Responding to Babies' Tears
From New Beginnings, Vol. 28 No. 3, 2009, pp. 4-7
For the first couple of weeks of my eldest son's life, he was pretty easy-going. He nursed fairly often but slept most of the time in between feedings. I thought I was a brilliant mother.
At two weeks, however, that honeymoon was over. He was often fussy, cried more often than I'd expected, and wanted to breastfeed on and off all evening long. I tried everything I could think of to soothe him, and while sometimes he'd settle down, often I couldn't figure out what he wanted.
I remember sitting and holding him against my shoulder, his eyes closed tightly and his little face red from the effort of crying, and saying: "I don't know what to do to help you, but I'm here." It seemed to be the best I could do.
Now that I've had four children and three grandchildren, I know the truth of that comment. Sometimes a baby's crying can be comforted away but sometimes it can't; just being there may be the best we can offer.
That inconsolable crying is often confusing and frustrating for new parents -- sometimes to the point of being dangerously so. Research has shown that when parents shake or abuse their babies, it's because the parents were frustrated and annoyed by the baby's crying.
Yet, since crying is so universal it seems that there should be some purpose to it beyond just driving parents crazy. Apparently there is -- and the need to breastfeed is part of that purpose.
Dr. Ron Barr, a Canadian physician, who has researched colic and infant crying for many years, has looked at babies around the world, not just in North America or Europe, so he's able to talk about the aspects of crying that cross cultural lines. He finds a consistent pattern everywhere in the world: babies don't cry too much in the first week or two, then they steadily increase the amount of crying over the next few weeks to a peak at around two months, and then gradually decrease the amount of crying after that.
Barr has also found that in all societies there are babies who cry more -- sometimes much more -- than average. We'd call them "colicky." There's nothing medically wrong with these babies, Barr says. They are just at the extreme end of the "crying continuum."
Barr's research, and other research he's reviewed, came up with several possible benefits of crying.
In traditional cultures, where breastfeeding is the norm, mothers usually respond to the baby's crying or fussing by offering the breast. Usually the baby will nurse briefly three or four times per hour. As Dr. Barr puts it, in those cultures, the baby controls the feeding process. (In ours, parents usually control it.) Frequent crying in the early weeks and months helps to make sure the baby gets plenty of milk and also establishes milk production so that there will continue to be abundant milk for many months to come.
Again, in those cultures, the parents pick up the baby when she cries and keep her close to them -- and this protects the baby from predators and other dangers. A baby not in her parents' arms or next to an adult body is at risk, so frequent crying makes sure she's safe. Our babies aren't as much at risk from wild animals or exposure to the elements, but they don't know that. As Dr. Barr notes: "Separation causes crying, and contact often stops it."
When mothers respond to the cries by breastfeeding, the baby gets benefits beyond just milk. The frequent feeding at the breast stimulates prolactin production, suppressing ovulation and making it less likely that the mother will get pregnant again. Prolactin is highest during night feedings, and we know that frequency of sucking at the breast seems to be more important in stopping ovulation than the duration of each feeding. In other words, it's more effective (in terms of suppressing fertility) for the baby to suckle for five short feedings in the evening than for two long ones. Frequent fussing and feeding in the evening mean two good things from a biological perspective: the current baby won't have his milk supply diminished by another pregnancy, and the mother is less likely to become anemic due to iron loss through menstruation.
When parents are not frustrated and angry, crying can create caring and nurturing emotions and strengthen the bonds between parents and baby. You know how that newborn cry tugs on your heart. These early weeks are a time for parents and baby to get to know each other, and for the parents to learn what soothes and comforts the baby. Frequent crying gives them lots of opportunities to practice and even feel successful!
Besides looking at the underlying reasons for a baby's crying, researchers are beginning to understand more about how mothers react. Dr. James Swain, a Canadian professor at Yale University, has been studying brain imaging of mothers' responses to crying. "A baby crying activates the circuits in the mother's brain that are similar to those that become overactive in people with obsessive-compulsive disorder," Swain says. "It also affects the parts of the brain that motivate us, help us appraise the environment, and calm us so we don't get too angry."
This brain activity makes sense when you think about the baby's needs: when she cries, she wants someone to be motivated to respond, to be a little obsessed with making sure everything is okay, and to stay calm while soothing her.
Swain's recent analysis of his data has been somewhat controversial. As part of his larger study, he had mothers who had given birth by elective cesarean section listen to their babies cry while he scanned their brains, and compared the results to scans done in a similar situation with mothers who had delivered vaginally. When the first set of scans was done, the babies were all between two and four weeks old, and Swain found that the mothers who had delivered vaginally were significantly more sensitive to the cries of their own babies. While none of the mothers in the study had clinical depression, those who were less sensitive to their babies' crying also showed more symptoms of depression.
Swain is quick to add: "This doesn't mean that mothers who have elective cesareans are bad mothers. We repeated the brain scans when the babies were about four months old, and by then the differences were much less. All that time holding and caring for and interacting with the baby compensated for any difference due to the method of birth." On the other hand, he says, "I think it tells us that we shouldn't take the elective c-section lightly."
Swain's work is built on past studies of the responses of adult brains to infant crying. Seifritz, a Swiss researcher, found in 2003 that the brains of women with or without children responded more to babies' laughter and crying than men without children did, but parents of both genders showed stronger reactions to crying. That reinforces Swain's observations that the experience of caring for their babies changes how parents' brains respond to crying.
If crying is supposed to help parents and babies connect, why is it also linked to abuse? What makes crying such a problem for parents in our society?
For one thing, parents in our society are often warned not to do the things that traditional parents naturally do to soothe their babies when they cry. Research by Barr and others has shown that babies cry only half as much when parents carry their babies in close contact with them (skin to skin as much as possible), sleep next to them, feed them very frequently, and respond quickly if their babies cry or fuss. But most parents in Western societies are told that these soothing actions will "spoil" the baby or cause other problems, so the baby cries more and more, and the parent gets more and more frustrated.
I was once in an airport, waiting for my flight, when I saw a father carrying around his baby. The baby wasn't crying hard, just fussing and unhappy, and the dad was patting his back gently as he walked up and down between the seats filled with tired travelers. It made me smile, but I was shocked when an older woman stood up and planted herself in front of the father. In a voice loud enough for all of us to hear, she berated him for "spoiling that baby" and let him know that the infant would be "ruined for life" if he kept on carrying and soothing him.
She couldn't have been more wrong. Silvia Bell and Mary Ainsworth from John Hopkins University found that mothers who responded quickly to crying in the first few months had babies who cried less often and for shorter periods of time at one year, compared to the mothers who delayed responding or sometimes ignored the crying.
So don't worry about spoiling your baby by responding when he cries, and don't hesitate to offer him the breast again, even if it's the fourth time in an hour. There's a natural process at work here that's designed to support you in both breastfeeding and mothering.
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Swain J.E., Tasqin E., Mayes L.C. et al. Maternal brain responses to own baby cry is affected by cesarean section delivery. J Child Psychol Psychiatry 2008 Oct; 49(10):1042–52.