. But the reverse can be true as well, when the slightest amount of discomfort may steer them into a crying frenzy.
- Fussing and crying are normal aspects of development during the first few months. It is, after all, the only way that babies can communicate their hunger, sleepiness or tiredness.
- There is no standard definition for “excessive” crying, but the question is when to take the cry seriously and seek medical help? When do the alarm bells start ringing?
Common Causes of Incessant crying in Infants
- A parent should first check for manageable causes of crying, most common of which are hunger, sleep, tiredness or overstimulation.
- Pain – Check for signs of illness or physical injury. Feel the skin to determine if the baby is overheated or too cold. Check to see if the clothing or diaper is too tight or if a hair is wrapped around a finger, toe, or the penis (called a hair tourniquet). Any foreign body in the eye must also be excluded.
- Fatigue or overstimulation – Babies often cry when they become tired or over stimulated from playing or being handled.
- Food sensitivities or gastro esophageal reflux – Food sensitivities may be suspected if an infant cries or spits up a large amount within an hour of feeding or if a baby has constipation or diarrhea or bloody stool.
- Cow’s milk protein intolerance – If the baby isn’t being breast-fed, hypoallergenic formulas may be tried in infants with cow’s milk intolerance that has regurgitation or loose or bloody stool. Infants who respond to the formula change may be given cow’s milk formula again at three to four months of age.
- Earache – especially during viral illnesses, pulling the ear or discharge from the ear must be taken seriously and treated promptly. It is advisable to get an ear checkup done in all babies even when they show no obvious cause of distress.
All parents would have heard of infantile colic or experienced it and it is a nerve wracking experience for them.
Colic épisodes are caused due to episodic intestinal contractions by gut hormones.
- Colic is often defined by the “rule of three”: crying for more than three hours per day, more than three days per week and for longer than three weeks in an infant who is well-fed and otherwise healthy.
- The crying appears more intense, and higher pitched than “normal” and babies are extremely difficult to soothe. The physician’s role is to ensure that there is no organic cause for the crying.
- Parents need support and reassurance that their baby is healthy and that colic is self-limited, mostly resolving by 4 months of age, with no long-term adverse effects.
- Mothers who are breastfeeding should be encouraged to continue. Burping after each feed and keeping the baby in an upright position helps to expel swallowed air while feeding.
- Simethicone a safe, over-the-counter drug for decreasing belly gas, may be tried. Carrying or swaddling the baby, a ride in the car, infant swing, gentle massage and warm baths may help to soothe an infant with colic.
- A product called “Gripe Water,” which may include a variety of herbal oils is touted to provide colic relief but it may contain hazardous substances like alcohol, steroids or other additives and hence I wouldn’t recommend it as newborns are especially vulnerable to these agents.
When to seek medical help?
If these causes have been eliminated and the baby continues to cry excessively, parents should consult their health care provider forthwith.
An Expert Blog by Dr.Shreya Sharma
Dr. Shreya Sharma is a childcare expert and an M. D. in Pediatrics; she is currently a Fellow Pediatric Endocrinologist in Bai Jerbai Wadia Hospital for Children, Mumbai.