Thursday, December 07, 2006

The Fussy One Month Old!

Nearly every day I look into the bleary eyes of a sleep deprived parent and hear their chief complaint: “fussy infant”. They look at me confused, and say “she was great!” They add, “She slept whenever and wherever. But now she’s crying all the time! There must be something wrong with her!” This is a common complaint and one of the most important visits you can have with your pediatrician. First and foremost, always call your pediatrician when you’re concerned about your fussy infant. After we rule out medical reasons for their fussiness, we can talk about ways to help your baby and you calm down.

After reading countless baby books, seeing hundreds of patients and having three babies of my own, I believe that most of these babies are overtired! At one month, they’ve reached an age where they haven’t learned to settle themselves, and they need your help. So when this little infant comes to me, I take a thorough history and do a complete physical exam. Once I’m confident that the baby is healthy, I immediately ask for a blanket and proceed to burrito-wrap the infant. Often the parent says, “Oh we’ve tried that but she fights it!” I then ask, “Does she sleep and then startle herself 10-20 minutes into her nap?” “Yes!” They reply, “How did you know?” I nod sympathetically and say “I’ve been there…” and I go ahead and wrap them anyway.

Remember the startle reflex is still prominent at one month of age and is often the culprit of a baby’s sleep disturbance. The following method was developed and perfected by my husband. Standing up, I take this little wrapped baby and encircle them in my arms holding them snug. With their head on my left upper arm I place a pacifier in their mouth and roll them slightly in toward my chest. This helps keep the pacifier from slipping out, and I can watch their facial expressions. Even if they seem upset and they are crying a lot, I keep them in the same position. I rock the two of us back and forth patting their bottom and back rhythmically, all the while saying “shhh shhh shhh” over and over. Ninety-nine percent of the time this cranky baby stops crying, begins sucking on their pacifier and then slowly drifts off to sleep. My visits nearly always end with the baby having to be woken up to be put back into the car seat so they can all go home.

A crying infant is a common and stressful event. Your pediatrician can help give you advice to help you through it. Unfortunately, sometimes in the midst of baby’s crying jag, even the most well-intentioned parent can lose their cool and shake their baby. Never shake an infant! The National Center on Shaken Baby Syndrome states: “In America, every year an estimated 1,200 - 1,400 children are shaken… Of these tiny victims, 25 -30% die as a result of their injuries. The rest will have lifelong complications.” So I encourage you to seek help when your baby is crying. If all else fails and you feel like you’re becoming angry it is safer to put your baby in her crib, and then take a shower and calm down than try to “wait” it out! There are many great books on how to soothe babies. They all give similar advice. The one I most recently read and liked was Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer by Dr. Harvey Karp.

Remember that soon this will be a distant memory. So when it’s late… and you’re holding your baby… and they finally fall asleep... Smile and savor the moment.
Good Luck!

Dr. Sheila Cason


Anonymous Anonymous said...

Thank you so much for recommending the book, "The Happiest Baby on the Block" in one of your articles. I got the book and DVD and after watching the DVD our lives have changed. We only watched it two nights ago and it has been miraculous! She was a somewhat fussy, borderline colicky baby and now she really is the happiest baby on the block.

4:50 AM  

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