Infant crying, fussing, and colic
An anthropological perspective on the role of parenting
© 2009 - 2013 Gwen Dewar, Ph.D., all rights reserved
Infant crying, fussing, and
? Babies everywhere cry, especially during the first 3 months after birth. Even chimpanzees follow this pattern (Bard 2004).
But this doesn’t mean that parenting has no influence. Parents have an important effect on the amount of time babies cry.
• Babies often cry because they are in pain, or distressed, or hungry. Prompt, loving care can make them feel better and stop crying. Failure to respond can make it worse.
• Babies tend to cry when they are out-of-contact with their mothers. Studies indicate that young babies cry when they are separated from their mothers and they usually stop crying when they are reunited (Bell and Ainsworth 1972; Christensson et al 1995).
• Carrying a baby can quiet him down -- but you have to keep moving. Research research suggests it's a common calming response in many mammals: Infants experience slower heart rates, reduced body movement, and reduced crying when they are carried by someone who is walking (Esposito et al 2013). But it doesn't last, even among healthy, non-colicky infants. Put the baby down and the calming effect may evaporate.
• Babies may be soothed by rocking and skin-to-skin contact (Byrne and Horowitz 1981; Spencer et al 1990; Gray et al 2000). In addition, babies under 8 weeks of age may cry less when they are safely and appropriately swaddled (van Sleuwen et al 2007).
• Far from getting "spoiled," young babies seem to cry less when they are indulged. In societies that promote a more indulgent approach to baby care (immediate responses to crying, very frequent nursing, lots of physical contact, and cosleeping), babies spend less time crying than they do elsewhere (e.g., Barr et al 1991). We see the same effect among chimpanzees, too. When chimpanzee infants are cradled by their mothers 100% of the time, they cry less than when they are held by the moms only 25% of the time (Bard 2004).
• If babies suffer from medical conditions that make them cry, treating those conditions may result in less crying.
• Some babies—called “fussy” or “high need” babies—are especially demanding. They may crave continual touch and motion, and very frequent nursing. They can’t self-soothe and have special problems trying to sleep alone (Sears and Sears 1996). For such babies, a “Pleistocene” or “proximate” approach to parenting may be an effective way to prevent effective crying (see below).
• Anxious or depressed parents might make their babies feel more tense or upset (though it seems unlikely that parental emotions are the primary cause of excessive infant crying or irritability)
It’s also likely that infant crying is influenced by smoking, alcohol, or caffeine.
For instance, some studies have reported that excessive crying was more likely among babies who were exposed to cigarette smoke during pregnancy or after birth (Reijneveld et al 2005; Shenassa et al 2004). Smoke exposure may increase levels of motilin, a hormone that induces potentially painful intestinal contractions (Shenassa et al 2004). Smoke exposure is also linked with poorer infant sleep, which could contribute to irritability (Mennella et al 2007).
Other studies suggest that alcohol exposure--during gestation and via breast milk—alters brain development, putting babies at higher risk for anxiety and depression (e.g., Zinc et al 2009). Anecdotal experience suggests that babies may become more irritable if they breastfeed after their mothers consume caffeine.
But of course tobacco, alcohol and caffeine are bad for babies in many ways. They can cause birth defects, miscarriage, brain damage, chronic disease, and SIDS (Yazdani et al 2004). So I suspect that most of my readers are already protecting their babies from alcohol, smoke, and caffeine.
So here I focus on what really concerns the conscientious parent:
Is excessive infant crying or fussing a sign that parents aren’t nurturing their babies enough?
It’s a loaded question, one that implicitly blames parents for their babies’ apparent misery.
It also implies a false assumption—i.e., that all babies are alike. Treat babies the same way and you’ll get the same results.
And yet it’s reasonable to think that physical nurturing—sensitive, responsive care that includes lots of physical contact—would be good for babies.
Babies are born with biases for social stimuli.
In general, babies are soothed by feeding (Shaw et al 2007), skin-to-skin contact (Gray et al 2000), and gentle touches that are combined with other forms of communication, like talk or eye contact (White-Traut et al 2009).
Moreover, we know that babies evolved in the context of being fed very frequently and carried around by parents, aunts, grandmothers, or siblings most of the day (Konner 2005). Among modern-day hunter-gatherers—people who still practice this “Pleistocene” approach to baby care, lengthy, inconsolable bouts of infant crying (or “colic”) are rare (Fouts et al 2004).
There is also experimental evidence suggesting that normal Western infants cry less when their parents make a special effort to carry their babies more often. In a randomized experiment, some mothers were assigned to carry their infants more, and their infants cried less relative to a control group (Hunziker and Barr 1986).
But—as many desperate parents know—even babies who are held and fed frequently may become colicky.
Carrying babies has many benefits, but it doesn’t cure colic
As noted above, keeping babies close may reduce stress levels and deter normal infants from prolonged bouts of crying. And holding babies may be beneficial in other ways, too.
For instance, one experimental study found that mothers who wore their infants in soft baby carriers were more likely to have securely-attached babies than were moms who carried their babies in portable infant seats (Anisfeld et al 1990).
Clinical and anecdotal experience also suggests that baby-carrying can be an effective approach for babies who are “fussy” or “high need” (Sears and Sears 1996).
But we shouldn’t get carried away with the cultural hypothesis of colic.
Experimental studies on Western babies suggest that increased carrying doesn’t reduce crying in babies who’ve been diagnosed with colic (Barr 1991; St James-Roberts et al 1995).
And research has failed to demonstrate that parenting differences within Western populations are linked with colic. For example, in one study, Ian St. James-Roberts and his colleagues tracked three groups of new parents—
• Parents living in London
• Parents living in Copenhagen
• A special group of parents who said they planned to practice “proximal care,” holding their infants at least 80% of the time between 8am and 8pm, breastfeeding relatively frequently, and responding rapidly to infant cries. Many (but not all) of these parents also practiced cosleeping.
Parents in all three groups kept behavior diaries and filled out questionnaires.
The results? London parents had the least amount of physical contact with their babies—50% less compared with the parents practicing “proximal care.” These parents also had the babies who cried the most.
But when it came to colicky babies—babies who cried excessively and inconsolably—there was no significant difference between groups (St James-Roberts et al 2006).
So why is excessive, inconsolable crying rare among hunter-gatherers?
I don’t know, and I don’t think anyone else does, either. But if you compare hunter-gatherers with the rest of us, there is more going on than a different approach to baby-carrying.
Possibly, the absence of colic amongst hunter-gatherers reflects differences in sleep, feeding, diet, parental support, or even genes:
Sleep. Some researchers speculate the colic is caused by an immature sleep/wake system. Perhaps colicky babies don’t produce enough melatonin in the late afternoon and evening. As a result, they become “hyper-alert (Jenni 2004). They might experience more intestinal pain, too, because melatonin also suppresses intestinal contractions (Weissbluth and Weissbluth 1992). If either of these hypotheses are correct, then maybe hunter-gatherers avoid colic because they sleep differently—sleeping opportunistically at various times of day (Jenni 2004).
Feeding. Hunter-gatherer babies get fed on demand and very frequently—-sometimes as frequently as 4 times an hour (Konner 2005). The meals are small, however, and this might protect babies from the worst symptoms of gastroesophageal reflux (also known as heartburn or acid reflux).
Diet. Hunter-gatherer diets are radically different from most agricultural, industrial diets. So it seems plausible that the rarity of colic is related to diet. For instance, hunter-gatherers don’t drink cow’s milk, and cow’s milk protein intolerance can cause excessive, inconsolable crying.
Parental support. Much of the research on colic has been done on Western populations where parents—usually mothers—spend long hours in social isolation with their babies. This might contribute to
maternal anxiety and depression, which, in turn, could aggravate the symptoms of colic.
Among hunter-gatherers, parents are virtually never alone with their babies. Not only do they get more adult contact, they get more babysitting help. And hunter-gatherer adults are notably tolerant around other people’s babies (Fouts et al 2004).
Genes. If colic has a genetic basis--such that certain genes increase a baby’s chances of being irritable or difficult to soothe--then we shouldn’t rule out the possibility that hunter-gatherer babies are less likely to possess these genes. Claims about the absence of colic among hunter-gatherers usually concern people like the !Kung San of South Africa or the Baka of Central Africa—people who show evidence of long-term genetic isolation from surrounding agricultural populations (Verdu et al 2009; Tishkoff 2004).
If you have a young baby who cries inconsolably, be sure to consult your pediatrician and get your baby screened for disease. Check out my overview of excessive, inconsolable infant crying as well as this article about the
medical conditions that can cause excessive crying in babies.
In addition, you might be interested in the scientific evidence that
some babies are just different
--responding more irritably to stimulation that doesn’t bother other babies.
...And a video about calming effect of baby-carrying
To take a look at the temporary power of baby-carrying in action, follow
to a video presentation by the researchers who've demonstrated physiological calming in human and rodent infants (Esposito et al 2013).
References: The anthropology of infant crying
Anisfeld E, Casper V, Nozyce M, and Cunningham N. 1990. Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment. Child Dev. 61(5):1617-27.
Barr RG, Konner M, Bakeman R and Adamson L. 1991. Crying in !Kung San infants: A test of the cultural specificity hypothesis. Developmental Medicine and Child Neurology 33: 601-610.
Bell SM and Ainsworth MDS. 1972. Infant crying and maternal responsiveness. Child Development 43: 1171-1190.
Byrne J and Horowitz F. 1981. Rocking as a Soothing Intervention: The Influence of Direction and Type of Movement. Infant Behavior and Development 4: 207-218.
Christensson K, Cabrera T, Christensson E, Uvnas-Moberg K and Winberg J. 1995. Separation distress call in the human neonate in the absence of maternal body contact. Acta Paediatrica 84: 468-473.
Esposito G, Yoshiaa S, Ohnishi R, Tsuneoka Y, del Carmen Rostagno M, et al. 2013. Current Biology epub ahead of print 10.1016/j.cub.2013.03.041.
Fouts HN, Lamb ME, and Hewlett BS. 2004. Infant crying in hunter-gatherer cultures. Behavioral and Brain Sciences 27(4): 462-463.
Gray L, Watt L, Blass EM. 2000. Skin-to-skin contact is analgesic in healthy newborns. Pediatrics 105(1).
Hunziker UA and Barr RG. 1986. Increased carrying reduces infant crying: a randomized controlled trial. Pediatrics. 77(5):641-8.
Jenni OG. 2004. Sleep-wake processes play a key role in early infant crying. Behavioral and Brain Sciences 27(4): 464-465.
Konner M. 2005. Hunter-gatherer infancy and childhood: The !Kung and others. In: Hunter-gatherer childhoods: Evolutionary, developmental and cultural perpectives. BS Hewlett and ME Lamb (eds). New Brunswick: Transaction Publishers.
Mennella J. 2007. Breastfeeding and smoking: Short-term effects on infant feeding and sleep. Pediatrics 120 (3):497-502.
Reijneveld SA, Lanting CI, Crone MR, and Van Wouwe JP. 2005. Exposure to tobacco smoke and infant crying. Acta Paediatr. 94(2):217-21.
St James-Roberts I, Alvarez M, Csipke E, Abramsky T, Goodwin J, and Sorgenfrei E. 2006. Infant crying and sleeping in London, Copenhagen and when parents adopt a "proximal" form of care. Pediatrics. 117(6):e1146-55.
St James-Roberts I, Hurry J, Bowyer J, and Barr RG. 1995. Supplementary carrying compared with advice to increase responsive parenting as interventions to prevent persistent infant crying. Pediatrics. 95(3):381-8.
Shah PS, Aliwalas L, and Shah V. 2007. Breastfeeding or breast milk to alleviate procedural pain in neonates: a systematic review. Breastfeeding medicine 2:74-82.
Shenassa E and Brown M-J. 2004. Maternal smoking and infantile gastrointestinal dysregulation: The case of colic. Pediatrics 114(4): 497-505.
Spencer JA, Moran DJ, Lee A, and Talbert D. 1990. White noise and sleep induction.Arch Dis Child. 65(1):135-7.
Tishkoff SA and Verrelli BC. 2003. Patterns of human genetic diversity: Implications for Human Evolutionary History and Disease. Annual Review of Genomics and Human Genetics 4: 293-340.
van Sleuwen BE, L'hoir MP, Engelberts AC, Busschers WB, Westers P, Blom MA, Schulpen TW, and Kuis W. 2007 Comparison of behavior modification with and without swaddling as interventions for excessive crying. J Pediatr. 149(4):512-7.
Verdu P, Austerlitz F, Estoup A, et al. 2009. Origins and Genetic Diversity of Pygmy Hunter-Gatherers from Western Central Africa Current Biology, 19 (4), 312-318
Weissbluth L and Weissbluth M. 1992. Infant colic: the effect of serotonin and melatonin circadian rhythms on the intestinal smooth muscle. Med Hypotheses. 39(2):164-7.
White-Traut RC, Schwertz D, McFarlin B, and Kogan J. 2009. Salivary cortisol and behavioral state responses of healthy newborn infants to tactile-only and multisensory interventions. J Obstet Gynecol Neonatal Nurs. 38(1):22-34.
Yazdani M, Ide K, Asadifar M, Gottschalk S, Joseph F Jr, and Nakamoto T. 2004. Effects of caffeine on the saturated and monounsaturated Fatty acids of the newborn rat cerebellum. Ann Nutr Metab. 48(2):79-83.
Zink M, Araç G, Frank ST, Gass P, Gebicke-Härter PJ, and Spanagel R. 2009. Perinatal exposure to alcohol reduces the expression of complexins I and II. Neurotoxicol Teratol. 31(6):400-5.
Content last modified 4/13