20th April 1997

When baby starts crying

"A baby," my old friend Dr. Som-asunderam used to say, "is someone with all noise at one end and no sense of responsibility at the other."

Since the only way in which a baby can express himself is by making a big noise at the top end, it is important that parents and others who may have to care for a baby understand how to interpret these noises.

Normal crying

During the first few weeks of life, the average baby sleeps most of the time - and when awake, cries often and loudly, usually without tears.

From about the sixth week, fortunately the baby has some wakeful periods without crying - and by the time that they are six months of age, most babies spend three to four hours per day without crying.

Crying should be noted when it lasts for long periods during which the baby normally should be sleeping or playing. For some strange reason, excessive crying seems to be more common with the first baby in a family - and the baby's crying becomes aggravated if the parents get angry with the child.

Common causes of crying are hunger, a soiled nappy, colic, infection and loneliness - so one should keep these causes in mind when assessing a crying baby.

Underfeeding

In practical terms, the commonest problem that causes a baby to cry is underfeeding - the baby is simply not getting enough food to "fill his stomach".

In such a situation, the infant will not gain weight as expected, and the motions may be dark-green in colour. If this happens, it is best to have the child assessed by a doctor.

Another common cause of discomfort is wet or dirty nappies - so this should always be looked for if the baby is putting a non-stop cry. Teething is another possibility - babies usually cut their milk teeth between the ages of 6 months and 2 years. The gums are often swollen and painful at the spot where the tooth is erupting. This sort of discomfort can make the baby cry, but it does not generally last for longer than a week.

Colic

Infant colic is another commonly seen cause of unexplained lusty crying in an infant. It is a distressing but harmless problem that can occur in infants from as early as a week of age and can last as long as four months. It typically is seen in the late afternoon and early evening and can last for two to three hours.

Loneliness

Some babies can cry because they feel lonely and are wanting comfort and attention. If the child stops crying when picked up and cuddled, the cause of the crying may well be this feeling of loneliness.

Infections such as urine infection, respiratory virus infection, gastroenteritis and middle ear infection can also result in discomfort and crying. A middle ear infection in a baby can cause a lot of distress and is suggested by fever, a running nose and baby pulling at this ear.

So when a baby starts crying excessively, the first thing to be done is to check for the above causes. If one is worried and cannot work out what the reason is for the baby complaining, one should seek advice from one's doctor.

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