What Can You Do When Your Baby Won't Stop Crying?

From the Show: Healthy Children
Summary: Crying serves several useful purposes for your baby. But, sometimes the crying won't stop. It's unnerving at the very least, so what's a parent to do?
Air Date: 2/25/15
Duration: 10
Host: Melanie Cole, MS
Guest Bio: Wendy Sue Swanson, MD, MBE, FAAP
Wendy Sue Swanson headshot high resDr. Wendy Sue Swanson is a board certified pediatrician, mother to two young boys and the author of the Seattle Children’s Hospital Mama Doc Blog, the first pediatrician-authored blog for a major children's hospital.

Dr. Swanson is interested in the intersection of media and medicine and its impact on the physician-patient relationship. Her online presence through her blog and Twitter has touched the lives of hundreds of thousands of parents who would have been beyond her reach without social media. Dr. Swanson works diligently to offer parents relevant, practical, and timely health information in accessible formats and she believes that a growing community of online physicians can empower parents and patients to make informed decisions based on science. Tackling issues from vaccines to potty training to work life balance, Dr. Swanson provides a voice of reason, not only as a pediatrician but also as a parent, helping parents gain clarity and eliminate fear when making decisions for their children. Her book, Mama Doc Medicine, published by The American Academy of Pediatrics, hit bookshelves in early 2014.

Dr. Swanson is the founder and executive director of Digital Health at Seattle Children’s. She is also an executive committee member of the American Academy of Pediatrics Council on Communications and Media. She is also on the Board of Advisors for Parents magazine and is on the board for the Mayo Clinic Center for Social Media. She is a weekly medical contributor with NBC affiliate KING 5 News in Seattle and is a practicing pediatrician with The Everett Clinic. Dr. Swanson is an advocate on the topic of vaccines and was named a CDC Childhood Immunization Champion in 2012. She was named to TIME Magazine's Best Twitter Feeds of 2013.
What Can You Do When Your Baby Won't Stop Crying?
Crying serves several useful purposes for your baby. It gives her a way to call for help when she’s hungry or uncomfortable. It helps her shut out sights, sounds, and other sensations that are too intense to suit her. And, it helps her release tension.

But, sometimes the crying won't stop.

It's unnerving at the very least, so what's a parent to do?

Try to pay close attention to your baby’s different cries. You’ll soon be able to tell when she needs to be picked up, consoled, or tended to, and when she is better off left alone.

You may notice that your baby has fussy periods throughout the day, even though she’s not hungry, uncomfortable, or tired.

Wendy Sue Swanson, MD, discusses your baby's crying habits, what they mean, and the best ways to deal with a fussy baby.

RadioMD Presents: Healthy Children | Original Air Date: February 25, 2015
Host: Melanie Cole, MS
Guest: Wendy Sue Swanson, MD

This is Healthy Children brought to you by the American Academy of Pediatrics on Here’s Melanie Cole, MS.

MELANIE: When you have a crying baby, there’s almost nothing else that goes on in your life that matters. It’s unnerving. It’s sad. You don’t know what to do for the baby. You’ve tried rocking; you’ve tried all the things that you think you need to do to calm this baby down. When is the excessive crying something that you actually worry about? Is the baby trying to tell you something? Does something hurt? I mean, there are a million reasons that babies cry. They could have a hair wrapped around their finger and you just never seem to know, but we’re going to find out here today.

My guest is Dr. Wendy Sue Swanson. She’s a Board Certified pediatrician and the author of Mama Doc Medicine, a rocking book for all parents.

Welcome to the show, Dr. Swanson.

So, calming a crying baby. When they’re crying, usually crying is clues. “I’m hungry. I’m wet. I’ve got to poop.” Something like that. When it keeps going and you’ve changed their diaper and you’ve fed them and they’re still crying, what’s the deal?

DR. SWANSON: Well, you bring up a good point. I think, in general, we think in a person’s lifetime, when they’re crying, they’re alarming us and sending up a flare that something’s not going well. There’s a different time in life that we can’t forget to mention when crying is just physiologic, meaning it’s really just a part of being a mammal. So, you know, the first couple weeks of life, babies don’t make a lot of noises. They may gurgle and they spurt and they breathe, but they don’t really cry. As moms are kind of getting through those baby blues, thank goodness, babies are really quiet. But, around 2 weeks of age, and accelerating up to 6-8 weeks of age, just as moms and dads are getting super tired, normal crying behaviors really accelerate and peak. At 2 months of age, some babies only cry about 20-30 minutes. We call those low criers, but there are high criers out there, Melanie, and it isn’t because there’s something wrong. It’s just the physiologic part of crying behaviors. We have had a lot of studies in the last years and kids will cry even up to 3, 4, 5 hours a day. So, just to be clear there are times in a child’s life in that early infancy, crying is just a part of being a baby. But you’re right, it is unnerving and there’s a lot that we can do.

It comes, I think, from a two-fold response. We have to make sure that there isn’t anything seriously wrong with our baby—that they don’t need to be changed because they’re wildly uncomfortable with their rash; that they’re not ready to feed and we missed it; that they’re not overheated, right? Things like that. And they don’t have something like what you mentioned, a hair tourniquet where a little piece of hair gets wrapped around their toe or their finger.

MELANIE: A hair tourniquet.

DR. SWANSON: Yes. That’s what they’re called, but they’re really rare. So, I think what we have to figure out is, is my baby okay? Making sure they’re not suffering from an illness or a fever or something that is really alarming. But, the other thing to remember is that we’re taking care and making sure our baby’s fed, they’re comfortable, they’re being held because you can’t spoil a newborn baby by holding them. And then, second, we have to take care of ourselves. We know that this is very unnerving and unsettling and particularly moms who are alone during the day after other family members are back at work, etc., it’s exhausting to have one of these high crier babies. So, nourishing ourselves, taking breaks, taking rests, knowing that if we are suffering from post-partum depression, that we really talk to people about that because it can make the crying experience even worse if we’re stressed and upset and angry. So, I think making sure we’re really always talking about a dual-pronged approach: making sure baby is safe, making sure mom and dad are safe, taking breaks, getting respite when we need it.

We can also talk about what we do for our babies physically to really help support them as well.

MELANIE: Okay. Well, I know that my daughter cried colicky. Oh, my God, she cried incessantly. Some of it was due to reflux, and then we noticed the pattern and it was after eating, so we had to have her sitting up and such. When gas seems to be the number one thing that I hear from parents is, “Oh, it’s gas. It’s gas. It’s gas,” try those Little Tummys and all those things. Do those work? How do we know if it’s gas?

DR. SWANSON: Good question. Let talk just about the kind of herbals. You know, back in 2000, there was a pediatric study published by the American Academy of Pediatrics that looked at 15 large studies, nearly 1000 babies, to say do things like probiotics, chiropractors, herbal supplements, sugar glucose solutions, those tea type solutions, did they help? And, unfortunately, no. None of those helped with those crying behaviors. Even where babies do that thing where they get all red in the face and they grunt and then they pass big gas and then they’re kind of a little bit happier. It’s like, “Oh, it’s gas that’s making them upset.” We don’t think there’s a lot of data to suggest that these herbals and supplements need to be given. You’re right that things like an intolerance for cow’s milk protein, sometimes physiologic gastroesophageal reflux or even gastroesophageal reflux disease that causes kind of acid burn, that can sometimes upset babies. So it’s always great if you’re worried about the amount of crying for your baby, I can’t tell you enough, I think you should go in to talk with your pediatrician to make a care plan. Because even if you’re just overwhelmed and excited that something might be wrong, getting the reassurance that a pediatrician doesn’t think so, but also getting their support in helping you know that you’re baby is well and healthy and helping you make a plan for what you do, like keeping your baby up after feeding, maybe potentially switching your diet, if you’re nursing, that can be important.

But, with crying behaviors one of the most important things I think we have to remember is that the minute we think we know what’s causing crying behavior in a newborn baby, it’ll shift and change. So, instead of being a sleuth or an investigator at home all the time, think, “What is it that just works?” I love thinking about Dr. Harvey Karp’s Five S’s where he talks about the “shushing”, the side, the swaddling, the swaying. What is it that your baby loves? What is it that calmed them on Tuesday? Keep doing it when you can. When you figure out a position your baby loves: a way that they love being held, music that they love, you know, sitting, lying on their tummy, lying on their back for a time right next to the washing machine that’s rocking and rolling and making a nice, soothing white noise--whatever it is, is great. Making sure your baby is in a safe environment and just kind of leveraging your great skills.

But always remember that you will not probably make all crying go away because that physiologic crying can still happen. So, when a baby’s crying inconsolably and you’re really frustrated and it’s been five minutes or it’s been 15 minutes or it’s been half an hour and grandma can’t come and relieve you, making sure to know, too, it’s okay to put your baby on their back in a safe crib and walk away for 5 minutes and give yourself a break. Go out on the porch. Have a soda. Take a break and give yourself some rest, too, because it’s that dual approach of making sure baby’s safe, making sure mom and dad are safe, too.

MELANIE: I absolutely agree with you about if you have to walk away or set the baby down, because, as you say, it’s so unsettling and you can see why some parents really get freaked out when the babies cry, but you’re saying if we do to set them down and we take that time for ourselves. Crying or whatever they’re crying about is not really harmful to this baby.

DR. SWANSON: That’s right.

MELANIE: I mean, letting them cry for a few extra minutes, it’s not going to hurt them in any way. That’s what a lot of parents think.

DR. SWANSON: You’re right. I think we have a culture that is very intolerant of crying. People complain on airplanes, people complain in the grocery store, people leer at us when our kids are tantruming when they’re 12 or 3 or 3 months. So, we have to, as parents, really be confident that this crying behavior in the newborn time, it’s okay and certainly, I worry so much more about parents than I do about babies with a baby crying for 5 minutes. We know that excessive crying is the number one trigger for shaking a baby. So seriously, I want parents to really understand that crying is okay from time to time and with these high criers making a good plan with your pediatrician to make sure there’s nothing medical going on and to also really know that this crying peaks at 6-8 weeks and then it really does get better. So, those babies that some people will experience as colicky, it is not forever that this goes on, so just making sure that you understand and can confirm that your baby’s really well and healthy; that you’re doing everything in the best way you can; and that you also know this will change with time. You can put into place respite and ways that you can tolerate even just letting your baby cry for 3-5 minutes knowing they’ll be safe, healthy and fine and also that you will be, too. I think this is the most important message we can give to parents who are raising these beautiful babies that will cry and scream and make some of our days so miserable.

I mean, I remember own baby crying and running up and down the stairs to get rid of my energy because it can be so frustrating.

MELANIE: It absolutely can and in 30 seconds, Dr. Swanson, kind of review the 5 S’s for us, just for people to give them a little help.

DR. SWANSON: Yes. I mean, I think really, the 5 s’s are just some skills that Dr. Karp really talks about where you can put your baby, on their side; you can “shush” them by making some nice noises; you can swaddle them. Babies love being burritos in those blankets because that kind of tightness sometimes can be really soothing. You can sway with them, right? You can sing to them. You can really find techniques and parents do a great job of this. Just know that when you use those 5 S’s, sometimes the crying won’t go away, too, and that’s just fine as well.

So, supporting your baby and supporting yourself at the same time. Really important to know that crying behaviors can be very, very normal.

MELANIE: Absolutely great information.

You’re listening to Healthy Children right here on RadioMD.

This is Melanie Cole.

Thanks for listening and stay well.
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