When a baby screams in distress for no obvious reason, pain is typically blamed. But babies can become distressed for reasons other than pain. This article explains how you to tell if your baby is in pain.
Is my baby 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 then they are suspected. There are many more common reasons for a baby's distress than pain... that are not always obvious.
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 then a common reason for this pattern of behavior is over-tiredness.
Distress 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
- 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 for distress
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.
What you can do to help
The 'cure' for distressed behavior in healthy, thriving infants does not lie with medications (over-the-counter or prescribed). In fact, the side effects of many medications can often make the problem worse. Some medications commonly given to infants that contain a sedative or alcohol will provide a 'perceived cure'. In reality they do little more than sedate the child.
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.
DISCLAIMER: This brief article can my 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.