Reasons why Babies Cry in the First Three Months, How to Tell The Cries Apart, and What to Do
by Malte Skarupke
I have twin daughters that just turned three months old. I decided to write up the list that I wish I had before they were born. Just reasons why they cry, how to tell the cries apart, and what to do in each case. Yes it’s hard to help babies because they cry for everything, but you can definitely tell the difference between an angry cry (“feed me”) or a pained cry (“I scratched myself”) or a sad cry. (“why did you wake me up?”) You can’t fix em all, but you can do a good amount.
This is just based on my experience of getting twins through three months. Every baby is different, but hopefully this still helps.
The most obvious one. Babies get hungry a lot.
How to tell if it’s this: You will hear this a lot and will know it well. It escalates quickly if not addressed. Also they often give signs ahead of time, like movement of the lips and tongue. The bigger difficulty is knowing when it’s not hunger. At some point you’ll be able to say “this sounds weird, not like hunger” but I also recommend installing one of those baby tracker apps on your phone. (pen and paper works fine, too) We stopped tracking most things pretty quickly, but you have to keep track of when they last ate. If it’s been less than an hour, then maybe they didn’t have enough and it’s hunger. If it’s been two hours, then it’s probably not hunger. If it’s three and a half hours, it’s probably hunger. Also just pick the baby up, and if they try sucking on your arm, they’re hungry. (sometimes they’re not hungry even after three hours)
What to do: Feed them. Sounds easy, but at first you will spend a ridiculous amount of time on this. Our kids easily got distracted while eating and then get mad at you if you don’t continue feeding after the distraction. Meaning this could happen: they drink, then take a break because they need to be burped, then drink a little more, then take a pause to poop in their diaper, then drink a little more, then get twitchy because they want the diaper changed, then drink a little more, and finally they’re happy. Early on it took us two hours to feed both twins. (while my example sounds extreme, we had few feedings where there wasn’t at least one interruption and they wanted more after)
The amount they eat changes a lot, especially in the first week. In the first couple days after birth, babies eat almost nothing and lose lots of weight. This is normal. When we came home from the hospital all the bottles we had at home seemed ridiculously large. The kids would drink ~10ml per feeding, but the lowest line on the bottle for measuring was at 30ml. But then the next day they ate twice as much, 20ml, then it doubled again the next day to 40ml, and then it increased again to 50ml. After that it increases more slowly, but it’s always increasing and you have to always adjust how much you think they should eat. (as I’m writing this the minimum they’ll eat is ~120ml, the maximum ~220ml. If they push the bottle out at less than 120, I know to wait five minutes and they’ll be hungry again)
2. Physical Discomfort
In the hospital one nurse told us that newborns really don’t want much. They just want to eat, sleep and poop. And be comfortable, which is a whole category in itself.
2.1 Dirty Diaper
No surprises here. You wouldn’t like wearing wet/dirty underwear either.
How to tell if it’s this: This cry starts light and escalates slowly. Often they just fuss a bit, going “eh, eh, eh”. Check the diaper. Don’t always trust the indicator. The indicator goes blue when they pee. If they only pooped, you can’t tell from the outside.
What to do: Change the diaper. When they’re very little you have to do this a lot. At the peak we went through roughly 25 diapers a day for our twins. Friends tell us similar numbers of 12 diapers per day for one kid. Another friend had a peak day of 20 diapers for one kid in one day. We probably overdid it, but at least if they have a clean diaper and they’re still crying, you can be sure that the problem is something else.
The most common reason for this is when they scratch themselves, or when something is wrong with the outfit. (like they somehow got both legs one one side or the diaper is on too tight)
How to tell if it’s this: A pain cry is super obvious. It sounds very different from other crying. It’s very clear they’re in pain. You’ll definitely hear this early on, like when they draw blood at the hospital to test for jaundice and other problems.
What to do: Usually you can address the source of the pain: Wrap their hands so they don’t scratch themselves, etc. Obviously go see a doctor if there is no clear reason. (though also read the point about gas below)
2.3 Too Hot / Too Cold
This one scared me a lot at first because how do you know how many layers they should wear when it’s freezing out? They’ll let you know if you get it wrong.
How to tell if it’s this: This one is a less intense version of the pain cry. It’s usually clear based on the context, you just have to remember that this could be the problem. E.g. we would dress the kids for freezing weather, then put them in a car seat in a car, and as soon as the car heats up, they’d get too hot and start crying.
What to do: Add/remove layers. If this was the problem, they will calm down very quickly once they are warmer/colder. The other point where this comes up is when giving them a bath. What I consider a nice hot bath is slightly too warm for a baby. But only slightly. They just want comfortable warm. (or get a bath thermometer)
2.4 Bright Lights at Night
Babies don’t like it. Took me too long to figure out. At a certain point in the evening you just want rooms to be somewhat dark.
How to tell if it’s this: I had a crying baby, picked her up, she was still crying, walked into a different room and she stopped. Turned the light on and she complained again. Easy.
What to do: Get smaller lights so you can control the brightness by turning most lights off.
3. Internal Issues
These are more difficult to deal with. You can’t always help them when it’s internal, but surprisingly often you can. One warning: This chapter contains cursed knowledge. There are words like “snot sucker” in here that you might not want to know about, but once you do know about them you can no longer ignore the crying of your baby. Where an innocent parent can just feel bad for their children and try to comfort them, you will know that there is this weird thing you could try that would help, and that knowledge won’t let you be…
3.1 Stuffy Nose
A booger can cause them to have trouble breathing, which is very upsetting for them.
How to tell if it’s this: If their nose is stuffy while they are crying, that’s a good hint, but if they didn’t have clear breathing before the crying, then it’s definitely this. In either case you can always try the snot sucker, it doesn’t hurt.
What to do: Saline spray and a snot sucker. Yes, you do weird things with babies. They can’t blow their own nose. Just spray saline in their nose, this will get them to sneeze which either ejects the snot right away, or at least moves it close to the surface where you can see it. Then you use the snot sucker.
3.2 Needing to Poop
Newborns often have trouble getting their poop out. They’re actually great at holding it in. It can be really obvious and the fix is easy, but somehow nobody tells you this… (or any of the other advice in this section…)
How to tell if it’s this: At least with our twins, it was very obvious. They’re clearly trying to push something out. Sometimes they’re grunting. Also, when they started sleeping a little longer at night, they almost always had to go in the morning. You’d always get this type of crying at some point between 5 and 8am.
What to do: Hold them over the sink. Take the diaper off, hands under the legs or butt, just hold them and wait. (the linked video shows holding the legs, but sometimes they like kicking while you hold them, and then it’s better to have the hands under the butt to leave the legs free) The first time I tried this I had a crying baby on my hand, the second time she was really calm and then the poop that she’d been struggling with for an hour came out easily. This was at 1 week old. It worked amazingly well. (she was still crying on the changing table both before and after, like they often did at that age, but while holding her over the sink she was very calm) It’s weird, but no more weird than the snot sucker. Apparently it’s just the normal thing to do with babies in some countries. The other thing that’s worked for friends of ours is a foot massage. Search Youtube, but I haven’t had luck with this myself, so no video recommendations.
3.3 Needing to Fart
You’d think this one is the same as needing to poop, but it’s completely different. I don’t know why. If it’s just a little fart, then they won’t cry. But if they’re really gassy, they will let you know.
How to tell if it’s this: This one sounds like they’re in pain. At least a little bit. The surest sign is when they cry, fart, and cry more. There are usually four farts or more behind that that you have to get out for them to calm down.
What to do: It took us way too long to realize that when they cry in pain, gas can be the problem. So I don’t have a fully established solution. If you try the “hold them over the sink” solution from the poop section, they’ll just be in pain as they try to get the gas out. Bicycle kicks and hip rotations worked sometimes, and some people say tummy massages are great. Unfortunately our kids resist the bicycle kicks once they start crying. Gas seems to be a really common problem so there are lots of products for sale that are supposed to help with this: Gas-X for babies, Gripe Water, Probiotics, tubes that you insert in the butt… I don’t like the Windi tube, but it works and I recommend using it once. It’s a hollow tube that you lubricate and then stick in their butt, and then the air has no choice but to come out. The reason why I recommend using it once is that you have to give a belly massage while doing it, which pushes the remaining air out, and it’s the only time you hear immediate results from a belly massage. So after that experience I got better at belly massages… Besides that my mom swears by fennel tea, and in the US Gripe Water seems to be the closest thing. I had one good experience with gripe water, but often it doesn’t seem to do anything. As I said, still trying to come up with a good solution since we realized this one so late.
3.4 Needing to Burp
If you didn’t burp enough after feeding, sometimes the baby will cry later.
How to tell if it’s this: There are two different sounds. If it’s not too bad, it sounds like they got something stuck in their throat. Not something big, it’s just a cry that’s a little raspy, where an adult would clear their throat and be done with it. The other one is if they managed to go to sleep, they will wake up with a loud cry. Which scared us a lot. Now we’re calm when that happens because we know it’s likely to just be a burp.
What to do: Pick them up and hold them vertical. High on your shoulder so there is some pressure on their chest but they have to hold their own head up. (you can’t do this when they’re too small) Patting the back is supposed to work but seems unreliable for us, even if we pat them really hard. Walking around with them or bouncing seems to help. When they were very young you could massage the lower part of their back, the soft spot between the ribs and the hips, and they would burp almost immediately. That stopped working once they got muscles there, but some people say that rubbing circles in that same area works…
When you put a baby down too soon after eating, or just move it too much, sometimes the milk comes back up.
How to tell if it’s this: This only happens less than thirty minutes after feeding. They were calm, you put them down, they immediately go to a slightly pained cry. Sometimes followed by throwing up a lot of milk.
What to do: Give them more time upright or at at an angle after feeding. After we saw this once or twice, we realized what to do and we would pick them up quickly enough again that they didn’t throw up.
4. Energy / Emotion
At first babies are really easy. They just want to sleep and are only awake long enough to eat and poop. But then they get more complicated.
4.1 Needing to Sleep
This one is weird. The kid needs to sleep but instead of calming down, they start to cry.
How to tell if it’s this: This happens once they stay awake longer. If they stay awake too long they get irritated very easily. The other thing that happened to us somewhat regularly with our kids is this: They’re tired, falling asleep in our arms, we put them to bed, but the act of doing that makes them become more awake. They get a bit fussy but only enough where we think they’ll soon calm down again. Then suddenly they get really angry and cry loudly. This goes on for a short time, say fifteen seconds, then they immediately fall into deep sleep. It’s almost as if they’re resisting the falling asleep.
What to do: Put them to bed and give them a minute. If it seems like they should be tired enough to fall asleep, then just watch a little. It sucks, but usually you don’t have to wait long to see which direction the crying goes. If the crying becomes less loud after a minute, give them another minute. If it doesn’t, it could be a different problem. This is not the “cry it out” sleep training. Really just wait a short time to see how it develops. As long as the trend is in the right direction, you can just let them be and it’ll end.
4.2 Scary New Situation
This happens for example the first few times when they take a bath, or when you undress them at the doctor.
How to tell if it’s this: It’s obvious from their facial expression. They are clearly concerned/scared.
What to do: Hold them securely and allow them to hold on. You don’t want their hands flailing around. In the bath I’d always hold them with my left arm behind their neck, curved so that they could grab onto the fingers of my left hand. Hold them close if you can. Also you just have to be calm. The goal here is to calm the baby down and if you are not calm and try to rush the bath, you’re just making things worse.
4.3 Being Bored
For us we first saw this at some point in the second month. Babies are usually happy to just be on their own, but at some point they want some attention.
How to tell if it’s this: This is a cry that’s not too loud and doesn’t escalate. The baby was alone for a while, then starts crying but seems happy when you get there. Definitely check the diaper first, but maybe they just want to be entertained.
What to do: At this point the baby can’t move around on its own and can’t even play. You can do some exercises with it like tummy time (it feels weird to have a crying baby and then make it do pushups in tummy time, but when they’re bored this sometimes helps. They stop crying, but may make “workout sounds” instead) or the bicycle kicks, or show it one of those high-contrast books like “Look, Look!”, (you have to hold it pretty close to their face) or a music toy. If the problem was something else, the baby will let you know. It certainly won’t sit there for 20 minutes happily looking at a book, and it will certainly get really loud if tummy time wasn’t the right choice.
4.4 Witching Hour
That’s what it’s called. For some reason it’s common for babies to get angry in the evening. This happened for us for at least half the days in the first three months. It sucks. It’s just very important that you know this exists. We were puzzled a lot early on before we knew this was a thing. (we’d wonder “you were doing so well all day, what’s up now?”)
How to tell if it’s this: This one sounds like they’re hungry. For us this happened after 6pm, and could go on until we were able to put them to bed. Which could be quite late. It’s the witching hour if you can’t figure out the problem. You change the diaper, they only eat a tiny amount, they don’t want to poop, they don’t want to sleep, there doesn’t seem to be anything you can do to help them.
What to do: Since this one sounds like they’re hungry, you’d think that feeding helps. It helps for like a minute, but they won’t eat much and then they get mad at you again. And if you try to feed them repeatedly they’ll drink too much and then throw up. (this literally happened three times to me…) We eventually got good at managing this, but it’s always draining. Step 1 is to strictly wait three hours between feedings during witching hour. Otherwise they either eat too much or too little and you’re creating more problems. Step 2 is to hold them and walk around with them. The movement is key. (when that gets exhausting they also like it if you bounce on a yoga ball while holding them) The way you hold them also matters. The superman hold works well, but I try to not overuse it so it doesn’t lose it’s power. Then, ~2 hours after their previous feeding, they sometimes fall asleep for 30 minutes to an hour. After that sleep, feed them and then put them to bed. This is the routine that we eventually figured out. I don’t know if it would have worked at the first witching hour. It never worked super well, but we managed. I just sometimes had to walk around while carrying a baby for 30 minutes or more so that they wouldn’t cry.
4.5. Cranky Tired
(I added this later in an edit) At some point (when they get closer to three months old) babies just want to stay awake. If you let them, they will get cranky. It won’t necessarily look like they’re tired.
How to tell if it’s this: This one sounds complainy and can get very loud. It seems like they have strong mood swings. One second they’re happy, the next they’re very upset at something, then they calm down again before getting upset at the next thing. It’s actually similar to the witching hour, so I buy the theory that the witching hour is related to being over-tired.
What to do: Once they’re over-tired, it’s too late and you will have a hard time getting them to sleep. You can sometimes still rock them to sleep, but they’ll complain even about that. The only fix is to get them to sleep before they’re cranky-tired. For us sleep training helped. Not so much the “cry it out” part of sleep training, but the “have a regular schedule with regular naps” part. We didn’t have this figured out at three months, that’s why I edited this in later. In the fourth month, managing their sleep was probably our biggest problem. But in hindsight this started before they were three months old. Once we had it worked out where they went down for three naps a day without complaint, this mostly went away. Getting there is a whole chapter on its own, which is why you can read so much about sleep training… Just remember that once you find something that works, they will cry a lot less. It’s just unfortunate that nobody seems to have found a really good sleep training method yet, so there is more crying during the training… But if you delay sleep training, you will just get more crying in the meantime than you would have gotten if you had just gotten it over with earlier. They really can sleep through the night at three months old. Getting the naps down actually took longer for us.
We got lucky and didn’t have this in the first three months. At all. So I can’t give recommendations here.
6. Easy Things
Here are some things that are easy to address but should be mentioned for completeness.
6.1. Woken Up From Sleep
Everyone knows to not wake a sleeping baby. Except sometimes they seem to sleep too much and you’re worried they’ll be off-schedule…
How to tell if it’s this: They just woke up from sleep, and it sounds sad, like “woe is me”.
What to do: We sometimes want to wake up the baby if they’re sleeping too long during the day. Like if it’s been almost five hours since their last feeding. Which is good at night, but not good during the day. Since they usually sleep on their tummy during the day (they just sleep better, and we can watch them, so it’s safe) we just flip them onto their back, and they’ll wake up sooner. Also, in the hospital we were told to feed them 8 to 12 times a day, and to wake them up if it’s been more than three hours since their last feeding. (I think because the twins were very little at first) This was bad advice. We did it for exactly long enough until they were back at their birth weight, then we let them sleep. They actually ate better and more often after that.
6.2 Workout Sounds
In the first months, babies should spend a lot of time on their tummy, (only while you can watch, due to SIDS) which makes no sense when you first hear it: Why does it matter if the baby is on their belly or on their back? It’s obvious the first time you try it: The baby immediately tries to raise its neck, working out the neck and arm. They need that exercise and they’ll often do a lot of it.
How to tell if it’s this: They’re in the middle of working out and are making sounds that sound like they are distressed, but are not cries. If they start crying, that’s not what I’m talking about here. In this video she makes a little bit of a sound at 20 seconds. She could get a lot louder than this, but it’s not crying.
What to do: Don’t do anything. When they had enough they can just lay down and rest. For some reason everyone around me wanted to pick up the baby as soon as it makes the slightest sounds, even though it was clearly exercising. I’d stop them from picking up the baby, we’d watch for ten seconds, then the baby decided that it had enough and would rest its head on the mat and relax. There was no problem to begin with. Obviously if they start actually crying, we’d try to find out what the problem is.
7. Fixes for All Kinds of Crying
Here are some things that always make a baby stop crying. Don’t abuse these. Sometimes you need to listen to the cry to find out what the problem is. If you always try to shut them down, you might just be leaving them hungry.
7.1 Shushing While Patting on the Back
This works like magic in the first month: Lay back on a pillow, put the baby on your chest, facing you, then do a slow rhythmic pat on their back (60bpm or slower) while making a calm sssshhh sound. After 30 seconds they stop crying and calm down and stay calm. Keep making the sssshhh sound until they have slept for at least a minute.
7.2 Holding Them While Walking Around
A baby complains less while you hold it. This can make it hard to tell if there is a problem, but sometimes this is necessary, e.g. during witching hour. When holding them is not enough, hold them and walk around. When that is not enough, do the “superman”: hold them so that they’re lying flat on their belly, your hand between their legs, their head in the direction of your elbow, their hands on either side of your arm. Here is a picture of me holding my twins:
If I do this and walk around, that has literally calmed them from every single thing they’re complaining about, except when they get really hungry. Meaning if even this doesn’t work, they must be hungry.
7.3 Stroller Rides
Babies fall asleep in strollers. Unfortunately we couldn’t do as many stroller rides as we wanted because it was freezing out this winter. Apparently Aquaphor protects their skin against the cold. We got a cream from a German brand that helped, too. Still even with that we were hesitant to take them out below 0 degrees after they got really bad heat rash once. The other thing you can do is drive them around in a car, but we don’t have a car.
The main thing to remember is that every baby is different and that you’ll have to adjust to them. Our twins are supposed to be identical twins but we’re not so sure. They’re easy to tell apart and had large differences in behavior from day one:
- As I mentioned above, we tried sticking to a “feed every 3 hours” schedule in the first week, which worked well for one twin, but was bad for the other. She would end up too tired to eat
- One twin had no problem eating in one sitting, the other often needed to poop after eating a little bit, then wanted to eat more after a break.
- One twin ate well on the breast, the other had to be bottle-fed often because she quickly got exhausted on the breast.
- One twin would push out the bottle when she was done, the other would just hang around, nibbling a little but not drinking much more (same on the breast)
There were more differences but the point is that even identical twins have large, noticeable differences from day one. You will have different experiences from us. You just have to notice these things and adapt to what works for the baby. There is no forcing them to do anything at this age, or trying to train them. I remember us being confused early on where one was crying and we said “she just ate, then pooped, then we changed her diaper, and she is still crying. What could possibly be bothering her?” Answer: She didn’t eat enough the first time because she needed to poop. We only noticed this pattern after a few days. There is nothing you can do about it. You just have to adjust to the kid. And then of course things change every week.
How good can you get at managing a baby’s cry? We never got very good. There were days where it felt like we had it under control and we had happy babies all day and everything was great. And inevitably the next day would be bad. After I had mostly finished this blog post we had a day where both twins were complaining a lot, always eating slightly less than I expected them to eat, and not napping well. We thought it might be gas because one of them seemed slightly pained, so we gave her Simethicone. Which didn’t really help a lot, and bicycle kicks etc. also didn’t work, so we thought the problem was that she hadn’t slept enough all day because that makes them generally irritated. Or maybe they hadn’t eaten enough all day, for similar effect. But inevitably at the next feeding she’d eat slightly less than I expected again and wouldn’t nap well. We were busy all day just managing these babies. (luckily it was a Sunday) Then in the evening I carried one of the twins around in Superman pose and she finally farts for a very long time. After that she stops complaining. The other one also farts a little bit during the next feeding and also finally sleeps. We finally put them both to bed, and the second one again wakes up thirty minutes later, crying. We finally use the Windi which gets a lot of gas out of her. After that she falls asleep like a stone and sleeps well…
So even after having learned all of the above, we still had days like that where we just had to try things. But since most days weren’t like that, I still think overall we got really lucky with our twins. They didn’t cry nearly as much as we heard from other people. From week one there seemed to always be a reason. Maybe that made it easier to identify these issues. But it could also mean that I’m missing at least one big thing that we just didn’t run into. Also keep in mind that this is literally just from the experience of getting two kids through the first three months. I would have loved to have this list up front because we often felt like terrible parents when we finally figured something out and realized that our kids had suffered unnecessarily, so if you’re currently at zero kids, hopefully this helps. If you already have more, feel free to tell me in the comments about all the things I forgot or got wrong. I’m sure there are many.
Appendix: After Four and a Half Months
I’m writing an appendix after four and a half months just to say how much has changed. It really is true that at three months old, babies change completely. So many of the problems above no longer happen to us: We never hold them over the sink any more to poop, they just go in their diaper, no problem. Gas is also easy for them. They don’t complain as much about a wet diaper any more, so we use fewer diapers per day. Bath time is now a pleasure, they don’t cry when their nose is only a little stuffy, reflux hasn’t been an issue in a while and the witching hour is gone. The new biggest challenge is getting them to sleep enough. I added an edit above about “cranky tired” which became a big issue during the third month, and became the main issue in the fourth month. At four and a half months, it feels like we’re finally doing well on that. (though still with room for improvement)
All of this is just to say: Things quickly got better once we made it past three months. There are always new problems coming up, but the new ones are more fun, like when they want to keep on playing with you even though you’re exhausted. That’s a good problem to have.
along with shusshing, you can try the really loud breathing thru your nostrils.
used to put the baby girl to sleep in 5 min in the evening.
would lay her down on the bed, face up, chest and head up on a pillow.
breathe really loud thru your nostrils, then start slowing down the speed , tempo, and intensity.
I think it reminds them of being in the womb, and hearing mama going to sleep….
she used to curl up onto her side, off the pillow, and nearly start snoring.
would leave her there for a half hour instead of immediately moving her to a crib.
we got to the point of always leaving her in our bed for the first sleep of the evening, think the scent helped comfort her too. really helps when they are overtired.
after a late feeding, then move her pretty easily, as long as you sat next to crib and did the breathing sequence.
great post, wish i had seen it when i needed it 30 years ago!
Good read. An entire section should be dedicated to “tired” though. Up until the age of about 3, nearly all “bad” behaviour is a sign the child is tired. It’s far too easy for adults, who only need 7 or 8 hours of sleep, to underestimate how tired their child is. A great response to nearly any acting out is, “oh, you must be tired. Let’s put you to sleep.” If the child is still awake five minutes later maybe you were wrong. In most cases though, they’ll be out like a light.
Thanks, that actually lines up with our experience in the last few weeks. Recently it feels like managing their sleep has become a bigger problem than managing their food. And since it is becoming such a big issue, it’s probably worth its own section. I might expand on this in the main text once I figured it out a bit more.
Great article! Thanks for creating such a comprehensive guide to help us all keep our sanity!
Something I just recently learned is that hair can get stuck around fingers and toes acting like a tourniquet and cutting off blood flow. I think it’s rare, but something to look for after a few frantic Google searches.
Awesome and fun post Malte. Our last one was born in February so we’re just coming out of this difficult phase. I can’t imagine having twins.
For when they get older, I found that light control is indeed super important (something that gets hard in Seattle near the summer solstice!). If it’s dark outside though, I found that instead of fighting them to go to bed, I can just turn off lights except where I want them moths to go 🙂