Understanding Newborn Fussiness: What's Normal?

It is perfectly normal for newborns to be fussy. Newborns can be surprisingly loud, fussy, and hard to soothe, especially when parents are exhausted and overwhelmed. Newborns often fuss when they are hungry, tired, or need a diaper change. They may also be overstimulated by noise, light, and activity, or they might miss the confines of the uterus. Fussiness usually starts at about 2 to 3 weeks, peaks at 6 weeks, and is gone by 3 to 4 months. It lasts on average 2 to 4 hours per day.

Soothing techniques for fussy newborns

It is perfectly normal for newborns to be fussy, especially during the first few months. They may be hungry, hot or cold, wet or soiled, spitting up or vomiting a lot, sick, bored, or experiencing colic. Here are some soothing techniques to help calm your fussy newborn:

• Respond consistently to your baby's cries. Holding and picking them up when they cry will not spoil them.
• Try a pacifier. Newborns under three months are not neurologically mature enough to calm themselves, and many are soothed by sucking.
• Rock your baby in your arms or in a baby carrier. The motion can be fairly vigorous as long as you are holding them securely.
• Take your baby for a walk in a stroller or a drive in the car. The smooth, consistent motion can be soothing and may lull them to sleep.
• Recruit help from family or friends. Sometimes a change of arms is all your baby needs to calm down.
• Make sure your baby is comfortable. Check their diaper frequently and ensure it is not too tight.
• Give your baby a warm bath or a shower with you, combining kangaroo care with the soothing powers of water.
• Swaddle your baby in a thin, lightweight blanket with their arms across their chest. Swaddled babies often sleep longer and more soundly.
• Try kangaroo care by placing your baby against your naked skin and covering both of you with a warm, soft blanket.
• Use a baby sling or carrier. The warm, dark, close comfort of a sling is soothing, and you can breastfeed anywhere undercover.
• If you are breastfeeding, offer the breast even if your baby is not hungry. Nursing for comfort is inherently soothing and will not overfeed your baby.
• Play white noise, such as the sound of a fan, vacuum cleaner, or hair dryer, or use a white noise machine. White noise simulates the whooshing sound your baby heard constantly in the womb.
• Make a "shush" sound directly into your baby's ear, mimicking what they heard in the womb.
• Sing songs or read books to your baby.
• Massage your baby. Massage has many benefits for both the baby and the giver.
• Place your baby in their crib on their back if they fall asleep in your arms.
• Take care of yourself and manage your stress. Eat a well-balanced diet, get enough sleep, and talk to others for support.

Reasons for newborn fussiness

It is normal for newborns to be fussy, especially during their first few months. Fussiness usually starts at about 2 to 3 weeks, peaks at 6 weeks, and is gone by 3 to 4 months. Fussiness tends to occur during the time of day that the baby usually stays awake more, with the most common time being in the evening before the baby's longest stretch of sleep.

Hunger

Newborns need to eat often, as in every two to three hours, so they may fuss as they start to feel hungry. Remember to burp them during and after they eat as well.

Tiredness

Newborns fuss when they are tired, so try putting your baby down for a nap or the night. Look for early sleep signs such as rubbing their eyes, yawning, and fussing.

Overstimulation

Too much noise, light, and activity can overwhelm a newborn. Try dimming the lights, turning down the TV or music, or putting them in a more subdued environment.

Discomfort

Newborns may be fussy due to discomfort from a wet or dirty diaper, being too hot or too cold, or needing to poop. They may also be experiencing discomfort from a food sensitivity or reflux.

Growth spurts

Babies often go through a fussy period when they are going through growth spurts.

Colic

Colic is when a healthy baby cries more than three hours a day, for more than three days a week, between the ages of three weeks and three months. It usually starts to improve at about 6 weeks of age and is generally gone by the time the baby is 12 weeks old.

If you are concerned about your baby's fussiness or if it seems unusual, don't hesitate to consult your paediatrician or healthcare provider.

Signs of abnormal fussiness

While it is normal for newborns to be fussy, there are some signs that may indicate abnormal fussiness that requires further investigation. Here are some key indicators:

Persistent and Excessive Crying

Colic is characterised by excessive crying in an otherwise healthy baby. It typically occurs between the ages of three weeks and three months, with crying lasting for more than three hours a day, for more than three days a week. Colic usually starts to improve around six weeks of age and is generally gone by the time the baby is 12 weeks old. If your baby's crying fits this pattern, it may be a sign of colic.

Crying Accompanied by Other Symptoms

If your baby's fussiness is accompanied by specific symptoms, it could indicate an underlying issue. These symptoms include:

• Fussiness after feeding: This could be a sign of gastroesophageal reflux (GER) or an intolerance to something in the mother's diet if breastfeeding.
• Arching their back: This, along with fussiness after feeding, could be a sign of reflux.
• Excessive spitting up or vomiting: Combined with the above symptoms and a failure to gain weight, this may indicate reflux or another issue.
• Fever: If your baby is younger than two months old and has a fever (100.4°F or 38°C), contact your doctor immediately as this could indicate a serious infection.
• Diarrhea or vomiting more than usual: This could be a sign of a stomach bug or another illness.
• Blood in vomit or stool: This is not normal and should be evaluated by a doctor.

Fussiness That Doesn't Respond to Soothing Techniques

If your baby's fussiness persists despite trying various soothing techniques, such as swaddling, white noise, motion, holding, and frequent feeding, it may indicate abnormal fussiness. Keep a diary of your baby's activities, behaviours, and responses to different soothing methods to discuss with your paediatrician.

Intense Parental Stress

A fussy baby can be incredibly stressful for parents. If you are feeling overwhelmed, depressed, or unable to cope, it is important to seek professional help. Postpartum depression can be a factor, and it is crucial to prioritise your mental health and well-being.

How to distinguish between normal and abnormal fussiness

It is normal for newborns to be fussy, and it can be challenging to differentiate between types of cries and what the baby needs. Here are some ways to distinguish between normal and abnormal fussiness:

Normal Fussiness

• Fussiness occurs around the same time each day, with the same intensity and duration.
• Fussiness responds to similar soothing techniques each time, such as motion, holding, feeding, etc.
• Fussiness occurs during the baby's typical wakeful period, usually in the evening before their longest stretch of sleep.
• Fussiness is often due to hunger, tiredness, discomfort, overstimulation, or a wet diaper.
• Fussiness typically starts at 2-3 weeks, peaks at 6 weeks, and resolves by 3-4 months.
• Fussiness typically lasts for 2-4 hours per day on average.

Abnormal Fussiness (Colic)

• Fussiness occurs for more than 3 hours per day, on at least 3 days per week, for 3 weeks or more.
• Fussiness is often unsoothable and prolonged, with crying that cannot be easily consoled.
• Fussiness is a constant mystery, with no identifiable cause.
• Fussiness is characterised by frequent, intense, and prolonged crying.
• Fussiness is accompanied by other symptoms such as fever, illness, or failure to thrive.

If you are concerned about your baby's fussiness, it is always a good idea to consult with a healthcare professional to rule out any underlying issues and ensure your baby's well-being.

When to seek help for a fussy newborn

While it is normal for newborns to be fussy, there are some signs to look out for that indicate when to seek help.

Fever

If your baby is younger than 2 months old and has a fever, call your child's doctor right away. Rectal temperature is the most accurate way to take a newborn's temperature.

Spitting up or vomiting

Contact your child's doctor if your baby is fussy after feeding, arches their back, has excessive spitting or vomiting, and is not gaining weight.

Dirty diaper

Stool is very irritating to the skin, and if not cleaned off promptly, can cause pain and burning.

Crying

If your baby is crying nonstop for more than 2 hours and cannot be consoled, seek medical advice.

Other signs

• Your baby is not moving or is very weak
• You think your child has a life-threatening emergency
• Your baby is less than 1 month old and looks or acts abnormal
• There is a bulging or swollen soft spot on their head
• Their scrotum or groin is swollen
• They cry when you touch, move, or hold them
• They will not drink or drink very little for more than 8 hours
• You are afraid someone might hurt or shake your baby
• Your baby is a high-risk child (e.g., with heart or brain disease)
• Your child looks or acts very sick
• Your baby is not gaining weight or seems hungry
• You are worn out from all the crying

If you are concerned about your baby's fussiness, it is always a good idea to get them checked by a doctor to rule out any illness.

Frequently asked questions