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Tips on coping with an excessively crying baby

What is “excessive crying”? It is normal for babies to cry up to 3 hours a day, and many cry significantly more than that.

What is colic? when an infant who is otherwise healthy cries for more than 3 hours per day, more than 3

days per week for at least 3 weeks. Starts aged 3-6 weeks, subsides at 3-4 months Up to 40% of babies have colic at some point Excessive vomiting, blood in stools and poor weight gain are not features of colic Colic is a feature of cows milk protein allergy but not all babies with colic are allergic to cows

milk protein

What is gastro-oesophageal reflux disease? Mild regurgitation of milk is benign If it is painful or affecting the baby’s growth, it becomes gastro-oesophageal disease Is the baby being overfed? 150-200mls/kg/day is more than enough. See above re cows milk protein allergy Thickeners may help. Use Enfamil or SMA Staydown for 6/12 maximum and not with

gaviscon Use gaviscon for up to 6 times per day Not much evidence for positioning, ranitidine or domperidone Omeprazole not licensed under 1

What is cows milk protein allergy? This is a non-IgE mediated disease, allergy testing will be negative. Typical symptoms tend to be eczema or gastrointestinal upset including reflux, vomiting,

‘colic’, constipation, loose stools, blood and mucous in stools. Management includes a 2-4 week trial of extensively hydrolysed formula (Nutramigen /

Aptamil Pepti) or amino acid formula (Nutramigen AA / Neocate). If breastfeeding, mothers need to go onto an exclusion diet (including soya). Do not use over the counter partially hydrolysed formula milks, these still contain cows milk

protein. Cows milk protein intolerance usually resolves around 14 months of age.

Resources: http://www.pascan.org/pdf/Swaddling_Guide.pdf http://www.cry-sis.org.uk/downloads/Crying%20Baby.pdf www.nspcc.org.uk http://www.nct.org.uk/one-one-support http://www.nhs.uk/conditions/pregnancy-and-baby/pages/soothing-crying-baby.aspx#close http://www.reflux.org/reflux/webdoc01.nsf/%28vwWebPage%29/CopingwithCrying.htm?O

penDocument - fantastic 4 page document on how to cope with your crying baby Babies! by Christopher Green. Published by Simon & Schuster. The diagrams on the

following page come from this book. Good humoured and sensible advice from a, now retired, paediatric consultant and father.

Downloaded from www.paediatricpearls.co.uk for clinical or educational reasons only

How to hold a crying baby – from Babies! by Christopher Green

Type of crying baby

Things to try

Things less likely to work

Active baby Slings, baby bouncers, allow to look around

swaddling

Tense baby Swaddling, firm holding, leave in peace

Jiggling up and down, patting

Grumbling baby Music, patting, dummy, leave alone

Baby bouncers

Colicky baby Pressure to abdomen (see pictures below), sucking, swaddling

Leaving alone – but do employ this when at the end of your tether