Upon coming out of the womb a newborn baby will cry and take the first breath. If this does not occur, the attending doctor will take the necessary steps to ensure that there is no airway obstruction and that the baby is breathing properly. From this point on, the baby learns that crying is a means of communicating with others.
Taking care of a newborn baby may be stressful enough for a mother, especially if it is her first child, but a newborn baby who cries excessively may be very distressing. Interpreting the causes of crying in the newborn baby is an essential part of motherhood. It is normal for a healthy newborn baby to cry two to three hours in a day. Some babies cry more than others and some cry more at night. As the mother bonds with the baby, she gradually gets to know why her baby is crying, whether it is a need for a feed, attention for a diaper change or some other cause of distress for the baby.
Causes of Crying in a Newborn Baby
Often it is difficult to understand why a baby is crying and it may become a task to soothe a crying infant. Some of the common reasons for crying in newborn babies includes :
A hungry baby will cry because this is the only form of communication at their disposal. Announcing their desire to be fed is one of the main reasons for sleepless nights for parents as a newborn may need to be fed every 3 to 4 hours at night.
Fixed schedules for feeds may not be enough to satiate the baby and even the slightest hunger pangs will cause irritability and incessant crying. Nevertheless, a feeding schedule can help reduce the frequency of crying bouts. In the first few days of life, a baby may tend to sleep for long hours and may not demand regular feeds.
A suitable feeding schedule will plan a feed every 2 to 3 hours during the day and every 3 to 4 hours at night. If this is not palliating the situation, demand feed may be a better option. For mothers with a low breast milk supply, fixed feeding schedules and even feeding on demand may not suffice as the quantity of milk is insufficient to satisfy the baby. In these instances, if breast milk production cannot be increased, then bottle feeding may have to supplement the breast feeds.
A baby who continues to cry after a feed is an indication of an insufficient milk supply, either due to breastfeeding or bottle feeding. Increasing the size of the feed may be an option.
In the first 6 months of life, breast milk is sufficient with no other fluids necessary, including water. However it is believed that a child may experience thirst either due to a strong formula mix, feeding cow’s milk to a newborn baby or a high salt content in breast milk.
It is important to note that a high salt intake by the mother does not determine the salt content of breast milk. When the mother is dehydrated or if there is poor drainage of breast milk from the tissues, the breast milk may contain a higher salt concentration which can lead to thirst. The newborn baby cannot understand nor communicate the feeling of thirst and may cry even after being fed.
Failure to attend to this problem can lead to a condition known as neonatal hypernatremia.
Wet or Soiled Diaper
A wet or soiled diaper usually causes significant discomfort and crying is the baby’s way of informing the caregiver that their diaper needs attention. However a wet or soiled diaper will not always cause a baby to cry and diapers should be checked frequently. If left unattended for long periods, a wet or soiled diaper can contribute towards nappy rash. The dry, itchy skin as a result of nappy rash will often trigger more bouts of crying.
Babies are dependent on the presence of others and some social interaction to develop and grow mentally and emotionally. If a baby is left alone for even short periods, they will cry to gain attention. When awake, a baby prefers to be carried, hugged and cuddled and when they grow lonely, they will cry and need to be pacified.
When feeding, babies often swallow air which leads to gas bloating. This can cause intestinal cramps, distension of the abdomen and abdominal pain. This will undoubtedly trigger bouts of crying. Whether breastfeeding or bottle feeding, it is advisable to take a few minutes after the feed to ‘burp’ the baby. Lactose intolerance may also cause gas bloating and gastrointestinal discomfort, especially in bottle fed babies.
The exact cause of colic is not known and may arise from a range of gastrointestinal problems. Colic triggers sudden bouts of loud and prolonged crying and the baby cannot be pacified easily despite the mother’s best attempts. Colic may be associated with gas bloating but if the baby is crying continuously, it is advisable to consult with a doctor. This condition may develop a few weeks after birth and often settles after three months of age. It causes both the baby and parents a great amount of distress and sleeplessness nights.
Baby’s temperature – heat and cold
Like adults, babies dissipate body heat through the skin. However a baby’s skin surface area is smaller than adults so it does not dissipate as fast and they therefore tend to feel hot easily. Anxious parents tend to dress babies warmly and wrap them tightly which can be uncomfortable and trigger bouts of crying and sleeplessness. Similarly, if a baby is feeling cold, they will cry until they are snugly wrapped and comfortable.
Enthusiastic parents tend to dress babies in clothing that they may consider appropriate and endearing but it may be uncomfortable for the baby. Tight elastic bands, woolen clothing and synthetic textiles may cause itching and skin irritation. This will obviously cause crying. It is important to consider your baby’s comfort rather than your own preferences when choosing appropriate clothing for your baby.
Nappy rash causes itching and discomfort and is often caused by wearing a wet or soiled nappy for a long time. Diarrhea can cause further irritation of the skin due to the feces in the diaper. Nappy rash can also occur due to an allergic reaction, skin conditions like seborrheic dermatitis or infantile eczema or infections like candidiasis.
A baby may cry when they are tired or want to sleep and some babies need more sleep than others. Newborn babies may need up to 16 hours of sleep or even more. If the baby is fatigued, it may be difficult to fall asleep despite the tiredness and may need more attention.
Change in position
Although newborn babies have very little mobility, they do not like to remain in the same position for long periods of time. At times, a crying baby may only be pacified when carried, rock or taken our for a ride in a stroller or car.
Noise, bright lights or crowds may make a baby irritable and lead to bouts of crying. A quiet room, that is dimly lit and set at a comfortable temperature may help the baby relax and sleep.
Some babies may cry incessantly for no apparent reason and get triggered into bouts of crying at specific times of the day. Despite the caregiver’s best efforts and attention, the crying may continue and there is no medical reason for this constant crying.
Breastfeeding babies may start crying if they can detect a change in the taste of breast milk. This may sometimes occur due to foods eaten by the mother. Caffeine and alcohol should be avoided as well as spicy foods.
Ear, nose and throat infections
Upper respiratory tract infections are the most common acute infections in babies. It can affect the nose or throat and often spreads to the ear. Apart from fever and mucus production (discharge), the baby may cry incessantly and become inconsolable.
Babies have an underdeveloped immune system and babies who are not breastfed are prone to recurrent infections. Apart from upper respiratory trace infections, childhood infections like chickenpox may also be a cause for crying. If the child has not developed the necessary immunity from the mother, they are at a risk of contracting these infections early in life if they come into contact with infected adults or children.
The incidence of allergies in babies is on the increase. The allergic triad of diseases, asthma, hay fever and eczema, are chronic conditions that can be a source of great distress for both the baby and mother. Consult with a pediatrician in order to manage these conditions appropriately and prevent any acute exacerbations.
There can be a number of causes that leads to bouts of crying in newborn babies. It can range from environmental factors to physical, mental and emotional aspects that leads to discomfort or distress. Some of the other causes of crying includes :
- Stressed or emotional mothers may convey these emotions to a baby, which can contribute to crying. This includes mothers suffering with postpartum depression.
- Separation, especially from the mother, can result in prolonged crying.
- Uncomfortable bedding and inappropriate baby facilities.
- Traveling or change of place.
- Gastro-esophageal reflux.
- Difficulty breathing.
- Insect bites.
- Heat rash or miliaria.
- Bacterial vaginosis and urinary tract infections (UTI’s) may occur in female babies.
- Intestinal obstruction – bowel obstruction can cause intense pain and vomiting. There is likely to be associated swelling of the abdomen and constipation.
- Meningitis is the inflammation of the lining of the brain and spinal cord. It may be infectious or non-infectious. Irritability, neck rigidity and seizures may occur. It may be associated with poor feeding and bulging of the soft area on the head.
- Injury may occur anywhere in the body and could be as a result of an accident, fall or abuse.
- Torsion of the testes.
- Retention of urine.
- Neonatal teeth, which occur in newborn babies are rare but could cause discomfort due to difficulty in feeding, biting the tongue accidentally or biting the hands or thumb.
- Dental eruptions or natal teeth which may be associated with other signs and symptoms of teething, including a fever, change in bowel movement, loss of appetite and incessant crying. This may occur in the first month of life.