Why does my baby cry all the time?

The first few weeks with a new baby are full of joy, but they can also bring plenty of questions and uncertainty. Crying is one of the most common concerns for new parents, and it isn’t always easy to know what’s normal. Here GP Dr Chloe Savident explains why babies cry, what to expect during the first few months, and when symptoms could suggest a condition such as reflux or cow’s milk protein allergy.

Is anyone ever fully prepared to step into the world of being a parent? When we brought our little girl home from hospital, we flip-flopped from excitement and happiness at the new baby in our life, to endless questions and doubts about if we were doing things correctly. We quickly learnt that well-meaning advice was often conflicting and that the internet could easily overwhelm us with information, especially when we were sleep deprived.

In my work as a GP, I often see parents finding the early weeks of parenting challenging. Questions such as “Is it normal for my baby to cry this much?”, “Why is my baby so unsettled?” and “Is my baby’s poo normal?” are common in my consultation.

How much crying is normal?

So how much do babies cry?There is a wide range of how much crying is normal and each baby is different. Babies use crying to communicate lots of different needs including hunger, tiredness, boredom, over-stimulation, being too hot or cold, wind and many other things in the first six weeks of life, it is common for babies to cry for around two hours in every 24-hour period and around 5% of babies will cry for more than four hours per day.

Crying typically peaks around two months of age, which coincides with leaps in brain development. After this, crying gradually reduces and babies quickly develop different cries for different needs. Colic can be distressing for parents. They often feel helpless and have tried everything they can think of to calm their little one. According to the National Institute for Health and Care Excellence (NICE), colic is repeated episodes of excessive and inconsolable crying in an infant. Babies with colic cry for more than three hours per day, three days a week for three weeks. Often crying peaks in the early evening. It can be exhausting for parents, but the good news is that it settles by itself with time, and babies are otherwise well and grow normally.

When could crying be a sign of something else?

Sometimes a baby is unsettled because of a medical issue that needs to be treated such as reflux or cow’s milk protein allergy. The challenge for parents and healthcare professionals alike is to piece together a picture of symptoms that lead us to the correct diagnosis and treatment. However, as with many things in medicine, there is often a grey area with overlap of symptoms, and it can take trial and error to get things right. As a wise doctor once told me, humans do not follow the textbooks and babies are no exception.

Understanding reflux in babies

Generally speaking, babies with reflux have upper abdominal symptoms with vomiting and distress when they feed. They are often happier upright and typically are worse when they are lying flat or at night-time. They usually have normal stools. Reflux often gets much better around six months of age because they are spending more time upright and start to have more solid foods in their diet. Most babies have between 150 and 180mls of milk per kilogram of body weight in 24 hours. If we consider that for an 80kg adult, that would equate to around 14 litres of milk per day. It is amazing how well adapted babies are.

What is cow’s milk protein allergy?

Lastly, I am frequently asked about cow’s milk protein allergy. This affects 2–7.5% of formula-fed babies and 0.5% of breastfed babies. It can lead to poor growth and therefore diagnosing this early is important. On the other hand, over-diagnosing cow’s milk protein allergy can lead to babies and mums having an unnecessary restricted diet for prolonged periods which can have health implications. Therefore, getting this diagnosis right is essential.

Typically, babies with cow’s milk protein allergy will have two or more systems affected such as eczema of the skin, abdominal symptoms with reflux, constipation or loose stool, and respiratory symptoms with a runny or blocked nose or a persistent cough. Usually, these babies respond quickly to treatment, but doctors and parents often forget the key step of re-trialling milk to ensure that the diagnosis is correct.

You’re not alone

Navigating life as new parents is tricky and rewarding in equal measure. I will never forget the scene of chaos of our first public toilet nappy change with our screaming baby of four days old on our inaugural trip to town as a family of three. For us and for many parents, the learning curve is steep but very much worthwhile.

If you’re worried about your baby’s crying, feeding, or just feeling overwhelmed, don’t struggle alone. Speak to your health visitor or give us a call to arrange to see your GP.

For babies with suspected allergies or more complex feeding concerns, you can book into see Dr Chloe Savident or Dr Vicky Carre in our Allergy Clinic.