Coping with a Crying Baby

Teaching Parents - Coping with a Crying Infant Curriculum
Developed by Jeanne Clarey Bruening

Audience:
Parents and caregivers dealing with persistent infant crying
(typically new parents of infants three months of age and under)

Objective:

To assist parents and caregivers in prioritizing and balancing their own needs as they learn to provide nurturing, quality care for their children
To prevent child abuse by educating parents and caregivers in matters of:
1. Establishing realistic expectations of parenting roles and responsibilities
2. Creating support systems
3. Utilizing stress management techniques
4. Locating available support resources

Coping with a Crying Infant

Whether your baby cries for one hour or for successive hours over many days, weeks, or months, caring for a crying infant can be intensely stressful. It’s important for you as a parent or caregiver to understand that whatever negative emotions you may be feeling, others have had those same thoughts and feelings; you are not alone and it's normal to be experiencing the emotions that typically accompany personal crisis. Some of the feelings you may have encountered include:

Exhaustion (physical and emotional)
Sadness; depression
Disappointment (with your baby, with yourself, or with your partner or spouse)
Despair; hopelessness
Fear (Will my child be okay? How long will I and/or my family relationships be able to endure these episodes?)
Anger or frustration with the situation
Anger or frustration with your partner
Anger or frustration with your child
Desire to harm or abandon your child
Resentment (it can sometimes seem that life now consists solely of keeping an unhappy infant content)
Loneliness and a sense of isolation
Confusion (commonly experienced due to the chaos and sleep-deprivation associated with parenting an infant as well as our society's often inadequate preparation of parents for the realities of caring for a child)
Defensiveness (when doctors, family, and other parents are providing all kinds of advice but nothing seems to be working for you)
Guilt (Am I doing something wrong? Is it okay to feel frustrated? Angry?)
Failure or inadequacy (Am I a "bad" parent? Am I doing something wrong?)

Although it might sometimes feel as though there is no end in sight to these trying circumstances, there are effective strategies to assist you in coping with your child's needs and with your own stress. Help is available via learning techniques for comforting your baby, meeting your own needs during a time of crisis, and finding and utilizing the resources available to you.

Why infants cry
All infants cry as a means of communicating their needs, as self-expression, and as a way to manage and organize stress or "let off steam." Parents can expect most babies under three months old to cry up to three hours per day.

Common reasons babies cry:

Hunger
Fatigue/tired
Body temperature is too hot or too cold (dressed too warmly or not warmly enough)
Wet or soiled diaper that needs changing
Need to be burped
Need to be held
Abdominal gas discomfort
Need to suck
Need to feel secure
Sensitivity to bright lights or loud noises
Over-stimulation
Boredom
Frustration
Clothing too tight or uncomfortable
Soiled clothing (clothing that is wet or dirty can make baby uncomfortable)
Management of stress (the process of learning about his new environment is both exciting and overwhelming for an infant)
Temperament (some babies simply cry more than others; excessive infant crying is not an indication that your baby will grow up to be an unhappy child or adult)
Stressful home environment (infants can experience sensitivity via excessive exposure to arguing, tension, or anger expressed between family members, an overly-stressed parent, parents coping with additional crisis occurring simultaneously such as moving, loss of a job, death of a loved one, etc.)

"Colic"
Beginning at around the second or third week of a baby's life (typically ending by three to four months of age), approximately 20 percent of babies experience what is often called "colic," or a regular, long period of crying each day usually beginning in the late afternoon or evening. Colic, a generalized term to describe an infant’s regular crying period, often comes on suddenly (a baby who was contentedly nursing, resting or interacting with a parent suddenly begins to scream) and can consist of several consecutive hours of inconsolable crying. Doctors don't currently believe that there is one single cause of colic but that it may be a different cause or collection of causes for each individual infant.

Additional reasons infants may cry:

Fever
Illness
Infection such as an ear or urinary tract infection
Acid reflux (stomach acid washing up into the esophagus)
Food allergy or sensitivity to something baby's breastfeeding mother has consumed (your doctor can provide a list of foods you may wish to avoid for awhile)
Allergy or sensitivity to formula (try changing formulas again temporarily even if you’ve recently changed brands)
Teething (usually doesn't begin until 4-7 months)
Vaccination discomfort (ask your pediatrician about administering a infant pain and fever reducer prior to vaccination)
Anemia (may occur in babies older than 10 months)
Constipation
Hair or thread twisted around baby's finger or toe, cutting off circulation (rare, but it does occur)
Adults who smoke in the home (second hand smoke or nicotine passed through the mother's milk into the baby's bloodstream can act as a behavioral irritant)
Consumption of caffeine, alcohol, or illegal drugs by a breastfeeding mother (if you are taking over-the-counter medications, check with your pediatrician to determine if the medications may be negatively affecting your baby)
Other medically-related issues

Providing comfort to a crying infant
Each infant's needs and preferences for receiving comfort are different. You may wish to try different comforting techniques at different times to see which work best for your baby. If one technique doesn't work when you first use it, try it again at a later date and you may find that baby responds. You may also discover some techniques on your own not listed here or in other resources that calm your baby. As long as you are providing safe comfort measures, do whatever works for your child. Babies often respond to calming techniques that involve soothing, rhythmic sounds, visual stimulation, rhythmic motions, or close physical contact and touching.

Comfort techniques:

Allow infants to eat and sleep on demand (especially during the first few months)
Check diapers frequently and change as soon as baby is wet or soiled
Speak softly to your baby before touching him or picking him up
Carry your infant against your body in a carrier such as a Baby Bjorn or sling
Play or sing soft music
Dance gently with your baby
Talk to and laugh with your baby (they love to hear the sound of your voice!)
Make eye contact (this can sometimes distract and calm baby; remember that their range of vision is around one-two feet)
Gently massage baby's arms or legs
Rock with your baby (standing or sitting)
Hold your baby so that his tummy is resting on your lap or forearm (ask your pediatrician or clinic nurse for one of many additional hold methods that can be used to comfort a crying infant)
Swaddle your baby in a blanket (tuck arms into his chest before wrapping) or hold your baby firmly but gently in your arms; these techniques can provide your baby with a sense of security
Keep lights low and noises to a minimum
Dress your baby in clean, soft, natural cotton clothing (in an appropriate weight for the season) without a waistband
Provide sucking opportunities, particularly for infants under six months. These can include nursing, a pacifier, offering your own clean, clipped pinky finger, or encouraging baby to "find his thumb" (whichever your parenting philosophy dictates)
Walk outside (holding baby, wearing an infant carrier, or using a stroller) or walk around the house to provide visual stimulation for baby
Provide skin-to-skin contact (lay your baby on your chest while you lie down)
Play recordings of womb sounds, heartbeats, falling rain, waves, or other white noise
Hum against your baby's head (some babies like the sound and sensation of the vibrations your voice makes)
Show your baby different objects including household items, pictures, and magazines (remember that everything is new to them, so almost anything will seem interesting)
Play a music box or wind-up stuffed animal
Give your infant a warm, soaking bath (you can hop in too and relax along with baby)
Gently stroke your baby's forehead or temples
Make exaggerated facial expressions (silly, happy, surprised, etc.)
Blow gently on your baby's head or forehead
Dance for your baby (graceful, silly, using colored scarves, etc.; infants usually love to watch the movements of others)
Recite rhymes or poems
Read a book or tell a story to your baby
Gently move baby's legs in a bicycle motion (may help to distract baby or alleviate discomfort that may be due to intestinal gas)
Take your baby for a drive in the car for 20 minutes or more; if baby falls asleep, bring sleeping baby and car seat into your home for continued rest
Provide short, quiet transition times between activities such as playing, feeding or diaper-changing by laying baby in your lap to allow baby to adjust to change
Allow someone else to try providing comfort (sometimes babies simply need to see a new face; if your baby responds to this change, it does not mean that you are not able to provide adequate comfort for your child or that your baby prefers someone other than you)
Put your infant in a baby swing or bouncy chair
Set your infant down on a blanket to give him a rest (infants sometimes cry due to over stimulation and simply need a break themselves)
Help your baby to look at himself in a mirror
Offer the following for baby to watch and/or listen to:
- running water from a faucet
- the tick-tock of a clock or metronome
- a ceiling fan
- sounds of a vacuum cleaner, dishwasher, clothes washer/dryer
- a running shower
- waves on a beach
- other children at play

Other possibilities to consider:
Initiate steps to create the most peaceful environment possible at home for baby. This may entail:

Slowing-down your lifestyle (try to limit your tasks and responsibilities only to those that absolutely must be attended to for now; use as much of your time and energy as possible to focus on baby, yourself, and your family)
Alter your expectations (parenthood and/or your child may not be as you'd expected them to be; re-examining and adjusting your perceptions and expectations can help)
If you are experiencing stress within your family, consider what may need to change at home to create a calm, peaceful environment. This may include:
Strengthening communications with your partner
Exhibiting expressions of support and respect to your partner (even when you may not feel like it)
Taking better care of yourself by
- delegating tasks to friends and family
- Getting more restEating nutritiously
- Allowing yourself regular breaks from your parenting responsibilities
- Seeking support and education through parenting support groups, Early Childhood Family Education classes, or family counseling

Look for symptoms of deterioration in your baby's mood such as fussing, whimpering, sucking on a fist (hunger), rubbing eyes or ears (tired) and try to respond before crying escalates. You may wish to use a chart to record your infant's daily feeding, changing, and behavior patterns to better assist you in predicting his needs.

Try to plan your activity schedule around baby's schedule. For example, don't plan to run an errand when you know your baby will probably be tired or hungry or try to fit too many tasks into too short a time frame with baby in tow. This will help limit the stress your baby experiences during the day and therefore may reduce incidents of crying.

Keep in mind that because healthy babies cry both to communicate and to express themselves, providing comfort to an infant doesn't necessarily mean stopping or preventing him from crying. It's okay (and important) for infants to have some opportunity to cry each day. You can hold, sing to, or talk to a crying infant and be assured that you are still providing comfort even if the crying doesn't discontinue immediately.

When considering comfort measures for your infant, do not include the following:

Leaving your baby in an infant seat on the top of an appliance such as a dryer (machine vibrations can cause seats to fall over the edge)
Leaving an infant unattended in an infant swing, a car, or anywhere not intended to safely contain an infant (laying your baby on his back in an up-to-date crib in a room at a comfortable temperature without bumper pads, stuffed animals, or thick blankets is a safe option)
Tossing or playing roughly with your baby
Offering your baby objects that are small enough to fit through a toilet paper tube (choking hazard)

Circumstances under which you should contact your Child's pediatrician

You suspect that your baby's crying might be related to a medical problem that has not yet been identified
You think crying may be due an already diagnosed medical problem becoming worse
None of the comfort measures you have tried are helping and you are concerned
Your baby of under six months has a fever of 100.2 degrees or higher
Your baby over six months has a fever of 102 degrees or higher
Your baby is not nursing or accepting a bottle
Your baby's diapers have not been consistently wet, baby has experienced successive episodes of diarrhea, or hasn't had a bowel movement for a period of time that is longer than usual

When you call your child's pediatrician, mention the duration and intensity of the crying you've observed, any patterns you've noticed and any variation on what has been "normal" for your child. You and your doctor may find it helpful for you to take notes to document your observations as they happen each day.

Caring for yourself
One of the best ways to ensure that you are equipped to provide quality care and comfort for your little one(s) is to take care of yourself. If you make self-care a priority, you'll find that your baby as well as yourself and your family are more likely to be content as well. Although it may seem impossible to find time for any of the suggestions listed below, make it a priority to include at least three of these (or add your own) suggestions for self-care each day -- even if you only spend ten minutes on each of them. Think of caring for you as part of your responsibility to your family!

Begin by trying to schedule at least a few hours each week for someone else to watch your baby (and other children, if you have them) so that you can plan time just for you. When no one else is available to care for your children, utilize your baby's nap times or quiet moments while baby contemplates a toy or interesting scenery to implement self-care activities. Keep a list of your favorite self-care activities on-hand for referral when you have a moment to relax or time away from home.

Ensuring adequate physical and emotional care for yourself might require that you set your crying baby down for awhile to give yourself a short break (perhaps 15-20 minutes). As difficult as this may be for you to do while your baby cries, it is sometimes necessary to ensure that you are allowing yourself the rest, nourishment, and relief you need to continue to be a loving and nurturing parent.

If you feel that you've reached the limit of your ability to cope and need a reprieve but no one else is available to care for your child, find a safe place for your baby (either in his crib or, if they are within your sight and hearing, on a blanket, bouncy seat, car seat, or infant swing).

Try to allow time each day for you and baby to get some outdoor exercise if weather and climate permit. Physical movement and fresh air can help to renew your energy, encourage a positive attitude, and lift your mood.

Self-care ideas and techniques:
If no one is available to care for your infant:

Take a nap while baby naps
Go for a walk with baby
Rock in a rocking chair
Take a warm bath (if baby isn't yet crawling, bring him into the bathroom and set him in a car seat or bouncy seat while you bathe or bring him into the bathtub to enjoy a soak with you)
Make a cup of decaffeinated coffee or tea and sit down to enjoy it
Eat a nourishing meal
Nurse while lying down if you are breastfeeding
Read while nursing
Take 10-15 minutes to read an article or a few pages of a fun, interesting, or relaxing book
Watch a funny or relaxing video
Write an e-mail or letter to a friend
Put on a recording of your favorite relaxing or upbeat music
Play a musical instrument
Browse on the Internet
Exercise
Start a journal for yourself or for your child
Create something (paint, draw, write a song or poem, sew, start a craft)
Take your baby to a park, free indoor play area, or mall (many malls now have rooms for feeding, nursing, or changing infants) Any of these locations are great places to meet other parents of babies -- many of whom will be there because they are experiencing exactly what you are and needed to get away too. Don't hesitate to strike up a conversation; you're likely to find a sympathetic ear and an encouraging friend!
Enroll in a parenting education class that you can attend with your baby or a small group that meets at your place of worship or community center
Don't answer the phone if you don't feel up to talking (turn off the ringer)
Try "tag-team parenting" (one parent attends to the crying baby for 1/2 hour or more while the other takes a break to do something for themselves, then trade responsibility)
Ask a caring adult family member or friend to hug or hold you
If you have other children, enroll them in classes, in part-time child care, in a program at your place of worship, or coordinate a playtime with neighbors (older children or senior citizens that live near you often enjoy the opportunity to entertain young children in your home while you're there to supervise)
Hire a mother's helper to assist with housework, child care, and possibly with errands and cooking (depending on the age of the helper)
Anticipate your baby's stressful times each day if there is a particular time during which he tends to be fussy and mentally prepare yourself for it
Permit yourself to experience a range of emotions
Laugh, punch a pillow, throw stuffed animals at the wall, sing, or whatever you need to do to express yourself
Try to hear your baby's persistent cries as though his voice were expressing thoughts and needs to you in words. For example, your baby may be saying, "I'm overwhelmed, Daddy!" (if he's over stimulated) or maybe "I'm hurting, Mommy!" (if he's suffering from gas or reflux). Hearing your infant's cries as communication attempts instead of just noise sometimes makes it easier to adjust to incessant crying (even if you are unable to determine the cause of the tears). This approach often makes it easier for you to focus on continuing to provide comfort to your baby
During difficult moments, remind yourself that intense crying only occurs for a relatively short duration in a child's life; crying will diminish eventually
Take deep breaths when experiencing stress; slow your pace of activities
Close your eyes and envision a beautiful place you've visited or a peaceful, fun time in your life
Focus on positive thoughts (think of wonderful things about your baby such as his smile, his sweet baby scent, cute sounds that he makes)
Keep a list or journal of happy, special or funny moments you experience with your baby (you think you'll never forget them, but they often slip from memory within a short period of time; your child will also love to hear these stories when he's older)
Laugh when you see your infant making funny faces and gestures (baby most likely doesn't know why you're laughing, but he'll love to hear the sound of your happy voice and it will almost certainly make you feel better)
Deliberately choose to laugh at small disasters and mistakes of yours and of those around you instead of feeling upset, critical, or discouraged; make this daily practice
Enjoy moments of closeness with your baby (children are only this dependent on you for a short time; treasure these moments together as often as you can)!

If someone can watch your baby for awhile:

Catch-up on sleep
Go for a walk alone or with a friend
Run an errand
Get a haircut, massage, manicure, or pedicure (or all of the above)!
Go to a movie (or rent a movie to watch while you lie in your own bed or on a couch in separate room from baby and caregiver)
Go out for a meal at your favorite restaurant
Meet a friend for coffee or lunch
Participate in a hobby or activity you enjoy:
- Gardening
- Cooking
- Shopping
- Attending an event or workshop
- Working out at a gym
- Sports activities (running, biking, fishing, sailing, golfing)

Brush up on your acting skills
One strategy for continuing to provide loving care for your child when you are feeling angry, frustrated, exhausted, or overwhelmed, is to act the way you want to behave -- not the way you feel like behaving. When we most need to receive support, it's frequently true that choosing to give love to another person (such as your child) provides the strength, encouragement and motivation we need to move ahead. Often, when we set aside our strong, negative emotions temporarily and choose to behave in positive, loving ways, our feelings follow our actions and the stress subsides. This approach could be likened to being an actor on a stage.

SAMPLE CIRCUMSTANCE: You haven't had more than a few hours of sleep in several nights. Your spouse is working long hours and you don't have friends nearby who can assist you with housework and care of the baby on this day. You don't have dinner ready because you haven't had time to make anything and you are very hungry. The laundry has piled up and the house is a mess. Your infant has been crying inconsolably for four hours and you have reached the limit of your ability to cope. You want to scream at your baby. You are angry with your spouse for not being more helpful or available. You feel alone, helpless, and you don't feel that you can manage one more minute.

STRATEGY: Think about what your baby needs from you and what personally you need at that moment. Your baby needs your patient love and you need peace, security, and rest. Even though it's the absolute opposite of what you feel like doing at that moment, you turn on some quiet music, pick up your crying infant, sit down in a rocking chair, take several deep breaths, close your eyes, shut out the noise of the crying, gently rub your baby's back and imagine that all is peaceful and manageable. Occasionally speak gentle words of love, understanding, and encouragement to your baby. Continue to provide affection for your baby as you relax and focus on receiving for yourself the comfort and security you are giving to your baby. Continue to close baby's crying out of your mind if he hasn't yet calmed in your arms. Give yourself enough time to calm yourself and to derive peace and comfort.

In moments of crisis, this tactic can seem impossible or as though it will be futile to even attempt it. Give it a try anyway. If it doesn't work the first time, keep trying under various circumstances. Behave in the very opposite manner that you feel like behaving:

Angry = speak loving words

Sad or lonely = call a friend or reach out to offer love, conversation, and companionship to your baby

Frustrated = give gentle touches and affection to your child

Most often, your feelings will follow and reinforce your actions. As a bonus, this strategy works when you are feeling frustrated with partner or spouse too!

Potential pitfalls that may add to your physical and emotional stress:

Not getting enough rest
Not eating nutritious foods or not eating frequently enough
Not getting regular fresh air and/or exercise
Not establishing regular opportunities to relax or have fun
Not seeking day-to-day emotional support and assistance with responsibilities
Pushing yourself to "get things done" instead of delegating responsibilities or letting them go for awhile
Spending time with people who drain you emotionally, have a negative attitude, are critical or complain frequently, or who create feelings of stress for you
Watching too much television or watching shows that are anxiety-producing or upsetting
Drinking caffeine or alcohol. This doesn't meant that you have to avoid them altogether; just be aware of your consumption and its impact on your body. Contrary to popular opinion, caffeine will not give you more energy and make you feel better in the long run; it will actually deplete your energy and your body's nutritional stores. Regular consumption of alcohol can have a dramatically negative effect your health and overall ability to function. For information on the impact of caffeine and alcohol consumption on the infant of a nursing mother, please contact your pediatrician or other health professional.

Who to call for support
Develop a list of available support people and keep it next to your phone. Include those who are able to come to your home to assist you as well as those who may simply provide support via telephone. These should be people you know you can count on to have a positive and encouraging attitude, to be understanding, to be empathetic listeners, and to be reliable and responsible.

Utilize this list when you need someone to:

Talk to
Make you laugh
Provide a break for you by caring for the baby for an hour, a day, or overnight so you can get out of the house, go for a walk, or catch-up on sleep
Stop by to visit with you
Care for baby's siblings if you have other children
Run errands
Cook and deliver meals for your family
Do the laundry or clean the house

Categories of people to include on your support list:

Spouse
Parents
Siblings (yours and/or your spouse's)
Grandparents
Friends
Neighbors
Co-workers
Your pediatrician or clinic nurses (phone support and advice)
Crisis management and parenting support organizations in your area

It is often difficult to reach out for assistance when you are feeling helpless, vulnerable, and exhausted but it is during such times that you most need and deserve help. Our society often communicates to parents that they should be self-sufficient and well-equipped to manage the rigors of child-raising without help when nothing could be further from the truth. Parenting, in particular, is an important time to learn to rely on the love and support of friends and family and to utilize the many professional parenting resources available today. Established crisis, family, and parenting assistance organizations exist for the very purpose of ensuring that parents just like you receive the support and advice they need. Many times, relief is as close as a quick phone call away. Most parents find that friends, family, and other parents are glad to provide help; you need only to ask them directly and help them to understand your specific needs.

Seeking critical help
If you feel you're beyond your ability to cope
Sometimes, the methods of self-care and coping previously listed here are not enough. Remember that no parent is immune to feeling that circumstances are beyond their ability to manage. If you find that the stress has become too intense for you -- that you are close to losing control, are angry, frustrated or stressed to the level that you think you might hit, shake, or otherwise harm your baby or yourself, be assured that you are not alone in these feelings but that you must take action immediately. Seek urgent help via:

Call 911
Call a Crisis Nursery or other crisis organization to assist you
Set your baby down in his crib and walk into another room to give yourself a break until you feel prepared to either call for help or attend to your baby again safely
Call a reliable spouse, friend, family member, or neighbor who can come to your home within a few minutes to watch your child for awhile
Bring baby to a neighbor's home
Bring baby to a place of worship or community center that you know is open
Bring baby to a police or fire station
Do whatever you need to do to ensure the safety of your child; don't try to continue to manage the situation alone if you feel out of control

Do not shake your baby under any circumstances. Even mild shaking can cause permanent damage or death. Set your baby down gently on a blanket or in his crib if you think you may be inclined to shake or harm him.

Your baby depends on you to provide loving and nurturing care for him; it's okay to need help but it's important that you reach out and ask for it. A wide range of professionals are available for you to contact who understand what you're experiencing; they won't judge or criticize you and are trained specifically to support and assist you.

If feelings of loss-of-control or a desire to harm your child persist or if you feel that you may hurt yourself or another family member, seek professional assistance from your family doctor, another medical professional, or any of the crisis organizations listed (following) immediately.

Resources for parents In Minneapolis
Crisis:
911
Crisis Connection 612-379-6363
United Way's First Call for Help 651-291-0211
Minneapolis/St. Paul metro area
An information specialist will refer you to an agency that can assist you based on your needs. This line also offers assistance for people speaking Spanish, Russian, Hmong, Vietnamese, and Somali languages
Greater Minneapolis Crisis Nurseries 763-591-0100
(or local crisis nurseries in your area)Typically provide free, drop-in care when you or your family are in crisis; check your phone book or the Internet listings by county
Crisis Intervention Center (Hennepin County) 612-347-3161
Check for local crisis intervention centers by county
Love Lines Crisis Center 612-379-1199
Child Abuse Hotline 1-800-621-6322

Other:
Your child's pediatrician or clinic nurses
Mpls. Children's Hospitals and Clinics Parent Warmline 612-813-6336
Free telephone consultation service to answer your concerns and questions regarding childhood developmental and behavioral issues
Mpls. Children's Hospitals and Clinics Parent Resource Center
Located in Mpls. Children's Hospital www.childrensonline.org/frc
Hopkins Family Resource Center 952-988-5350
Baby Center web site www.babycenter.com
Parent Soup web site www.parentsoup.com
Your local place of worship
Frequently provide small groups for parents to meet together as well as connections to other parenting resources
National Center on Shaken Baby Syndrome www.dontshake.com
PAGER (Pediatric and Adolescent Gastroesophageal Reflux Assocation)

www.reflux.org

� 2002-3 Jeanne Clarey Bruening

Edition 2

Check with your
doctor first!