About Babies

Ways To Soothe A Fussy Baby
By Dr. Sears

Babies fuss and parents comfort. That's a realistic fact of new family life. It helps to understand what calms a baby and why. Most calming techniques involve at least one of these four interactions:

Rhythmic motion
Soothing sounds
Visual delights and distractions
Close physical contact and touching

Calming techniques (except visual ones) are like re-inventing the womb that baby has been used to for nine months. Here are baby-calming techniques that we have found worked with our own fussy babies, and that we have been able to glean from experienced baby-calmers in our pediatric practice. Remember that your baby has individual needs. Try these techniques as a starting point and improvise. After a few months, you and your baby will have a large repertoire of fuss- busters that work.

MOTIONS THAT MELLOW

WEARING BABY IN A SLING

A baby carrier will be your most useful fuss-preventing tool. Infant development researchers who study babycare practices in America and other cultures are unanimous in reporting: infants who are carried more cry less. In fact, research has shown that babies who are carried at least three hours a day cry forty percent less than infants who aren't carried as much. Over the years in pediatric practice, I have listened and watched veteran baby-calmers and heard a recurrent theme: "As long as I have my baby in my arms or on my body she's content." This observation led us to popularize the term "babywearing." "Wearing" means more than just picking up baby and putting him in a carrier when he fusses. It means carrying baby many hours a day before baby needs to fuss. This means the carrier you choose must be easy to use and versatile. (We have found the sling-type carrier to be the most conducive to babywearing. Baby becomes like part of your apparel, and you can easily wear your baby in a sling at least several hours a day.) Mothers who do this tell us: "My baby seems to forget to fuss." The sling is not only helpful for high-need babies it's essential. Here's why babywearing works:

The outside womb. Being nestled in the arms, against the chest, and near the parent's face gives baby the most soothing of all environments. Mother's walking motion "reminds" baby of the rhythm he enjoyed while in the womb. The sling encircles and contains the infant who would otherwise waste energy flinging his arms and legs around, randomly attempting to settle himself. The worn baby is only a breath away from his parent's voice, the familiar sound he has grown to associate with feeling good. Babies settle better in this "live" environment than they do when parked in swings or plastic infant seats.

Sights aplenty. Being up in arms gives baby a visual advantage. He now can have a wider view of his world. Up near adult eye level, there are more visual attractions to distract baby from fussing. The distressed infant can now pick from a wide array of ever—changing scenery—select what delights him, and shut out what disturbs him. And seen from such a secure perch, even the disturbing sights soon become interesting rather than frightening.

The expanding mind of a growing infant is like a video library containing thousands of tapes. These tapes record behavior patterns that baby has learned to anticipate as either soothing or disturbing. Babywearing mothers tell us: "As soon as I put on the sling, my baby's face lights up with delight, and he stops fussing." The scene of mother putting on the sling triggers a replay in baby's mind of all the pleasant memories she's experienced in mother's arms, and she can anticipate the pleasant interaction that is soon to follow. She stops fussing. She's no longer bored.

SUCKING ON THE MOVE. Sometimes motion alone won't calm a frantic baby; she needs an additional relaxation inducer. Settle baby in a carrier and, while walking or dancing, offer baby the breast. Motion and sucking are a winning combination that settles even the most upset baby.

Babywearing makes life easier for parents. Not only is it good for the infant, it's good for the mother as well. The carrier gives you a comforting tool that usually works. After baby gets used to being worn and you get used to wearing baby, you have more options and more mobility. You'll feel as though you've gained an extra pair of hands, especially around the house, and you can go more places. Baby is content, since "home" to a tiny baby is being with mom, even though mom may be in the middle of a busy shopping center or at a party full of adults.

A baby who fusses less is more fun to be with, and drains less energy from the parents. Infants and parents can then direct the energy they would have wasted on managing a fussy baby into growing and interacting. That's why carried babies thrive—as do their parents.

Familiarity breeds contentment. Living in a carrier keeps infants content because it keeps them in constant contact with the familiar sounds, touches, movements, and visual delights of the parents. Being nestled in a familiar position is especially calming for the baby who is easily distracted and falls apart at the first sight of a strange person or place. The worn baby is always surrounded by things he knows. From this secure homebase, the baby has less fear of the unfamiliar—and adjusts without a fuss.

Proximity fosters calmness. A baby who is worn is in mother's arms and literally right under her face. With this close proximity, mother can teach baby to cry "better." As soon as baby gives a hint that he is about to fuss, mother, because she is right there, can preempt the cry and keep it from escalating into an all-out fit. Being close to your baby helps you learn to read your baby's pre-cry signals so that you can intervene to meet baby's needs before he has to fuss. Baby in turn learns to be more at ease using non-crying modes of signaling since, during babywearing, he has learned that these signals receive an immediate nurturing response.

Babywearing and daycare. Carrie had a high- need baby who was content as long as he was in a sling, but she had to return to work when Evan was six-weeks-old. I wrote the following "prescription" to give to her daycare provider:

Rx. To keep Evan content: Wear him in the babysling at least three hours a day. -- William Sears, M.D.

How to wear your baby in a sling. Some mothers take to babywearing like a duck takes to water; others may initially find the sling awkward. Also, some babies at first have difficulty settling in the sling. Perhaps they find it too confining. For the best long-term results, get your baby used to being worn in the first week of life, so that she soon realizes that the sling is where she belongs. It takes some practice, but the sling will soon become your norm of infant care. Take lessons from veteran parents who have logged many miles wearing their babies in a sling in various carrying positions and in many circumstances. Find one of these experts to show you how to wear the sling so it's most comfortable for you and most settling for baby. Keep experimenting with various positions until you find one that works; the favorite position may change with baby's moods and motor development. Most high-need babies prefer to be carried in the forward-facing position.

For a busy parent of a fussy infant, a baby sling will be one of your most indispensable infant-care items. You won't get dressed without it.

A Babywearing Story

"I thought for sure I would have a baby who slept through the night, in his crib, in his room, and that he would awake only to feed and to get his diaper changed. How naive! Jason knew what kind of parenting he needed right from the start. He was truly a fussy baby, and we nicknamed him "More." He screamed if I put him down even to get dressed. He seemed to nurse constantly, and he rarely slept. As long as he was in my arms or nestled on my husband's chest, he was content, happy, and alert. Any deviation from that was a disaster for everyone. A friend of mine recommended a baby sling so that I could have my hands free to do other things and so I wouldn't feel resentful of all the time a baby takes up. The sling was our savior! I loved carrying him, and it allowed me to get other things done. The sling ended the pass-the-baby-around sport that so many parents have accepted as just the way things are. There is no way Jason would have stood for being bounced around from person to person for an entire day. An added benefit of the sling was that he was able to nurse anywhere and everywhere while in the sling. We went everywhere with him—weddings, funerals, dinners, grocery shopping, doctor's visits and vacations. Christmas shopping with Jason in the sling was a breeze. I can't imagine how mothers maneuver strollers through the narrow aisles in most stores. Everywhere we went people remarked how wonderful my baby was. I always pointed out that since my child felt right and was getting his needs met, he really had no reason to be upset."

DANCING WITH YOUR BABY
It's only natural that movement calms fussy babies. Their whole uterine existence was a moving experience. Babies crave movement after birth because to them it is the norm. Being still disconcerts babies. They don't understand it and it frightens them. Movement relaxes them.

Watch a room full of veteran baby calmers and you will witness a wide variety of dance steps. Each parent has found the dance routine that best suits the mood of both partners, adult and infant. In fact, you can usually spot mothers of high-need babies in a crowd—even without their babies. They are the ones who are swaying back and forth all the time. A mother once told me that as she was standing at a party holding a glass of ginger ale, another mother came up and commented on the fact that she seemed to be teetering back and forth a bit. The observer concluded, "I know you haven't had too much to drink. You must have a baby!"

Our hobby as a couple is ballroom dancing, so this way of relaxing our babies, and us, came naturally. Baby calming by dancing is based on the physiologic principle called vestibular stimulation . There are three tiny balances located behind baby's ear called the vestibular system. These are set for three planes of movement: up and down, back and forth, and side to side. Dance steps that use all three of these movements stimulate the vestibular system best and are most likely to comfort baby. If babies could choreograph their own dance steps, the routines that contain movements in all three planes (up, down, side-to-side, back-and-forth) would be their favorites.


WAYS TO MAKE BABY-DANCING FUN
In baby dancing, style is as important as getting the steps right. Here are some tips that can make dancing with your baby more comforting and more fun.

1. Hold your partner. Cling to your little partner in whatever position works. Try the neck nestle, warm fuzzy, colic carries, shoulder drape, forward-facing hold, elbow rest, hip carry, or shoulder ride. During the first three to four months be sure to support your partner's wobbly, weighty head.
2. Choose the right rhythm. How fast to dance? Remember, while in the womb your baby was used to the rhythm of your pulse, usually around 60 to 70 beats per minute. Try to rock and swing to this rhythm, approximately one beat per second, "one and a two and a..." The volume, tempo, and type of music may change with your baby's mood, and yours. Baby's womb environment is actually quite loud, so don't be surprised if your baby prefers big band sounds.
3. Choose light dancing. Select a dance that you like, one that suits your mood and energy level, lest the dancer wear out before the fusser. One rainy night Lauren, our youngest, could not give herself up to sleep. Martha wracked her brain for what to do next when inspiration came from the weather. She started singing "Raindrops Keep Falling on My Head" (from the old movie Butch Cassidy and the Sundance Kid) and did a very jazzy dance step to match the jazzy tune. Lauren soon forgot she was resisting, relaxed into the fun, and nodded off before long. This winning tune got replayed and danced for many a night thereafter. Martha looked forward to it as a fun way to lull Lauren into Dreamland.
4. Use props. To keep your arms from wearing out before your legs, nestle baby in a sling as you dance.
5. Dinner dance. Some babies love to breastfeed in the sling while you dance. Your movement plus baby's sucking is a winning combination for settling even the most upset baby. Change partners. Babies usually prefer dancing with mother, after all, she's the dance partner baby came to know even before birth. It's as if baby says to the mother, "I like your style." This also explains why some fathers get frustrated when they try to cut in, offering some relief to worn-out dancer mom. Sometimes babies vehemently protest this change in partners, and father hands baby back to mother saying, "You take her, I give up." Yet many high-need babies like a change in routine and welcome dad's different holds and steps. And don't forget to invite grandmother to the dance. She has patient and experienced arms and can probably show baby some pretty fancy stepping from her days as a baby dancer.

SWINGING BABY
Walk past any playground, peer into any nursery and you'll see happy babies swinging contentedly. The regular swinging motion calms babies. To meet the high demands of fussy babies and frantic parents, infant-product manufacturers have introduced a variety of baby swings to the ever-growing market of baby-soothing devices. None of these synthetic substitutes work as well as the encircling arms, soft breasts and warm body of a parent, all of which remind baby of the womb. But let's face it, "wombs" wear out, and substitute arms are sometimes necessary to save a parent's sanity, or at least allow mother to take a shower.

Swings are particularly useful during happy hour, that stretch of time in the late afternoon to early evening when you're busy preparing or having dinner and babies are notoriously difficult. Try winding up your mechanical sub in order to wind down a fussy baby. The tick-tocking sound plus the monotonous motion will usually settle an upset baby. Some newer swings even oscillate in a circular motion rather than the traditional back and forth motion. It's best to borrow a swing or try one out on your baby at the store to avoid investing in something that your baby will shun. While some high-need babies won't settle for less than the highest tech swing (those that move in two planes, play lullabies, and have a plush seat), others will calm with a simpler swing that hangs from a door or porch frame. Some babies prefer these swings on ropes over the mechanical ones with their rigid supports; they like to sway in a circular motion rather than swinging from front to back. Some babies don't like any type of swing; perhaps they get dizzy. In that case, it's back to the human swing.

PARENT TIP

Mechanical swings are one of the most commonly recalled infant products. Be sure to buy an JPMA-approved swing. Beware of used swings or ones bought at second-hand stores that may not contain proper safety harnesses.

We warn parents against overusing mechanical swings. A high-need baby, if he doesn't reject the device outright, will tend to bond strongly to a swing if he's put in it routinely. It's especially important for the high-need baby to bond to people, rather things.

PARENT TIP

"My baby liked the trio of singing, slinging, and swinging. I would wear her facing out in the sling while swinging on a playground swing and singing to her."

FREEWAY FATHERING (or mothering!)
If you've tried several of the home-based tricks to settle baby and none have worked, take a ride. Place baby in a carseat and drive for at least twenty minutes, non-stop if you can. Then return home and carry the whole package (sleeping baby in the carseat) into your home.

I used freeway fathering at times to give Martha a much-needed baby break. Sometimes Martha and I would take a drive together for some couple communication time as our moving baby drifted off to sleep. Sometimes I would bring a pillow along, so after our baby fell asleep and we returned home, I would stretch out in the front seat for a bit of recharging.

"During one car ride my husband and I carried on an entire conversation to the tune of "Swing Low Sweet Chariot" so that our baby stayed happy and we could get some important communicating done."

STROLLING IN A CARRIAGE
For many modern mothers, wearing babies in carriers has replaced pushing them in carriages. Certainly babies would give two thumbs up to this improved mode of travel. While most babies settle better when worn than when wheeled, some high-need babies like a change of scenery and sometimes settle better in a carriage or stroller. Some infants shun the flimsy, hard, rough-riding collapsible strollers and prefer the old-fashioned, cushy, bouncy (expensive!) prams. That's typical of high-need children.

Warning about babies sleeping in carriages. Carriages are designed to soothe babies and sometimes get them to sleep, but it is not safe to leave baby sleeping in a carriage unattended. Carriage mattresses are too plush, and carriages often hold blankets and fuzzy toys that may occlude baby's breathing. Many infants have been smothered while left sleeping unattended in baby carriages.

ROLLING BABY
Kneel on the floor and drape baby tummy-down over a beach ball. Hold baby with one hand and slightly roll the ball from side to side.

WALKING WITH BABY
One of the easiest baby—and parent—calmers is a simple walk. When our babies were fussy and obviously needed a change of scenery, I borrowed a motto from Knute Rockne, the famous Notre Dame football coach: "When the going gets tough, the tough get going." I would nestle our baby in a sling and take a long walk, each time trying to vary the route and the attractions. We would walk past moving cars, moving people, trees, parks, children playing, up and down hills, around curvy paths, and oftentimes along the beach. Martha also enjoyed the walking routine. Sometimes we began the day with a baby walk, which seemed to start the day off better for both of us. Other times, when our babies were going through the stage when they fussed a lot around dinner time, we would take a walk around 5 o'clock, which sometimes mellowed them out enough that they would reward us by forgetting to fuss that evening. Besides calming fussy babies, long pleasant walks are good exercise for parents.

Get outdoors! We have always believed that if our babies were going to fuss they may as well fuss outside. Feeling housebound with a fussy baby is a double punishment that few parents can tolerate. This is especially true for those persistent p.m. fussers who need a half-hour to an hour each evening to blow off steam. In that case, they may as well have their evening blast amid a change of scenery for you.

Taking a walk is good therapy for a mother who is struggling with burnout . A mother who is having trouble managing her new life and who also has a high-need baby is at risk for serious post-partum depression or high levels of anxiety. This mother-baby pair needs to be out of the house, walking briskly for forty-five minutes to an hour in the morning and again after they have a nap. Mother may worry that she's away from the house and "not getting enough done," but remember, "home" to a baby is where mother is, and what she is doing is important. Walking will calm both mother and baby, and the exercise releases endorphins in the brain that soothe emotional and mental distress. Walking can help a new mother settle into a more balanced and peaceful life so that she can reflect balance and peace to her baby.

HAPPY HOUR
Many fussy or colicky babies seem to go to pieces in the late afternoon or early evening, just when your parental reserves are already drained. If your baby is a "p.m. fusser" around the same time each day, play "happy hour" before baby's colic hour occurs. Treat baby and yourself to a late afternoon nap. Upon awakening, go into a relaxing ritual, such as a twenty-minute baby massage, followed by a forty-minute walk carrying baby in a sling. With this before-colic ritual, baby is conditioned at the same time each day to expect an hour of comfort rather than an hour of pain.

COLIC CARRIES
Here are four time-tested holds for putting a tense baby in relaxed arms:

The arm drape (also called the football hold). Rest baby's head in the crook of your elbow; drape baby's stomach along your forearm and grasp the diaper area firmly. Your forearm will press against baby's tense abdomen. When baby's tense limbs dangle instead of stretch out, baby is beginning to relax. For variety, try reversing this position, with baby's cheek in the palm of your hand and her diaper area in the crook of your elbow.

Colic curls. Babies who tense their tummy and arch their back often settle in this position. Slide baby's back down your chest and encircle your arms under his bottom. Curl baby up, facing forward with his head and back resting against your chest. As an added gas reliever, try pumping baby's thighs in a bicycle motion. Or, try reversing the forward-facing position: baby's feet up against your chest as you hold him. In this position, you can maintain eye-to-eye contact with your baby.

The handstand (beginning around age four months). Let baby face forward with his back up against your chest as he stands on one of your hands. Lean slightly back to discourage baby from lunging forward and be ready to catch the lunger with the other hand in case he does. (You can press the other hand up against baby's abdomen if that warm pressure seems to help.) The combination of the visual attractions of facing forward plus the concentration needed for baby to maintain standing often cause baby to forget to fuss. The handstand also works well with baby resting against you chest-to-chest and his head peering over your shoulder; there's less chance of baby lurching forward out of your arms this way.

The neck nestle . Here's a high-touch baby calmer where dad shines. While walking, dancing, or lying with your baby on your chest, snuggle her head against the front of your neck and drape your chin over her head. Then hum or sing a low-pitched melody like "Old Man River" while swaying side to side. The vibration of your voice box and jaw against your baby's sensitive skull can often lull the tense baby right to sleep. Some of my most memorable moments are of holding my babies in the neck nestle position while singing the Sears family "Go to sleep" song: Go to sleep, go to sleep, go to sleep my little baby. Go to sleep, go to sleep, go to sleep my little girl.

For added comforting and sleep-inducing success, try the above holds while walking or dancing with your baby. Add soothing sounds and moving attractions, such as beaches, water running in the kitchen sink, or moving traffic.

SOUNDS THAT SOOTHE
Along with motion, most babies are soothed by sounds, preferably ones that remind them of the womb. The most calming sounds are rhythmic, monotonous, low-pitched and humming in quality, with slowly rising crescendos and decrescendos, and a sound pattern that repeats at a rate of 60 to 70 pulses per minute. Infant product manufacturers have capitalized on research into soothing sounds by producing a variety of sleep-inducing sound makers that use "white noise"—a monotonous, repetitive sound involving all the frequencies audible to the human ear; this will lull an overloaded mind into sleep. However, you don't need to go out and buy a special tape or gadget to lull your baby to sleep. 

SIGHTS THAT DELIGHT
A captivating image can distract some babies in the midst of a crying fit and sidetrack others before they have a chance to howl. Try these:

MAGIC MIRROR
This scene has pulled our babies out of many crying jags. Hold the fussy baby in front of a mirror and let her witness her own drama. Place her hand or barefoot against its image on the mirror surface and watch the intrigued baby grow silent.

HAPPY FACES: spend a lot of time in face-to-face contact with your baby, showing baby exaggerated (but pleasant) facial expressions. Remember which facial expressions he likes and replay them later when he fusses. High-need babies demand a lot of connecting experiences, face-to-face and eye- to-eye contact is what they need in order to know they are being heard and seen clearly. All this connecting is why high-need babies grow up to be good communicators that are sensitive to the body language and nonverbal cues of others. They get plenty of practice.

SILLY FACE: Give baby a sudden change of face. Put on your silliest or most dramatic facial gestures and direct them at baby. These antics take babies by surprise, causing them (at least temporarily) to forget why they are fussing.

MISCELLANEOUS MOVING ATTRACTIONS: Seldom do you have to buy stuff to hush little babies. You'll be amazed what natural baby calmers are all around your home. We've enjoyed placing our babies in front of these natural "visual stimulators" .

TOUCHES THAT RELAX
INFANT MASSAGE High-need babies have tense muscles that need help relaxing. Every baby needs lots of touching. High-need babies (of course!) need more. Infant massage is an enjoyable way to touch and soothe your infant. You can learn the art of infant massage from an infant massage instructor (ask your local childbirth instructor if she can recommend someone). An instructor can be especially helpful if your baby seems to be overstimulated by touch. You can also teach yourself using the instruction manual, Infant Massage: A Handbook for Loving Parents by Vimala Schneider (Bantam Books, 1989). Some very sensitive high-need babies actually pull away from being touched because they find it threatening or over- stimulating. In this case, a routine of careful, gentle touches can gradually accustom this baby to being handled and will help him to eventually enjoy touching.

THE WARM FUZZY Here's a high-touch soother where father can really shine. Dads, lie down and drape baby skin- to-skin over your chest, placing baby's ear over your heart. As baby senses the rhythm of your heartbeat plus the up-and-down motion of your breathing, you will feel the tense baby relax. His fists will uncurl and his limbs will dangle limply over your chest. By the time baby becomes three or four months of age, he may squirm and easily roll off your chest. Then try letting your baby nestle against you with the top of his head in your armpit and his tummy resting comfortably against the side of your chest. In this position, baby's ear can still hear your heart beat and sense your steady breathing. Pat his diapered bottom with your free hand to reinforce the calm feeling.

NECK NESTLE . Place the baby in the snuggle position and lift him up a bit until his head nestles into your neck and your neck and chin drape over baby's head. You will have found one of the most comforting and calming holding patterns. In the neck nestle dad has a slight edge over mom. Babies hear not only through their ears but also through the vibration of their skull bones. By placing baby's head against your voice box, in the front of your neck, and humming and singing to your baby, the slower, more easily felt vibrations of the lower-pitched male voice often lull baby right to sleep. As you rock and walk with your baby, sing a calming song such as "Old Man River."

Another attraction to the neck nestle is that baby feels the warming air from your nose on her scalp. (Experienced mothers have long known that sometimes-just breathing onto baby's head or face will calm her. They call this "magic breath.") My babies have enjoyed the neck nestle more than any of the other holding patterns, and I have, too. Dads, become a shareholder in the family art of babywearing.

NESTLE NURSING Undress your baby down to a diaper and lie down on the bed together. Curl up womb-like around your baby, face-to-face, tummy-to-tummy, and let the baby nurse. This is especially soothing if mom's clothing allows for lots of skin contact. The natural calming powers of touching, sucking, your breathing and heartbeat, along with gentle strokes from your fingers will relax even the fussiest baby and send her off into peaceful sleep. Martha calls this hold the teddy bear snuggle.

A WARM BATH TOGETHER This one's for mother and baby. Mothers of high-need babies have put in a lot of hours of hydrotherapy because it works! Recline in a half-full tub, and have dad hand baby to you. If you are alone, have baby "stand by" in an infant seat right next to the tub until you are ready to bring her into the tub. Place baby tummy-to-tummy against your chest and let baby breastfeed in the water (your nipples being a couple inches above the surface). Baby is floating a bit while nursing, which adds to the soothing effect. Taking a bath with baby helps to relax mom as well as baby. Leave the faucet running and the tub's drain open a bit. The drip of the warm water not only provides a soothing sound, but also keeps the water comfortably warm.

Getting the sleeping baby out of the tub is a bit of a challenge. Some babies will stay asleep while they are handed off to someone waiting with a warm, dry towel. Most high-need babies don't sleep through handoffs, however. You may have to plan to just stay in the tub awhile. Have some relaxing music on that you can enjoy. Or have a book handy (this may or may not work depending on the design of your tub). If you really don't want to stay in the tub the whole time baby sleeps, and he doesn't hand off well to someone (or you're alone), plan your strategy for getting both of you out of the tub and resettled on your bed. Have the infant seat next to the tub with the warm, dry towel draped over it. (Try having a hot water bottle there keeping the towel warm until you're ready to place baby on the towel.) If baby wakes up during this transfer, don't despair. Wrap yourself up in your own big, fluffy bath sheet, pick baby up calmly and head for your bed. Snuggle up together with as little fuss as possible and baby may obligingly nurse back off to sleep for you.

REASONS WHY BABIES FUSS
Very simply, babies fuss for the same reasons adults fuss: they hurt either physically or emotionally, or they need something. There is a wide spectrum of types of crying. At the quieter end is the baby who fusses to be picked up but is easily comforted and satisfied as long as he is held. At the other extreme is the baby who hurts – the inconsolably crying baby who merits the label "colicky."

FUSSES TO FIT While in the womb, the preborn baby fits perfectly into his environment. Perhaps there will never be another home in which he fits so harmoniously – a free-floating environment where the temperature is constant and his nutritional needs are automatically and predictably met. The womb environment is well organized. These babies miss the womb.

Birth suddenly disrupts this organization. During the month following birth, baby tries to regain his sense of organization and fit into life outside the womb. Birth and adaptation to postnatal life bring out the temperament of the baby, so for the first time he must do something to have his needs met. He is forced to act, to "behave." If hungry, cold, or startled, he cries. He must make an effort to get the things he needs from his caregiving environment. If his needs are simple and he can get what he wants easily, he's labeled an "easy baby"; if he does not adapt readily, he is labeled "difficult." He doesn't fit. Fussy babies are poor fitters, who don't resign themselves easily to the level of care they are being given. They need more, and they fuss to get it.

THINGS PARENTS SHOULD KNOW ABOUT BABY'S CRIES
1. An infant's cry – the perfect signal. Scientists have long appreciated that the sound of an infant's cry has all three features of a perfect signal.

First, a perfect signal is automatic. A newborn cries by reflex. The infant senses a need, which triggers a sudden inspiration of air followed by a forceful expelling of that air through vocal cords, which vibrate to produce the sound we call a cry. In the early months, the tiny infant does not think, "What kind of cry will get me fed?" He just automatically cries. Also, the cry is easily generated. Once his lungs are full of air, the infant can initiate crying with very little effort.

Second, the cry is appropriately disturbing: ear-piercing enough to get the caregiver's attention and make him or her try to stop the cry, but not so disturbing as to make the listener want to avoid the sound altogether.

Third, the cry can be modified as both the sender and the listener learn ways to make the signal more precise. Each baby's signal is unique. A baby's cry is a baby's language, and each baby cries differently. Voice researchers call these unique sounds cry prints, which are as unique for babies as their fingerprints are.

2. Responding to baby's cries is biologically correct. A mother is biologically programmed to give a nurturant response to her newborn's cries and not to restrain herself. Fascinating biological changes take place in a mother's body in response to her infant's cry. Upon hearing her baby cry, the blood flow to a mother's breasts increases, accompanied by a biological urge to "pick up and nurse." The act of breastfeeding itself causes a surge in prolactin , a hormone that we feel forms the biological basis of the term "mother's intuition." Oxytocin, the hormone that causes a mother's milk to letdown, brings feelings of relaxation and pleasure; a pleasant release from the tension built up by the baby's cry. These feelings help you love your baby. Mothers, listen to the biological cues of your body when your baby cries rather than to advisors who tell you to turn a deaf ear. These biological happenings explain why it's easy for those advisors to say such a thing. They are not biologically connected to your baby. Nothing happens to their hormones when your baby cries.

3. Ignore or respond to the cry signal? Once you appreciate the special signal value of your baby's cry, the important thing is what you do about it. You have two basic options, ignore or respond. Ignoring your baby's cry is usually a lose-lose situation. A more compliant baby gives up and stops signaling, becomes withdrawn, eventually realizes that crying is not worthwhile, and concludes that he is not worthwhile. The baby loses the motivation to communicate with his parents, and the parents miss out on opportunities to get to know their baby. Everyone loses. A baby with a more persistent personality— most high-need babies—does not give up so easily. Instead, he cries louder and keeps escalating his signal, making it more and more disturbing. You could ignore this persistent signal in several ways. You could wait it out until he stops crying and then pick him up, so that he won't think it was his crying that got your attention. This is actually a type of power struggle; you teach the baby that you're in control, but you also teach him that he has no power to communicate. This shuts down parent-child communication, and in the long run everybody loses.

You could desensitize yourself completely so that you're not "bothered" at all by the cry; this way you can teach baby he only gets responded to when it's "time." This is another lose-lose situation; baby doesn't get what he needs and parents remain stuck in a mindset where they can't enjoy their baby's unique personality. Or, you could pick baby up to calm him but then put him right back down because "it's not time to feed him yet." He has to learn, after all, to be happy "on his own." Lose-lose again; he will start to cry again and you will feel angry. He will learn that his communication cues, though heard, are not responded to, which can lead him to distrust his own perceptions: "Maybe they're right. Maybe I'm not hungry."

4. Be nurturing. Your other option is to give a prompt and nurturant response. This is the win-win way for baby and mother to work out a communication system that helps them both. The mother responds promptly and sensitively so that baby will feel less frantic the next time he needs something. The baby learns to "cry better" , in a less disturbing way since he knows mother will come. Mother structures baby's environment so that there is less need for him to cry; she keeps him close to her if she knows he's tired and ready to sleep. Mother also heightens her sensitivity to the cry so that she gives just the right response. A quick response when baby is young and falls apart easily or when the cry makes it clear there is real danger; a slower response when the baby is older and begins to learn how to settle disturbances on his own.

Responding appropriately to your baby's cry is the first and one of the most difficult, communication challenges you will face as a mother. You will master the system only after rehearsing thousands of cue-responses in the early months. If you initially regard your baby's cry as a signal to be responded to and evaluated rather than as an unfortunate habit to be broken, you will open yourself up to becoming an expert in your baby's signals, which will carry over into becoming an expert on everything about your baby. Each mother-baby signal system is unique. That's why it is so shortsighted for "cry trainers" to prescribe canned cry-response formulas, such as "leave her to cry for five minutes the first night, ten minutes the second," and so on.

5. It's not your fault baby cries. Parents, take heart! If you are responsive to your baby and try to keep him feeling secure in his new world, you need not feel that it's your fault if your baby cries a lot. Nor is it up to you to stop your baby's crying. Of course, you stay open to learning new things to help your baby (like a change in your diet or a new way of wearing baby), and you get your doctor involved if you suspect a physical cause behind the crying. But there will be times when you won't know why your baby is crying—you'll wonder if baby even knows why he's crying. There may be times when baby simply needs to cry, and you needn't feel desperate to make him stop after trying all the usual things.

It's a fact of new parent life that although babies cry to express a need, the style in which they do so is the result of their own temperament. Don't take baby's cries personally. Your job is to create a supportive environment that lessens baby's need to cry, to offer a set of caring and relaxed arms so that baby does not need to cry alone, and to do as much detective work as you can to figure out why your baby is crying and how you can help. The rest is up to baby.

"When I was confused about my mothering, I asked a seasoned calm, impartial mother to observe how I handled my baby on a typical day in my home. Although I know I'm the expert on my own baby, sometimes it's hard to be objective, and a voice of experience can be helpful."

6. What cry research tells us. Researchers Sylvia Bell and Mary Ainsworth performed studies in the 1970's that should have put the spoiling theory on the shelf to spoil forever. (It is interesting that up to that time and even to this day, the infant development writers that preached the cry-it-out advice were nearly always male. It took female researchers to begin to set things straight.) These researchers studied two groups of mother-infant pairs. Group 1 mothers gave a prompt and nurturant response to their infant's cries. Group 2 mothers were more restrained in their response. They found that children in Group 1 whose mothers had given an early and more nurturant response were less likely to use crying as a means of communication at one year of age. These children seemed more securely attached to their mothers and had developed better communicative skills, becoming less whiny and manipulative.

Up until that time parents had been led to believe that if they picked up their baby every time she cried she would never learn to settle herself and would become more demanding. Bell and Ainsworth's research showed the opposite. Babies who developed a secure attachment and had their cues responded to in a prompt and nurturing way became less clingy and demanding. More studies were done to shoot down the spoiling theory, showing that babies whose cries were not promptly responded to begin to cry more, longer, and in a more disturbing way. In one study comparing two groups of crying babies, one group of infants received an immediate, nurturant response to their cries, while the other group was left to cry-it-out. The babies whose cries were sensitively attended to cried seventy percent less. The babies in the cry-it-out group, on the other hand, did not decrease their crying. In essence, crying research has shown that babies whose cries were listened and responded to learned to "cry better"; the infants who were the product of a more restrained style of parenting learned to "cry harder." It is interesting that the studies revealed differences not only in how the babies communicated with the parents based on the response they got to their cries, but there were also differences in the mothers, too. Studies showed that mothers who gave a more restrained and less nurturant response gradually became more insensitive to their baby's cries, and this insensitivity carried over to other aspects of their parent-child relationship. Research showed that leaving baby to cry-it- out spoils the whole family.

7. Crying isn't "good for baby's lungs." One of the most ridiculous pieces of medical folklore is the dictum: "Let baby cry, it's good for his lungs." In the late 1970's, research showed that babies who were left to cry had heart rates that reached worrisome levels, and lowered oxygen levels in their blood. When these infants' cries were soothed, their cardiovascular system rapidly returned to normal, showing how quickly babies recognize the status of well being on a physiologic level. When a baby's cries are not soothed, he remains in physiologic as well as psychological distress.

The erroneous belief about the healthfulness of crying survives even today in one of the scales of the Apgar score, a sort of test that physicians use to rapidly assess a newborn's condition in the first few minutes after birth. Babies get an extra two points for "crying lustily." I remember pondering this concept back in the mid 1970's when I was the director of a newborn nursery in a university hospital, even before fathering a high-need baby had turned me into an opponent of crying it out. It seemed to me that awarding points for crying made no sense physiologically. The newborn who was in the state of quiet alertness, breathing normally, and actually pinker than the crying infant lost points on the Apgar score. It still amazes me that the most intriguing of all human sounds—the infant's cry—is still so misunderstood.

LETTING BABY "CRY-IT-OUT" YES, NO!
If only my baby could talk instead of cry I would know what she wants," said Janet, a new mother of a fussy baby. "Your baby can talk," we advised. "The key is for you to learn how to listen. When you learn the special language of your baby's cry, you will be able to respond sensitively. Here are some listening tips that will help you discover what your baby is trying to say when he cries.

The cry is not just a sound; it's a signal – designed for the survival of the baby and development of the parents. By not responding to the cry, babies and parents lose. Here's why. In the early months of life, babies cannot verbalize their needs. To fill in the gap until the child is able to "speak our language," babies have a unique language called "crying." Baby senses a need, such as hunger for food or the need to be comforted when upset, and this need triggers a sound we call a cry. Baby does not ponder in his little mind, "It's 3:00 a.m. and I think I'll wake up mommy for a little snack." No! That faulty reasoning is placing an adult interpretation on a tiny infant. Also, babies do not have the mental acuity to figure out why a parent would respond to their cries at three in the afternoon, but not at three in the morning. The newborn who cries is saying: "I need something; something is not right here. Please make it right."

At the top of the list of unhelpful advice – one that every new parent is bound to hear – is "Let your baby cry-it-out." To see how unwise and unhelpful is this advice, let's analyze each word in this mother-baby connection- interfering phrase.

"Let your baby." Some third-party advisor who has no biological connection to your baby, no knowledge or investment in your baby, and isn't even there at 3:00 a.m. when your baby cries, has the nerve to pontificate to you how to respond to your baby's cries.

The cry is a marvelous design. Consider what might happen if the infant didn't cry. He's hungry, but doesn't awaken ("He sleeps through the night," brags the parent of a sleep-trained baby). He hurts, but doesn't let anyone know. The result of this lack of communication is known, ultimately, as "failure to thrive." "Thriving" means not only getting bigger, but growing to your full potential emotionally, physically, and intellectually.

"Cry…" Not only is the cry a wonderful design for babies; it is a useful divine design for parents, especially the mother. When a mother hears her baby cry, the blood flow to her breasts increases, accompanied by the biological urge to "pick up and nurse" her baby. ("Nurse" means comforting, not just breastfeeding.) As an added biological perk, the maternal hormones released when baby nurses relax the mother, so she gives a less tense and more nurturing response to her infant's needs. These biological changes – part of the design of the mother-baby communication network – explain why it's easy for someone else to advise you to let your baby cry, but difficult for you to do. That counterproductive advice is not biologically correct.

"It…" Consider what exactly is the "it" in "cry-it-out": an annoying habit? Unlikely, since babies don't enjoy crying. And, contrary to popular thought, crying is not "good for baby's lungs." That belief is not physiologically correct. The "it" is an emotional or physical need. Something is not right and the only way baby has of telling us this is to cry, pleading with us to make it right. Early on, consider baby's cry as signaling a need – communication rather than manipulation.

Parent tip: Babies cry to communicate – not manipulate
"Out" What actually goes "out" of a baby, parents, and the relationship when a baby is left to cry-it-out? Since the cry is a baby's language, a communication tool, a baby has two choices if no one listens. Either he can cry louder, harder, and produce a more disturbing signal or he can clam up and become a "good baby" (meaning "quiet"). If no one listens, he will become a very discouraged baby. He'll learn the one thing you don't want him to: that he can't communicate.

Baby loses trust in the signal value of his cry – and perhaps baby also loses trust in the responsiveness of his caregivers. Not only does something vital go "out" of baby, an important ingredient in the parent- child relationship goes "out" of parents: sensitivity. When you respond intuitively to your infant's needs, as you practice this cue- response listening skill hundreds of times in the early months, baby learns to cue better (the cries take on a less disturbing and more communicative quality as baby learns to "talk better"). On the flip side of the mother-infant communication, you learn to read your infant's cries and respond appropriately (meaning when to say "yes" and when to say "no," and how fast). In time you learn the ultimate in crying sensitivity: to read baby's body language and respond to her pre-cry signals so baby doesn't always have to cry to communicate her needs.

What happens if you "harden your heart," view the cry as a control rather than a communication tool and turn a deaf ear to baby's cries? When you go against your basic biology, you desensitize yourself to your baby's signals and your instinctive responses. Eventually, the cry doesn't bother you. You lose trust in your baby's signals, and you lose trust in your ability to understand baby's primitive language. A distance develops between you and your baby and you run the risk of becoming what pediatricians refer to as a doctor-tell-me-what-to-do. You listen to a book instead of your baby. So, not listening and responding sensitively to baby's cries is a lose-lose situation: Baby loses trust in caregivers and caregivers lose trust in their own sensitivity.

Mother loses trust in herself. To illustrate how a mother can weaken her God- given sensitivity when she lets herself be less discerning about parenting advice; a sensitive veteran mother recently shared this story with us:

"I went to visit my friend who just had a baby. While we were talking, her three-week-old started crying in another room. The baby kept crying, harder and louder. I was getting increasingly driven to go comfort the baby. Her baby's cries didn't bother her, but they bothered me. My breasts almost started to leak milk! Yet, my friend seemed oblivious to her baby's signals. Finally, I couldn't stand it anymore and I said, 'It's okay, go attend to your baby. We can talk later.' Matter-of-factly she replied, 'No, it's not time yet for his feeding.' Incredulous, I asked, 'Mary, where on earth did you get that harmful advice?' 'From a baby-training class at church,' she proudly insisted. 'I want my baby to learn I'm in control, not him.'"

This novice mother, wanting to do the best for her baby and believing she was being a good mother, had allowed herself to succumb to uncredentialed prophets of bad parenting advice and was losing her God-given sensitivity to her baby. She was starting her parenting career with a distance developing between her and her baby. The pair was becoming disconnected.

WAYS TO TEACH YOUR BABY TO CRY BETTER
Here are some time-tested listening tips that can help you decode the meaning of your baby's cries, respond nurturantly, and gradually create a communication relationship so that baby doesn't always have to cry to communicate:

1. View your baby's cries as a communication rather than a manipulation tool. Think of your baby's cries as a signal to be listened to and interpreted rather than click into a fear of spoiling or fear of being controlled mindset.

2. Better early than late. New parents may be led to believe that the more they delay their response to baby's cries, the less baby will cry. While this may be true of some easy, mellow babies (they become apathetic), infants with persistent personalities will only cry harder and in a more disturbing way. Learn to read your baby's pre-cry signals: anxious facial expressions, arms flailing, excited breathing, etc. Responding to these pick-me-up signals teaches baby that he doesn't have to cry to get attended to. Again, forget the fear of spoiling. Studies have shown that babies whose cries are promptly attended to actually learn to cry less as older infants and toddlers.

3. Respond appropriately. You don't have to pick up a seven-month-old baby as quickly as a seven-day-old baby. In the early weeks of cue-response rehearsals, respond intuitively and quickly to each cry. As you and your baby become better communicators, you – and only you – will know whether a cry is a "red alert come now" cry or one that merits a more delayed response.

Learn that magic cry-response word appropriately, which implies balance – knowing when to say "yes" and when to say "no." In fact, you will naturally start off as a "yes mom," then intuitively become appropriately a "yes and no" mom. When in doubt, say "yes." It's much easier to fix over-responding – you just back off a bit. It's more difficult to repair the distrust that stems from under-responding and becoming disconnected.

4. Try the Caribbean approach. A system we have developed to model calmness to a baby is one we dubbed the Caribbean attitude: "No problem, mon!" Imagine your seven-month-old baby playing at your feet and you're on the phone. Baby starts to fuss and give pick-me-up gestures. Instead of dropping the phone and anxiously scooping up fussing baby, put on your happy face, caringly acknowledge baby and make voice contact, "It's okay, Molly…" In this way, your body language is reflecting, "No problem, baby; no need to fuss." Another favorite phrase in the Caribbean is "don't worry, be happy." By your body language, convey to your baby – be happy, not fussy.

THE SHUTDOWN SYNDROME
Throughout our 30 years of working with parents and babies, we have grown to appreciate the correlation between how well children thrive (emotionally and physically) and the style of parenting they receive.

"You're spoiling that baby!" First-time parents Linda and Norm brought their four-month-old high-need baby, Heather, into my office for consultation because Heather had stopped growing. Heather had previously been a happy baby, thriving on a full dose of attachment parenting. She was carried many hours a day in a baby sling, her cries were given a prompt and nurturant response, she was breastfed on cue, and she was literally in physical touch with one of her parents most of the day. The whole family was thriving and this style of parenting was working for them. Well-meaning friends convinced these parents that they were spoiling their baby, that she was manipulating them, and that Heather would grow up to be a clingy, dependent child.

Parents lost trust. Like many first-time parents, Norm and Linda lost confidence in what they were doing and yielded to the peer pressure of adopting a more restrained and distant style of parenting. They let Heather cry herself to sleep, scheduled her feedings, and for fear of spoiling, they didn't carry her as much. Over the next two months Heather went from being happy and interactive to sad and withdrawn. Her weight leveled off, and she went from the top of the growth chart to the bottom. Heather was no longer thriving, and neither were her parents.

Baby lost trust. After two months of no growth, Heather was labeled by her doctor "failure to thrive" and was about to undergo an extensive medical exam. When the parents consulted me, I diagnosed the shutdown syndrome. I explained that Heather had been thriving because of their responsive style of parenting. Because of their parenting, Heather had trusted that her needs would be met and her overall physiology had been organized. In thinking they were doing the best for their infant, these parents let themselves be persuaded into another style of parenting. They unknowingly pulled the attachment plug on Heather, and the connection that had caused her to thrive was gone. A sort of baby depression resulted, and her physiologic systems slowed down. I advised the parents to return to their previous high-touch, attachment style of parenting—to carry her a lot, breastfeed on cue, and respond sensitively to her cries by day and night. Within a month Heather was again thriving.

Babies thrive when nurtured. We believe every baby has a critical level of need for touch and nurturing in order to thrive. (Thriving means not just getting bigger, but growing to one's potential, physically and emotionally.) We believe that babies have the ability to teach their parents what level of parenting they need. It's up to the parents to listen, and it's up to professionals to support the parents' confidence and not undermine it by advising a more distant style of parenting, such as "let your baby cry-it-out" or "you've got to put him down more." Only the baby knows his or her level of need; and the parents are the ones that are best able to read their baby's language.

Babies who are "trained" not to express their needs may appear to be docile, compliant, or "good" babies. Yet, these babies could be depressed babies who are shutting down the expression of their needs. They may become children who don't speak up to get their needs met and eventually become the highest-need adults.

 

Martha and Dr. William  Sears

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