My two-year-old son kept asking this as his baby sister moved into her developmental crying stage. The house had been relatively quiet for the first few weeks after her birth, but her crying spells seemed to increase with every week of life. As a pediatrician, I am fairly immune to the sound of crying in the office but was much less so in the home environment!

I carefully checked for pathology such as under or over feeding, signs of infection, gastroesophageal reflux disease (GERD), a hair tourniquet, injury and other reasons for crying that could be addressed and fixed. Having ruled these out, I realized that indeed, my daughter was exhibiting signs of developmental crying. This is a great name for explaining the crying that occurs in most babies in the first 3 months of life. The acronym PURPLE was created to teach about this normal crying.

“P” is for peak of crying. Babies may cry more each week, most in the second month, then less in months 3-5.
“U’ is for unexpected. Crying may come and go without explanation.
“R” is for resists soothing. Babies may not stop crying no matter what methods are employed by caregivers.
“P” is for pain-like face. Babies appear to be in pain- drawing up legs, arching back, becoming red in the face, even if they are not.
“L” is for long lasting. Infants may cry for 5 hours per day or more.
“E” is for evening. Many infants tend to cry during the “witching hours” between 5pm and 10pm.

Unable to sit by and watch her cry, I leaned into the evidence-based steps for soothing a fussy baby- also known as the 5 S’s.

1. Swaddling in a wrap to constrain the arms and legs.
2. Side or stomach holding
3. Shushing sounds of voice, radio static, fan, dryer, air conditioner or car ride
4. Swinging gently- remembering to never shake a baby!
5. Sucking on a pacifier or finger (if not hungry)

Babies also respond to high caregiver emotion such as anxiety, so it is important for parents to take some deep breaths and give each “S” solution several minutes to take effect.

Some babies go beyond the typical crying to colic which is defined by crying for at least 3 hours per day, at least 3 days per week, starting before 3 months post term. Such prolonged crying can be a huge stress for families. Researchers in the Fussy Baby Network have found value in a family prescription for REST: Reassurance, Empathy, Support and Time away.

Reassurance comes from visiting your pediatrician for a thorough physical exam to rule out problems that may need to be addressed.

Empathy comes from realizing that most parents typically report “loving” their infants around 6 weeks of age when they finally smile! The early ambivalence with a crying infant is a normal feeling, especially in first time parents. Support is important when faced with a fussy infant. This is one of the most important protections for children at all ages. Crying tends to increase beginning at 2 weeks post term, right when some partners return to work or helpful relatives leave. Both parents need to work on their new parenting skills by learning to console the fussy baby in their own special and safe manner.

Time away can be helpful, especially if the crying goes on for months. This is a good time to reach out to friends and family for some help. Simply having someone else hold the baby can be a chance for parent time together.

The first few months can shape the parent-child relationship. Your pediatrician is here to help by screening for the emergence of both the “baby blues” emotionality and for more serious postpartum depression. We are here to partner with your family to ease the stress of parenting a fussy baby.