Baby Fussiness: What’s Normal and What’s Not

Babies cry. It’s one of the primary ways they communicate their needs. When infants are hungry, tired, uncomfortable, overstimulated, or need a diaper change, fussing and crying help signal that they need something.

As a new parent, it can be difficult to tell the difference between normal baby fussiness and crying that may be a sign of something more concerning. And when your baby seems impossible to soothe, it’s easy to feel overwhelmed, frustrated, exhausted, or unsure of what to do next.

While some crying and fussing are expected during infancy, there are times when excessive or prolonged crying may deserve a closer look. Here’s how to recognize what’s normal, what may not be, and when to reach out to your pediatrician.

Normal Baby Fussiness

Babies cry a lot, even when they’re happy, healthy, and well cared for. Healthy infants typically follow a crying curve, gradually increasing from birth to 5 to 6 weeks. Fussiness may peak or plateau at this point until crying typically begins to decline around 3 months of age.¹

It may seem like an infant should only cry for a specific reason, and if you could just find that reason, you could stop the fussing! But that’s not always the case, as babies can also cry for other reasons we may not immediately recognize. Let’s take a look at some ways to help determine if your baby’s crying patterns are typical:

Related: 6 Different Baby Cries and What They Mean

Possible Reasons for Normal Crying

Crying for a predictable reason is almost always typical baby fussiness. Again, this is their primary way to communicate. If they stop crying after you remedy the source of their discomfort, this crying is very likely to be normal. Some common reasons you might have a fussy infant include being tired, hungry, hot, cold, overfull, bored, lonely, or having a wet diaper.^2,9

In other instances, there is a cause, but you may be unable to identify or quickly rectify it. For example, one less obvious source of fussing is overstimulation.^10,11 Just as we can get overstimulated by their crying, our babies can get overstimulated by our typical environments.¹¹ They may need the opportunity for a reset in a low-stimulation setting.^4,5,10,11 (I sometimes had success rocking my swaddled newborn daughter in a dark room with quiet white noise to settle her during a fussy episode.)

Imagine being in a relatively quiet, comfortable, warm place for 9 months, only to suddenly find yourself in a very loud, cold place. That would be a major adjustment for anyone.

Related: 10 Reasons Your Baby Might Be Fussy (and How To Help)

Unexplained Crying Can Also Be Normal

It can also be common to have “unexplained crying.” One to two hours total of unexplained crying throughout the day is to be expected.² When considering whether unexplained crying is normal, it’s essential to note if the baby is otherwise happy when they aren’t crying. If your baby is consolable and content between periods of crying, their fussing is likely within the normal range.²

When Baby Fussiness Might Be a Concern

Although crying is a normal part of infancy, there are times when prolonged or unusually intense fussiness may signal that your baby needs additional support or evaluation.

Some professionals define excessive crying as “colic,” which is “frequent, prolonged and intense crying or fussiness in a healthy infant,” according to the Mayo Clinic.³ Excessive crying affects between 5% and 40% of infants globally and accounts for 10-20% of pediatrician visits in early infancy.^4,12 Colic usually starts to present itself by week three.¹³ Just as normal infant crying increases in the early weeks and peaks around week six, excessive crying or colic also often peaks around week six.^2,3,4 The condition usually resolves on its own between three and four months.³

Sleep-deprived new parents may have shorter fuses, and in this state, it can be easy to think that an average level of infant crying may be outside the normal range.¹⁵

So, how do you know if your infant’s crying is above the standard crying curve? Below are some characteristics of colic to consider:

1. Their Crying Falls Under Wessel’s “Rule of 3’s”

The original criteria for a colic diagnosis fell under what’s known as Wessel’s “Rule of 3’s” and were as follows:^1,4,5

1. Crying for more than three hours per day
2. On at least three days per week
3. For three weeks or more

While this can be a good starting point for identifying whether your baby’s fussiness is excessive, the medical field is now accounting not only for the amount of crying but also its nature and intensity.¹

2. Your Baby Is Unsoothable

Even in typical fussiness, it may take some time to figure out why your infant is crying and how to make them feel better. However, most often, you’ll be able to soothe them eventually (or they may soothe themselves!). If you would classify your infant’s fussiness as often unsoothable and prolonged, this may be outside the normal range.^3,4,5,16

Related: 11 Ways to Soothe a Fussy Baby

3. The Cause of Crying Is Difficult To Identify

Sometimes, not being able to identify the cause of your baby’s crying can be expected. But if their crying is often or always a mystery, this may be abnormal.⁵ If you’d describe excessive crying as a part of your baby’s character, their crying patterns may fall outside the typical range.

4. Your Baby Otherwise Appears Healthy

For you to classify infant fussiness as abnormal, there can’t be a clear medical cause for the crying in a child under 5 months old when the symptoms start and stop.⁴ For instance, your infant must not have a fever, blood in the stool, or other known or obvious illness. They must also be eating and growing appropriately and demonstrating no evidence of failure to thrive.^2,4

Contact your pediatrician right away if your baby develops a fever, difficulty breathing, poor feeding, vomiting, lethargy, or other concerning symptoms alongside excessive crying.

Related: The Five S’s To Soothe Your Baby

Ways to Help With Baby Fussiness

If you’ve identified that your baby’s crying feels excessive, you may wonder what to do about it. Unacknowledged colic is associated with higher rates of maternal postpartum depression and shaken baby syndrome, so addressing it can help protect you and your baby.⁴ Your medical provider or baby’s pediatrician may be able to counsel and educate you on treatments, interventions, and coping strategies.

Below are some resources and interventions to consider if you think your baby may be experiencing prolonged crying:

Treatment for excessive crying often focuses on helping soothe your baby while also supporting exhausted parents through the process.

1. Talk to Your Pediatrician

There isn’t always a medical reason or cause for abnormal crying. However, if you feel your baby is crying above the average amount, reach out to their pediatrician for a visit. They’ll take a medical history and physical examination to ensure no underlying medical cause for the fussiness. If no concerning symptoms are present, your pediatrician may review some of the therapies below for excessive crying.

2. Try Behavioral Intervention

Some parents report success with different behavioral interventions. Some things that can potentially help include:^2,4

• Infant swings
• Car rides
• Pacifiers
• White noise
• Low-stimulation environments
• Increased holding and snuggling

Although none are guaranteed to improve crying, many are low-risk strategies worth discussing with your pediatrician. Just be sure to discuss any behavioral interventions with your pediatrician to ensure safety.

Related: 9 Tips for Calming Your Fussy Baby in the Car Seat

3. Make Dietary Changes

Diet or feeding changes aren’t typically recommended as a treatment for extreme fussiness, particularly for formula-fed infants.⁶ If there’s a family history of allergy, some doctors may recommend a brief trial of a hypoallergenic, hydrolyzed formula to treat excessive infantile crying.

A review of studies showed a possible positive effect on breastfed infants’ crying by eliminating allergens from the mother’s diet.⁸ However, this can be difficult for the mother. Your doctor should encourage continued breastfeeding over maternal dietary changes (in the absence of bloody stools or other explicit symptoms of food allergy or intolerance in the infant).¹⁷

Related: Foods That Make Breastfeeding Babies Fussy

4. Talk to Your Pediatrician About Remedies and Supplements

If you’re dealing with a fussy infant, family or friends may have suggested trying gripe water or simethicone drops. While these are generally safe to try, no benefits have been shown for excessively fussy infants. Gripe water comes in many different formulations, so you have to ensure there aren’t potentially harmful ingredients.⁶ Other medications have been used to treat colic in the past, such as dicyclomine and cimetropium, but these aren’t recommended due to the potential for life-threatening effects such as sleepiness or apnea.⁶

Several studies have also examined colic treatment with a specific probiotic strain: “Lactobacillus reuteri.” They show some promising results, but research is still underway, and the efficacy of this intervention is far from guaranteed. Still, this option could be worth exploring with your pediatrician.⁷

Related: How to Use Gripe Water for Your Fussy Baby

5. Explore Complementary Therapies Carefully

Some people have reported success with decreasing infant crying by using herbal teas and other herbal remedies. However, experts need to do more research to examine side effects, standardize dosages, and ensure that consumption doesn’t interfere with a hunger for milk.⁶ In addition, there are some potentially toxic herbal remedies, so it’s better to avoid these.

Although studies haven’t demonstrated a benefit over placebo, some parents anecdotally report success with chiropractic care for their fussy infants.⁶

(Hoping to find relief, a friend of mine sought chiropractic care three times per week for her fussy and inconsolable 6-week-old. She noticed more regular and frequent bowel movements and a happier and calmer demeanor in her little one.)

Reassurance for Parents of Fussy Babies

While excessive crying is undoubtedly tough on you and your baby, there are a couple of positives to keep in mind about excessive crying:

1. It’s Self-Limiting and Self-Resolving

Even without any intervention or treatment, excessive fussiness will go away on its own.^3,4 No matter what, there’s an end in sight. However, this doesn’t mean you should suffer in silence, wait it out, or accept your fate as the parent of a colicky baby. After all, making it through four months of excessive crying can feel like an eternity while you’re living it.

2. It’s Benign

It may be a relief to know that infant fussiness and excessive crying don’t always indicate that something severe is wrong. In addition, one study found that colicky babies showed no difference in temperament by toddlerhood compared to unaffected infants.¹⁴ Parents of babies who cry excessively also show no long-term anxious or depressive symptoms once the fussing has resolved.⁶

Related: Why Some Babies Are Harder (and That’s Okay)

Remember: You’re Not Alone

Life with any newborn is tough. Your world has just been flipped upside down! While recovering from the physical trauma of birth, you’re now responsible for a tiny human who depends on you for everything. You’re adjusting to your new life and learning each other’s cues. With very little sleep, any amount of crying can set you over the edge. And with a new, fussy baby, it can feel like there’s no escape. But remember that you’re not alone! One review suggests that anywhere from 3% to 28% of infants suffer from colic.¹

Fussiness can feel endless in the moment, especially when you’re exhausted and trying everything you can to comfort your baby. But in most cases, crying gradually improves with time as babies mature and adjust to the world around them.

If your baby’s crying feels excessive or concerning, don’t hesitate to reach out to your pediatrician for guidance and reassurance. With support, patience, and time, you and your little one will get through this phase together.