The Fussy Baby Book: Parenting your high-need child from birth to five. Martha Sears

all during my pregnancy.” Her prediction came true. Charlie came out crying, and kept crying. He announced to the world that his was a voice to be reckoned with. Even during that magnificent passage from obstetrician’s hands to mother’s breasts Charlie let out a shriek that startled the obstetrician so much that Janine feared he would drop him. While most newborn’s cries evoke a sympathetic and tender feeling in the listener, Charlie’s did not. His cries were so shrill, they made everyone want to plug their ears and run. Charlie’s cries soon cleared the birth room.

      Janine, an otherwise unflappable mother, cringed when her baby shrieked. The nursery nurses couldn’t stand Charlie’s quickly escalating cries, so at the first shriek they would immediately shuttle him out to his mother (which was good for Charlie, who wanted to be with his mother).

      On the day of discharge, Janine confided to me that Charlie’s cries were interfering with her relationship with her baby. She admitted she didn’t have those love-at-first-sight feelings new mothers are supposed to have. I knew that many infants’ cries become steadily more shrill and disturbing at two weeks of age than when they are newly born. If we didn’t do something, Charlie’s cries – and his relationship with his family – were going to get worse instead of better.

      So Janine and I developed a three-part plan to help mellow out Charlie’s cries. My instructions to her were as follows:

      1. Wear him almost constantly in the baby sling so he has no need to fuss about feeling alone.

      2. Feed him frequently, at least every two hours during the day, and as needed during the night. Don’t wait for him to fuss to announce feeding time. As soon as he opens his mouth for anything more than a yawn, fill it with a breast within the first millisecond. (Jan knew I was exaggerating, but she got the point.)

      3. Keep a list of situations that set off Charlie’s cries. Try to anticipate his needs and feed him, rock him, sing to him – whatever it takes to keep him from crying.

      I also suggested Charlie’s parents tape-record his cries so they could keep track of their progress in mellowing Charlie’s temperament. Sure enough, within a week Janine said, “I finally enjoy being with him. He cries much nicer now.”

      Why do some infants cry with such shrill, nerve-racking noises? Having seen several babies like this one who were “born” criers, I have come to wonder if the baby is affected by the stress hormones that mother made in order to handle a particularly stressful pregnancy or painful delivery.

      

      Give baby a calm start. Some babies are born criers, but the care they get during the first few days can influence whether or not they stay that way. Let’s look at the two room-accommodation options a newborn used to have: a slot in the nursery or a spot close to mum.

      The nursery option. Fresh from a soft, warm womb and a little time in mother’s arms, a baby born even relatively recently would take a bumpy ride to the newborn nursery, where he would stay on a static mattress in a plastic box, surrounded by bright lights, chatty adults, and a line-up of other babies in plastic boxes. What he needed was to stay with his mother so that he could gaze at her face and use her smell, her movements, and her holding to help him stay calm and feel safe. He was miserable and frightened in the plastic box and cried desperately. If there was a nurse there who had time, she might pick him up, but chances are he’d have to wait. He’d cry and cry until he exhausted himself to sleep, in the process experiencing very disturbing feelings. Bonding was severely disrupted, and he learnt that he could not trust that his needs would be met.

      The nursery option was a biologically incorrect set-up. The nurse was the one who initially heard the baby’s cry, but the mother (in another room) is the one who is biologically programmed to calm the cries. Most infants have two phases to their cry. The early phase, called the attachment-promoting phase, is the perfect signal, disturbing enough to prompt the listener to want to pick up and hold the baby and give a comforting response, but not so disturbing as to make the listener want to avoid the baby. In the nursery arrangement, this is the phase of the cry that the nurse heard, and she eventually took the baby down to the mother’s room. However, by the time baby got to his mother, his cries were in the next phase – the avoidance-promoting phase. His cries escalate into a shrill sound, and the mother is presented with an anxious, frightened baby whose cries cause her to be anxious, even frightened. The mother is the one person who is biologically programmed to calm the cries, yet she is not present for the opening sounds that would have made this an easy, welcome job. Mothers and babies who started out life in separate rooms were out of sync. In fact, studies have shown that infants who show long bouts of anxious and disturbing crying (dubbed the “infant distress syndrome”) were placed in the nursery rather than kept with mother from birth.

      know your limits

       Nothing pierces parents’ hearts more than the cry of their baby. Yet cries can push dangerous buttons, too: feelings of anger, helplessness, despair – feelings that may overwhelm you and fill your mind with scary thoughts. Some very loving mothers have confided to us crazy thoughts they’ve had, such as throwing their baby out the window. And while it’s not unusual to plead with your baby to “please, be quiet”, there are good mothers who, on occasion, actually scream “shut up” at their baby. These feelings are aggravated even more by the fatigue that comes with parenting a fussy baby.

       You can guard against doing something that you would immediately regret by rehearsing ahead of time what you would do if you felt yourself about to snap. Programme this behaviour into your mind, play-act it when things are going well, so that you will know how to react if you are pushed past your limit. When you feel overwhelmed by anger, feel like yelling at your baby, or feel that you are at your wit’s end, do one of the following: hand your baby to a less distressed set of arms; put your baby down momentarily and walk out of the room to compose yourself; put your baby in the sling and take a long, hard walk; or call an empathic friend, one who has survived the same trials.

       Having these angry feelings does not mean that you are not a good mother. The mothers most bothered by their infant’s cries are often the ones who are most sensitive. Sensitivity can work to your advantage as a mother because it prompts you to try many ways of comforting your baby. Yet this same sensitivity can also set you up to feel like a failure if you can’t stop the crying. Having these feelings means that you are a tired mother, and your baby’s cries are getting to you. Take these emotions as a signal that you need some help in managing your feelings, managing your own care, and managing your baby’s cries.

      The rooming-in option. Baby awakens in mother’s arms or with mother nearby and begins to cry. Because mother is right there, she hears the attachment-promoting sounds of baby’s cry, which trigger in her a nurturant response. She immediately caresses and comforts her baby – before the cry has to escalate into a more disturbing sound or enter the avoidance-promoting phase. After several of these cry-response rehearsals, mother learns to recognize baby’s pre-cry cues: a squirm, a grimace, followed by lip-smacking attempts to find something to suck on. Mother offers her breast before baby has to cry. Soon baby learns that he does not have to cry, certainly not in a disturbing way, to get what he needs. (As an added perk, the attachment-promoting phase of the infant’s cry can trigger the release of mother’s milk-releasing hormones, giving her a biologic boost for comforting; the avoidance-promoting phase of the infant’s cry can tie the mother up in knots, inhibiting her milk-releasing reflex.)

      Early in my years as a newborn nursery director, I realized the difference between how nursery-reared and rooming-in babies act. We used to say, “Nursery-reared babies learn to cry harder; rooming-in babies learn to cry better.”

      Imagining how your newly born baby feels can be a learning experience for a new mother who is struggling to develop a parenting style. Everything changes for the baby at birth. Think how he must feel in the drastically new environment in which he finds himself. He goes from warm, dark, smooth wetness, where he is held on all sides, and never experiences need of any kind, to cold, light, rough dryness, where he is alarmingly free on