The new push to educate parents via the PURPLE Crying campaign is one that makes me cringe inside. I read the mission statement and catchy acronym and …
I get it.
I get that they are trying to educate parents about “normal infant crying” so there is a realistic expectations when going home. Babies do cry a lot. Most cry a lot more than any new parent ever imagined. The mission to decrease the incidence of Shaken Baby Syndrome is an admirable and needed cause.
We are required to show all parents a “Shaken Baby Syndrome” video in the hospital where I work and most parents cavalierly proclaim, “How could anyone shake a baby?” As if the urge to shake one’s baby is a designation for a different subset of people that they will never belong.
There is space for education here. Babies are hard and babies that cry A LOT will challenge even the most serene personalities.
I am a patient woman and I am ashamed to admit that I have had to put my babies down and walk away for fear of loosing my temper. It can happen to anyone and parents need to have the most realistic expectations education will allow, though nothing can truly prepare a person for the trial by fire that is parenting.
Yet, I read the PURPLE ad campaigns and I think there is a great disservice being delivered to parents. Babies who cry excessively and act like they are in pain are NOT normal and should NOT be ignored. Babies who are consistently crying for periods of 5 hours are NOT okay. Telling parents that all babies cry like this and will simply outgrow it is NOT good advice.
I have been that momma. I have had a baby that cries like this. I have had doctors tell me it is “normal” and she will outgrow it. Guess what.
It wasn’t normal.
She was in pain.
It took her over a year to outgrow it.
There was a reason for her cries.
What is PURPLE Crying?
Here it is, straight from the horse’s mouth:
The Period of PURPLE Crying is a new way to help parents understand this time in their baby’s life, which is a normal part of every infant’s development. It is confusing and concerning to be told your baby “has colic” because it sounds like it is an illness or a condition that is abnormal. When the baby is given medication to treat symptoms of colic, it reinforces the idea that there is something wrong with the baby, when in fact, the baby is going through a very normal developmental phase. That is why we prefer to refer to this time as the Period of PURPLE Crying. This is not because the baby turns purple while crying. The acronym is a meaningful and memorable way to describe what parents and their babies are going through.
The Period of PURPLE Crying begins at about 2 weeks of age and continues until about 3-4 months of age. There are other common characteristics of this phase, or period, which are better described by the acronym PURPLE. All babies go through this period. It is during this time that some babies can cry a lot and some far less, but they all go through it.PURPLE Crying Website
What is normal infant crying?
There are so many bits of misinformation mixed with nuggets of truth here that I find it difficult to start.
Let begin with the definition of colic and why I too find it a misleading and vague label. Colic is a term used to define a baby that cries more than “normal” with no real medical diagnosis to attribute to the crying. There are all sorts of definition for the term colic and different hypothesis for the reason some babies seem to cry excessively. I do not believe colic is ever “normal.”
WHAT IS NORMAL?
Fact: Babies cry.
Fact: Babies cry a lot.
Fact: Babies cry a lot more than new parents expect.
So here lies the issue. New parents, and even veteran parents, do not like to hear their baby cry. It is distressing and frustrating when babies have crying jags that seem unexplainable. For new parents, there is a learning curve for managing a young baby and how to efficiently sooth said baby. Medical providers know this and often attribute a parents complaints of, “My baby cries a lot,” to new parent nerves and inexperience. There is some truth here. We all have to learn early on about the tricks of nurturing a baby. It is not intuitive and takes a bit of time to master. So there is a degree of “normal” crying that can seem excessive to new parents.
WHAT IS NORMAL?
Fact: Babies have fussy times of day.
Fact: Babies have fussy times of life.
Babies, especially young babies (8 weeks or less) tend to have times of day that they are more irritable and difficult to sooth. The evening hours (affectionately known as the witching hours) are most notable for fussy baby complaints. Babies are tired by the end of the day. Generally they are in sensory overload, they are overtired, and they are cluster feeding to tank up for their longest period of sleep. This is all NORMAL. Cranky evening babies are nearly universal. The best thing you can do is breastfeed on demand, baby-wear, and get you little one on an age appropriate sleep schedule. These tactics will help get you through, though there is a degree of grinning and bearing during this phase of life.
Babies also have times in their development where they are decidedly “more difficult.” These phases can be attributed to growth spurts, sleep regressions, wonder weeks, teething, etc. The fact is that they come and they go.
But this advice, is not fact.
“The problem with the word ‘colic’ is this: most people think some infants have colic, and others do not have colic, but we now know is that all infants have those features of crying (the increasing and decreasing crying curve, the unexpected crying times, unsoothable crying, and so on).”PURPLE Crying website
All babies do not have colic and saying that all infant crying on a continuum is the just varying degrees of infant colic is very misleading.
It is like saying all babies sleep well. It is just on an increasing and decreasing curve.
Not all babies have features of colic. That is the biggest load of BS I have ever heard. That is something someone who has not lived with a “colicky baby” would say. When you have a baby that truly cries excessively, you know it. You look at your peers and their babies and you see that your baby is not normal.
WHAT IS NOT NORMAL?
PURPLE crying babies are NOT NORMAL.
Babies that appear to be in pain are NOT NORMAL. They arch, they claw, they act frenzied, they kick their legs, they have clenched fists, they have a high pitched scream. This is NOT NORMAL.
Babies who cannot be soothed and cry for hours at a time on a daily basis are NOT NORMAL.
There are lots of reasons why these babies cry excessively and many of them can be easily treated. To simply tell parents, “they will outgrow it” is not helpful. It is not helpful to the baby. It is not helpful for the parents. And you know what? Being told it was “normal” didn’t make me feel any less frustrated or alone.
Babies do cry a lot but they should not cry all the time. They should respond to soothing techniques most of the time. They should not appear in pain. Prolonged crying spells on a daily basis is not the norm.
What could be causing my baby’s crying?
If you have a baby that cries excessively, there are several potential and likely causes. These are the bullet points providers should be reviewing with parents. We should be diving deeper instead of blowing parents off as “inexperienced newbies” and helping them learn how to manage their baby.
- Is baby tongue-tied? Tongue tied babies can have excessive crying for a couple of reasons. TT infants with latch difficulty will often swollen a lot of air during feeds. This can make them gassy and have stomach pain. The air they are swallowing can also result in them refluxing up their stomach contents more readily. Some TT babies are not getting enough to eat and become frustrated at the breast. Hunger or frustration resulting in nursing strikes can lead to long spells of crying.
- Is baby getting enough sleep? I know this sounds silly, but overtired babies will cry and cry and cry. Often, we are keeping our young babies up too long between naps and paradoxically they end up sleeping less instead of more when they are overtired. Babies who are uncomfortable from any of the other reasons listed here tend to be poor sleepers further compounding their fussiness. I plan on writing more about infant sleep in the future but until then, I HIGHLY recommend Wee Bee Dreaming. Her blog is fantastic and walks you through how to maximize your infant’s sleep.
- Does mom have oversupply? Is oversupply really a problem? YES! Most babies feeding from a mom with oversupply will have characteristically colic like crying spells. These babies are essentially choking on the fast flow of their mother’s milk during let down. They too end up swallowing air during feeds. Foremilk/hindmilk imbalance was also attributed for some of their stomach pains (though there is now debate about foremilk/hindmilk imbalance and its validity). Nonetheless, these babies are usually very uncomfortable and mom needs counseling on techniques to manage her milk supply.
- Is mom making enough milk? If there is a TRUE supply issue, than baby will fuss from hunger. How do you know if baby is getting enough? Read more here. This not common (or not as common as it is diagnosed). Read this post before you decided your baby’s cries are related to hunger: Top 5 Mistaken Signs of Low Breastmilk Supply
- Does baby have food allergies or intolerances? This is where a lot of these babies are struggling and it is being ignored. Any breastfeeding mother with an infant experiencing excessive crying spells should consider dropping ALL DAIRY/SOY from her diet. Formula fed babies should trial switching to a dairy/soy free formula. These foods are hard on adult digestive tracts and can be problematic for infants even if they do not have a food allergy. Read here for more information of Food Allergies and Intolerances. If you don’t believe me, Ask Dr. Sears. He has a long history of speaking on this topic and advocating that prolonged infant crying is NOT NORMAL. If you suspect diet is a trigger for your baby, read this post about the Total Exclusion Diet and how it can help you resolve your baby’s crying.
- Does baby have infant reflux? Does your baby:
- Arch scream/ howl
- Make ruminating, regurgitating noises
- Have frequent/painful hiccups
- Projectile vomit
- Have acidic (clear) painful spit up
- Pull away/refuse breast/bottle
- Cycle of eating/vomiting/crying/eating/vomiting/crying
- Have Sandifer Syndrome posturing
Sound familiar? Here is a full list of reflux symptoms.
Not all refluxers vomit. If you think reflux is an issue, you need to address your diet immediately and follow up with your baby’s primary care provider.
If your provider says you have colic and it will pass… get a new provider. Babies with PURPLE crying are NOT NORMAL and should NOT be ignored. All of these potential causes have treatments or interventions that can help baby feel better!
Why should we let them cry? How can we say they are not in pain? Remember, it was not that long ago that the medical world believed infants did not feel pain as adults. Now all doctors and nurses know this to be untrue and are taught to recognize and treat infant pain. This mentality of minimizing what infants are telling us is a remnant of that old way of thinking.
If your baby is crying excessively, go to your doctor. Explain in detail how much your infant cries and other signs and symptoms you feel to be related. Your doctor should be part of your team. Have your baby evaluated by a Board Certified Lactation Consultant. They can tell you if the crying is related to milk supply or tongue tie. Finally, look at your diet. Drop dairy and look closely at the top 8 food allergen list.
You and your baby are not alone. This will pass. But in the meantime, get some help.
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