Why Is My Baby Crying? How to Tell If Your Baby Is in Pain
One of the most puzzling jobs for parents is trying to figure out why their baby becomes so distressed. When the reason is not obvious, pain is often the first thing parents suspect and/or the first thing suggested by well meaning friends, family and health professionals. (Most often without having asked you a single question to rule out other reasons for distress).
No doubt, others have made comment about your baby's distress... "It's probably tummy cramps", "It might be gas", "She could be constipated", "I think its colic", "It's possibly reflux", "Perhaps she's teething" and the list goes on and on. These could all be valid reasons for a baby to become distressed, but in reality these problems occur far less often than they are suspected. There are many more common reasons for a baby's distress than pain... that are not always obvious.
- Crying and distress in babies do not automatically mean they are in pain
- Healthy, thriving babies often show distressed behaviours due to tiredness, hunger, overstimulation or unmet needs rather than physical pain
- Signs commonly thought to indicate pain can also occur in babies who are stressed or overwhelmed
- Understanding when crying occurs can help parents identify likely causes and respond appropriately
- If you are concerned your baby may be in pain or unwell, medical assessment is important
How to tell if your baby is in pain
Caring for a distressed baby for hours on end, sometimes day after day, is one of the most emotionally heart wrenching and exhausting experiences a parent will face, and it can be difficult to 'see the forest for the trees' when it comes to figuring out what the actual problem is. It may only be through a process of elimination that you can confidently rule out pain as the reason for your baby's distress.
If your baby calms quickly once she has been picked up but after a brief period she once again starts to cry (even in your arms) this may indicate that her need is for something more than a cuddle. If you have ruled out more obvious reasons for a crying baby than a common reason for this pattern of behavior is over-tiredness.
Distress in babies does not automatically mean pain
Just like adults, babies can become stressed at times. Each baby may display their distress in slightly different ways. Distressed behavior commonly seen in healthy, thriving infants, include the following...
- persistent crying
- screaming
- straining
- pulling up legs
- back arching
- clenched fists
- flailing/jerking arm and leg movements
- feeding difficulties, i.e. refusing to feed or "fighting" feeds
- extreme wakefulness
Obviously, if a baby is experiencing pain she's likely to become distressed. However, it's not always a simple matter to tell whether a baby's distress is due to pain or not, because babies will also display the same distressed behaviors for many reasons that have nothing to do with pain or physical discomfort.
Reasons why your baby could be crying and distressed
Your baby cries to indicate a need for something. If this need is not satisfied, both her crying and her behavior will continue to escalate, often to the point of distress. Having reached this point many babies, particularly those under the age of 3 months, may find it difficult to calm (even with parents help).
Your baby's temperament will influence how quickly and to what degree her behavior will escalate. (Temperament alone is sometimes blamed for distressed behavior, but it's not that simple).
When your baby displays distressed behavior can provide a clue to the possible cause. If your baby's crying or distressed behavior occurs...
- During play, consider over-stimulation
- Soon after feeding, consider tiredness (see tired signs). Where gastric symptoms are present and your child is also gaining large amounts of weight also consider over-feeding (see hungry baby).
- Immediately on waking; during the night, after a brief nap or soon after you placed her into her crib asleep, consider a sleep association.
- In the evening; or after a long period awake; or following a day out (even 1/2 day out for babies younger than 6 months) consider over-tiredness.
- During feeding,see common bottle feeding problems or how to tell when your baby is getting enough breast milk.
How to help when your baby is crying
The management of distressed behaviour in healthy, thriving infants does not usually rely on medications, whether over-the-counter or prescribed. In some cases, medications may have side effects that can worsen unsettled behaviour rather than resolve the underlying cause.
Some products may appear to reduce crying temporarily by making a baby drowsy, but this does not address why the distress is occurring. For this reason, identifying and responding to your baby’s needs is generally more effective than masking symptoms.
Where your baby is healthy and thriving the 'cure' for distressed behavior lies in making changes to the way you provide care.
- When attempting to calm an already distressed baby choose soothing methods that are aimed towards reducing stimulation and encouraging sleep.
- To reduce the occurrence of distressed behavior, encourage a flexible feeding and sleep routine for your baby. By doing this you will provide the sensory cues to assist your child to organize her internal body clock. It will also assist you to anticipate her needs and hence accurately interpret what her behavior means before she reaches the point of distress.
When crying feels relentless and the cause isn’t clear, it’s easy to assume the worst. A comprehensive feeding and sleep assessment can help you understand what’s really driving your baby’s behaviour.
Many distressed babies are physically well — but small care adjustments can make a significant difference.
Book a ConsultationWhen to seek medical advice
If your baby’s crying is persistent, worsening, or different from their usual behaviour, or if you notice signs of illness such as fever, vomiting, poor feeding, lethargy, breathing difficulties, or you are unable to settle your baby despite supportive care, seek medical advice. Trust your instincts, if you are concerned your baby may be in pain or unwell, a doctor can assess your baby and help rule out medical causes.
DISCLAIMER: This brief article can by no means make a diagnosis as to the reasons for your baby's prolonged crying or distressed behavior. If you are concerned that your baby has pain, please see a doctor.
Written by Rowena Bennett.
About Rowena
Rowena Bennett (RN, RM, CHN, MHN, IBCLC) is a leading infant-feeding and sleep specialist and author of several books on infant feeding and behaviour, including the widely acclaimed “Your Baby’s Bottle-Feeding Aversion: Reasons & Solutions". With over three decades of clinical experience across child health, midwifery, mental health, and lactation, she has helped thousands of families worldwide understand and resolve complex feeding challenges through her evidence-based, baby-led approaches.