Research: Why Some Babies Cry More - Infant Crying, Colic, and Early Tantrum Behavior

Generated: 2025-12-30 Status: Complete

TL;DR

Why does your baby cry more than others? Genetics explains 50-70% of the variation—it’s temperament, not your parenting. Crying peaks at 6 weeks (126 min/day average), then declines. Colic affects 10-40% of infants and is mostly benign. The ONLY intervention with strong evidence is L. reuteri probiotic for breastfed babies (NNT=2-3). What definitively DOESN’T help: giving screens during tantrums—it prevents kids from learning emotional regulation. What DOES help: responding to infant cries builds attachment; for toddler tantrums, acknowledge emotions then redirect. Most importantly: excessive crying predicts parental depression more than anything else. Your mental health matters—sleep deprivation is not a badge of honor, it’s a medical crisis.

Quick Reference

Crying by Age

Evidence Summary

Research Findings

Source: PubMed

Normal Crying Development and the “Cry Curve”

The most comprehensive meta-analysis of infant crying patterns analyzed data from 57 studies across 17 countries with 7,580 infants (PMID:35438798). Contrary to popular depictions showing a dramatic “peak and crash” pattern, this 2022 study by Vermillet et al. found that at the traditional cry peak (5-6 weeks), the pooled estimate for cry and fuss duration was 126 minutes per day (SD = 61), with high heterogeneity across studies. The initial rise and subsequent decay in cry duration were not as dramatic as commonly portrayed, and formal modeling showed that crying duration remains substantial throughout the first year of life after an initial decline.

Dr. Ronald Barr’s seminal work established the “normal crying curve” showing crying increases in the first month, peaks in the second month, and decreases by the fourth month (PMID:2332126). This research formed the basis for the Period of PURPLE Crying program, which uses the acronym PURPLE to describe normal infant crying characteristics: Peak of crying in month two, Unexpected, Resists soothing, Pain-like face, Long lasting, and Evening crying. A randomized controlled trial of 1,279 mothers found that receiving PURPLE Crying educational materials led to higher knowledge about infant crying and behaviors considered important for preventing shaken baby syndrome (PMID:19255065).

Excessive Crying and Colic

Infantile colic, traditionally defined by Wessel’s “rule of three” (crying more than 3 hours per day, for more than 3 days per week, for longer than 3 weeks), affects an estimated 10-40% of infants depending on diagnostic criteria. A comprehensive systematic review of reviews and guidelines compared common colic interventions (PMID:32102827). The review found that probiotics, particularly Lactobacillus reuteri DSM 17938, showed the most promise for breastfed infants.

Multiple meta-analyses have examined L. reuteri’s efficacy. An individual patient data meta-analysis of four double-blind trials involving 345 infants found that the probiotic group averaged 25.4 fewer minutes of crying/fussing time than placebo at day 21 (95% CI: -47.3 to -3.5), with authors recommending L. reuteri for breastfed infants with colic but noting insufficient data for formula-fed infants (PMID:29279326). A 2015 meta-analysis of six RCTs with 423 infants similarly found treatment effectiveness at two weeks (RR = 2.84) and three weeks (RR = 2.33) but not at four weeks (PMID:26509502). A network meta-analysis of 32 RCTs with 2,242 patients concluded that L. reuteri DSM 17938 was superior to other interventions (PMID:29390535).

The etiology of colic remains multifactorial and incompletely understood. Current theories implicate gastrointestinal factors (gut microbiome dysbiosis, cow’s milk protein intolerance, lactose overload), neurological immaturity, and psychosocial elements. A prospective study found that infant microbiota composition in colicky infants was associated with cry/fuss time at baseline and predicted persistence of crying at 4-week follow-up and child behavior at 2 years (PMID:32279681), supporting the gut-brain axis hypothesis.

Maternal dietary interventions show mixed results. A randomized clinical trial found that a maternal low-FODMAP diet reduced crying-fussing durations by 32% compared to 20% on a typical diet (PMID:30306603). Another proof-of-concept study similarly suggested that reducing maternal intake of indigestible and slowly absorbed short-chain carbohydrates was associated with improved colic symptoms (PMID:28631347). However, a systematic review noted that maternal diets eliminating cow’s milk may help breastfed infants with colic, but evidence quality remains moderate.

Manual therapies showed moderate to low-quality evidence of benefit, reducing crying time by 33-76 minutes per 24 hours in some studies, though a 2018 meta-analysis found only moderate strength evidence for a 1.27-hour daily reduction (95% CI: -2.19 to -0.36) with inconclusive effects on sleep and parent-child relations. Simethicone showed no benefit or negative effects. A systematic review examining complementary and alternative medicines concluded they were not effective for infantile colic (PMID:37119443).

Importantly, behavioral management interventions showed some effectiveness. A controlled study found behavioral management reduced fussing/crying by 51% compared to 37% in an empathy group and 35% in controls (PMID:8065857). However, another RCT found that specific interventions proved no better than reassurance and support alone (PMID:8337017), highlighting the importance of parental support regardless of intervention type.

Genetic and Temperamental Factors

A groundbreaking 2025 Swedish twin study of 1,000 twins examined genetic versus environmental contributions to infant crying. Researchers found that at 2 months, genetics explained approximately 50% of variation in crying duration, increasing to 70% at 5 months. This within-family comparison of monozygotic versus dizygotic twins provides the strongest evidence to date for substantial heritability of infant crying.

A study of 990 infants at 6 and 12 months using the Laboratory Temperament Assessment Battery identified distinct temperament profiles showing stability and heritability, particularly for withdrawn/inhibited infants (PMID:31273766). Twin studies consistently find heritability estimates for temperament dimensions (emotionality, activity, shyness, sociability, attention/persistence) ranging from 0.20 to 0.60. Specific to negative emotionality, twin research shows substantial heritability (approximately 31%) and shared environmental contributions (57.3%) at both 5 and 18 months.

Excessively crying infants demonstrate higher levels of negative emotionality and lower capacity for self-regulation during laboratory examinations at 5 and 10 months compared to typical criers. Infants diagnosed with excessive crying at 4 months were judged temperamentally more “difficult” at 30 months. A German longitudinal study found that temperamental traits—particularly negative emotionality and difficult temperament—substantially contributed to both externalizing and internalizing behavioral problems, with decreased predictive power of regulatory problems after including temperamental variables suggesting mediation effects (PMID:28286548).

The developmental psychopathology literature emphasizes gene-environment interplay. Longitudinal findings demonstrate bidirectionality: observed infant negativity predicted declines in supportive parenting by toddlerhood, while harsh parenting during infancy predicted increased toddler negativity. Multiple studies show associations between infant negative reactivity and later psychosocial outcomes are moderated by parental behavior, highlighting that genetic predispositions interact dynamically with environmental factors.

Prenatal influences also play a role. Maternal smoking during pregnancy has been linked to infant temperamental difficultness in a study of over 18,000 infants using the Millennium Cohort Study (PMID:18339824). Acoustic cry analysis found that maternal alcohol consumption during pregnancy related to more dysphonation and higher first formant frequencies in infant cries, while cigarette smoking related to higher pitch and greater formant variability (PMID:8890509). Infants prenatally exposed to higher cortisol levels showed more crying, fussing, and negative facial expressions (PMID:14580753).

Parenting Interventions and Crying Outcomes

The relationship between parenting interventions and infant crying presents a nuanced picture. A classic RCT by St James-Roberts et al. comparing supplementary carrying and increased parental responsiveness from birth found no differences in crying and fussing amounts between intervention and control groups at 2, 6, and 12 weeks (PMID:7862477). Similarly, a behavioral intervention trial using videotaped instructions on swaddling, side positioning, white noise, jiggling, and sucking found the intervention ineffective in decreasing total crying among normal infants (PMID:20453177).

However, interventions targeting parental mental health and responsiveness show more promise. The Sleep SAAF Responsive Parenting trial randomized 212 primiparous Black mothers to responsive parenting or safety control interventions delivered during home visits at 3 and 8 weeks postpartum, empowering parents to first use non-food soothing strategies when responding to crying (PMID:37148966). The Attachment and Biobehavioral Catch-up (ABC) intervention assessed whether individual burden and neighborhood crime density were associated with parents’ beliefs about infant crying as an indicator of responsive parenting (PMID:34038230).

A comprehensive scientometric review of 60 years of research on infant cry and caregiver responsiveness found that sensitive parenting behavior toward distressed infants predicted secure attachment development, as demonstrated in foundational research by Bell and Ainsworth (1972). However, more recent research produces mixed findings on whether response frequency affects crying amounts. One replication study by Bilgin and Wolke (2020) found no associations between responding to infants’ crying in the first 6 months and attachment classifications or behavior problems at 18 months, though there were weak negative associations between “cry it out” methods and crying frequency at 18 months.

The “cry it out” debate remains contentious. A 2020 study found no adverse effects on attachment at 18 months from leaving infants to cry (PMID:32155677). However, a published commentary challenged these conclusions, arguing the method appears overall detrimental to attachment and development (PMID:33608871). Follow-up studies at 5 years found no differences in 20 outcomes including child behavior, relationships, and maternal mental health, though critics note that cortisol levels remain elevated during crying even after behavioral extinction.

Research on maternal emotional responses shows that mothers’ negative emotional reactions to crying were linked with less sensitive responses to infant distress, which associated with insecure attachment. Prenatal maternal anger and anxiety in response to infant crying predicted attachment outcomes independent of observed sensitivity, with maternal anxiety positively associated with resistant behaviors.

Parenting Behaviors Associated with Increased Crying

While research clearly identifies behaviors that help soothe crying, evidence for parenting behaviors that increase crying is more limited and complex. A study examining mothers’ emotional reactions to crying found that negative maternal responses posed risk for subsequent attachment insecurity, but the mechanism appears to be through reduced sensitivity rather than directly causing more crying.

Early attachment research suggested that crying frequency increased as the number of ignored crying episodes increased. However, this finding has not been consistently replicated in more recent, methodologically rigorous studies. The Bilgin and Wolke replication study found only weak associations between “cry it out” methods and crying frequency.

Research on parenting stress suggests a bidirectional cycle: infant crying increases parental frustration and depression, which in turn may reduce parenting sensitivity and effectiveness at soothing. A study examining parental responses to infant crying found that child physical abuse risk and hostile priming influenced parental responses, suggesting that parental mental health and stress significantly impact crying management.

Longitudinal research indicates that harsh parenting during infancy predicted increased toddler negativity, but whether this translates to increased crying specifically remains unclear. The evidence suggests that parenting quality affects the trajectory of emotional regulation development rather than immediately increasing or decreasing crying per se.

Infant Self-Regulation Development

A longitudinal case study documented crying behavior development during the second half of the first year, observing two female infants twice monthly from 7 to 14 months (PMID:20557946). Crying behavior became more sophisticated with age, and notably, “fake crying” was observed at 11-12 months during naturalistic mother-infant interaction, suggesting emerging emotional regulation and social communication skills.

Temperament in infancy is defined as individual differences in reactivity and self-regulation to environmental stimuli. A longitudinal study of 339 Asian first-time mothers examined relationships between maternal beliefs about crying and infant temperament over 4 months, finding complex bidirectional influences. Research demonstrates that infant negativity predicted declines in supportive parenting by toddlerhood, while harsh parenting during infancy predicted increased toddler negativity, illustrating the transactional nature of self-regulation development.

Regulatory problems in infancy (sleeping, feeding, excessive crying) were associated with increased risk of ICD-10 and DC:0-3R disorders diagnosed at 1.5 years in a community-based cohort study. Children’s unfavorable temperamental predispositions such as negative emotionality contributed substantially to both externalizing and internalizing behavioral problems, with decreased predictive power of regulatory problems following inclusion of temperamental variables indicating mediation effects.

A large longitudinal study examined maternal responses to infant crying at 4 weeks and 6 months and offspring depression at age 18, finding some evidence for associations between early maternal responses and later mental health outcomes, though mechanisms remain unclear.

Developmental changes in stress physiology also influence self-regulation. Research shows a developmental shift in adrenocortical functioning between 2 and 6 months, with cortisol levels and stress responses decreasing with age (PMID:7789193). Infants exposed to higher prenatal cortisol showed higher pre-stress cortisol values and blunted stress responses (PMID:22315044), suggesting prenatal programming of stress regulation systems.

Tantrum Development in Toddlers

Tantrums most commonly occur between ages 2 and 3, though they may begin as early as 12 months. A large-scale study found temper tantrum prevalence follows a quadratic trajectory: 87% of 18- to 24-month-olds, increasing to 91% in 30- to 36-month-olds, then sharply decreasing to 59% in 42- to 48-month-olds. Among 1,490 children aged 3-5 years, 83.7% displayed some tantrum form during the past month, but only 4.4% had daily tantrums.

Research distinguishes between normal developmental tantrums and concerning patterns. A study of “Temper Tantrums in Toddlers and Preschoolers” examined longitudinal associations with adjustment problems, finding that while tantrums are normative in toddlerhood, certain characteristics predict later difficulties. Another study examining “Developmental Pathways from Preschool Temper Tantrums to Later Psychopathology” identified specific tantrum features associated with increased risk for later mental health problems.

The developmental shift from infant crying to toddler tantrums reflects emerging cognitive and emotional capacities. Toddlers experience frustration related to growing autonomy drives paired with limited communication skills and executive function. As language develops and self-regulation improves, tantrum frequency typically decreases, though individual differences in temperament continue to influence emotional reactivity.

StatPearls notes that tantrums are equally common in boys and girls and typically resolve with development and consistent parenting. However, certain warning signs merit clinical attention: tantrums lasting longer than 15 minutes, extreme aggression toward self or others, very frequent tantrums (multiple times daily), inability to calm with parental intervention, or tantrums that worsen after age 4.

Long-term Outcomes for High-Needs Babies

Several longitudinal studies have tracked outcomes for infants with regulatory problems including excessive crying. A prospective study followed infants with crying, sleeping, and feeding problems from 5 months through 56 months, finding that in approximately 8% of infants, regulatory problems persisted across preschool years, with multiple regulatory problems and feeding difficulties increasing odds of eating problems at 20 and 56 months (PMID:19886897).

A landmark study from the Mater-University of Queensland cohort of 7,223 babies found that maternal-reported behavioral dysregulation at 6 months was associated with significantly higher prevalence of maternal-reported behavior problems at 5, 14, and 21 years (P < 0.001) (PMID:23027170). This extended follow-up provides the longest-term outcome data available for infant regulatory problems.

Research on excessive infant crying specifically found it doubles the risk of mood and behavioral problems at age 5-6 years, with evidence for mediation by maternal characteristics (PMID:27422707). Another study found that 18.9% of 53 infants with persistent crying had pervasive hyperactivity problems compared with 1.8% of 62 controls (odds ratio: 14.19) (PMID:12042542).

A prospective longitudinal study of 4,427 children examined whether regulatory problems (crying and feeding problems in infants older than 3 months) predict cognitive outcomes in preschool children born at risk, finding associations between early regulatory problems and later cognitive performance (PMID:19433987).

A meta-analysis examining the impact of crying, sleeping, and eating problems in infancy on childhood behavioral outcomes found that all single regulatory problems were significantly associated with childhood dysregulated behavior. Combined regulatory problems in infancy serve as early markers of mental health problems during early childhood.

However, these associations should be interpreted carefully. Many high-needs babies develop normally, and the studies identify increased risk rather than deterministic outcomes. Parental mental health, socioeconomic factors, and ongoing parenting quality significantly influence trajectories. Early intervention targeting both infant regulation and parental support appears protective.

Parental Mental Health Impact

The bidirectional relationship between infant crying and parental mental health is well-established. A systematic review found that maternal depression and anxiety are both consequences and predictors of excessive infant crying (PMID:28900745). Maternal lifetime and incident anxiety disorders robustly predicted excessive crying, highlighting the importance of early maternal mental health identification (PMID:24972780).

A prospective cohort study of 1,290 pregnant women followed through 8 weeks postpartum found statistically significant associations between high depressive and anxiety symptom scores during pregnancy and infant crying problems, with previously reported strong postpartum associations also observed (PMID:34789174). This prospective design suggests maternal mental health may influence infant crying patterns, though bidirectional effects are likely.

A study using ecological momentary assessment found that infant crying predicts real-time fluctuations in maternal mental health in ecologically valid home settings. Mothers reporting excessive infant crying also reported higher caregiver frustration, emotional distress, and concurrent depression and anxiety symptoms. The immediate, in-the-moment impact of crying on maternal well-being highlights the acute stress that crying episodes generate.

Research examining support interventions found significant promise. A study evaluating a support package for parents of excessively crying infants found significant reductions in depression and anxiety, with numbers meeting clinical criteria halving after intervention (PMID:29667223). A day-clinic program helping families with persistent crying and sleep problems similarly demonstrated improvements in both infant behavior and parental mental health.

Associations between infants’ crying, sleep, and cortisol secretion showed that mothers’ psychological well-being and sleep were greatly predicted by infants’ morning salivary cortisol levels, sleep disruptions, and crying intensity in infants with colic (PMID:24457194). This physiological link between infant stress regulation and maternal functioning underscores the biological embedding of the parent-infant dyadic stress system.

Research emphasizes that infant crying is the biggest risk factor for infant abuse and is associated with premature termination of breastfeeding, parental distress and depression, and poor parent-child relationships. A systematic review of parental perceptions and experiences found that infant crying generates profound anxiety in parents, often accompanied by feelings of helplessness and inadequacy.

Parent-child interventions decrease stress and increase maternal brain activity and connectivity during own baby-cry. Neuroimaging research shows that cortisol levels increase when listening to infant crying, possibly to activate and facilitate effective care behavior in both sexes (PMID:24757127), though chronic exposure to crying may alter these neurobiological responses.

Shaken Baby Syndrome Risk and Prevention

Infant crying is frequently the precipitating circumstance for abusive head trauma (shaken baby syndrome), with the peak incidence coinciding with the peak crying period at 6-8 weeks. The number one reason perpetrators give for shaking is anger or frustration because the baby wouldn’t stop crying. The Period of PURPLE Crying program was specifically developed to prevent shaken baby syndrome by educating caregivers about normal crying patterns.

StatPearls’ Pediatric Abusive Head Trauma chapter notes that inconsolable or excessive crying, particularly during the PURPLE crying period, is a significant risk factor. Simple educational programs and community nursing support programs have been shown to be helpful in preventing shaken baby syndrome. The delivery of simply worded information cards on the dangers of shaking and alternatives to dealing with crying has been shown to change parental knowledge and understanding of appropriate child behavior management techniques.

Previous studies have shown that educating new mothers or pregnant women about infant crying may prevent shaken baby syndrome. A randomized controlled trial found that receiving Period of PURPLE Crying materials led to higher maternal knowledge scores about infant crying and for some behaviors considered important for shaken baby prevention (PMID:19255065). Another study examined effectiveness of an educational video about infant crying on prevention of shaken baby syndrome among pregnant Japanese women and their partners (PMID:33790092).

Research emphasizes several key prevention messages: (1) crying peaks at 6-8 weeks and is normal; (2) crying may be inconsolable despite best soothing efforts; (3) it is never safe to shake a baby; (4) it is acceptable to place the baby in a safe location and take a break; (5) caregivers should develop a plan for managing frustration before crisis moments.

Acoustic Characteristics of Infant Crying

Research using spectrographic analysis has attempted to distinguish pain cries from hunger and other cries. A study examining acoustic discrimination of three types of infant cries found that pain-induced cries had significantly stronger second formant amplitudes than fussy or hungry cries, with discriminant function analysis correctly classifying 74% of procedural pain-induced crying specimens (PMID:2030994).

Sound spectrographic analysis of pain cries in preterm infants (302 cries from 48 preterm infants born at 30-37 weeks) identified distinctive acoustic patterns (PMID:6884256). The newborn pain cry is characterized as tense and strident, with modifications of frequency and spectrographic tracing showing both laryngeal and vocal tract participation (PMID:17287031).

However, despite these acoustic differences, recent research shows that neither machine learning algorithms nor trained adult listeners can reliably recognize the specific causes of crying when distinguishing between common causes like hunger, discomfort, and separation. One study found cries were categorized with only 71.68% reliability by analyzing visual features extracted from spectrograms. This suggests that while pain cries may have distinctive features, in practice, caregivers must rely on context, timing, and trial-and-error rather than cry acoustics alone to determine infant needs.

Research Gaps and Limitations

Despite decades of research, significant gaps remain in understanding infant crying:

Mechanisms of Colic: The exact etiology of colic remains unknown. While gut microbiome, food intolerances, and neurological factors have been implicated, no single mechanism explains all cases. More research is needed on phenotyping different colic presentations.

Formula-Fed Infants: Most probiotic research focuses on breastfed infants. Evidence for formula-fed infants with colic remains insufficient for clinical recommendations.

Long-term Intervention Effects: While some studies follow children to age 5-21 years, few interventions have been evaluated for long-term impacts on child development and parent-child relationships.

Cultural Variation: Most research comes from Western, educated, industrialized, rich, and democratic (WEIRD) populations. The Vermillet meta-analysis noted that most studies were from the US, UK, and Canada. Cross-cultural research on crying patterns, parental responses, and developmental outcomes remains limited.

Mediation and Moderation: While research establishes associations between crying and later outcomes, the mechanisms remain poorly understood. Are effects mediated by parental mental health, attachment quality, or other factors? What factors moderate risk?

Responsive Parenting Definitions: Studies define and operationalize “responsive parenting” inconsistently, making cross-study comparisons difficult.

Crying in Context: Most research examines crying duration as a primary outcome but doesn’t adequately address contexts, triggers, soothability, and qualitative aspects of parent-infant interaction during crying episodes.

Genetic Mechanisms: While twin studies demonstrate heritability, specific genetic variants associated with crying propensity remain largely unidentified. Gene-environment interaction research is in early stages.

Father and Non-Maternal Caregiver Research: The vast majority of studies focus on mothers. Father responses, involvement in soothing, and mental health impacts are understudied.

Optimal Support Models: While support interventions show promise, optimal timing, format, intensity, and content of support programs for parents of excessively crying infants require further research.

Official Guidelines

Source: Professional Organizations

Summary of Recommendations by Organization

Defining Normal vs. Excessive Crying

What Organizations Define as “Normal” Crying

AAP/AAFP Consensus:

• Crying begins in the second week of life
• Peaks around 6 weeks of age at approximately 2-3 hours per day (126 minutes average)
• Gradual decrease after 6 weeks
• Resolution by 3-4 months (may persist until 6 months in some infants)
• Evening fussiness (“witching hour”) is typical

PURPLE Crying Characteristics (National Center on Shaken Baby Syndrome): The Period of PURPLE Crying describes normal infant crying patterns:

• Peak of crying: 6-8 weeks of age
• Unexpected: Crying comes and goes without reason
• Resists soothing: Baby may not stop crying no matter what you try
• Pain-like face: Even when not in pain
• Long lasting: Can cry for hours (up to 5 hours/day)
• Evening: Clustering in late afternoon/evening

Implementation of the PURPLE program in British Columbia, Canada was associated with a 35% reduction in abusive head trauma-related hospital admissions among children under 2 years.

WHO Normal Developmental Pattern: Most parents easily respond to infant crying by comforting them, with crying serving as a normal communication method during the first 3 years.

Defining “Excessive” or Pathological Crying

Rome IV Diagnostic Criteria for Infant Colic (2016):

For Clinical Purposes, ALL of the following must be present:

1. Infant <5 months of age when symptoms start and stop
2. Recurrent and prolonged periods of crying, fussing, or irritability that occur without obvious cause and cannot be prevented or resolved by caregivers
3. No evidence of failure to thrive, fever, or illness

For Clinical Research (additional requirements):

• Caregiver reports of crying/fussing ≥3 hours/day during ≥3 days in 7 days
• Total 24-hour crying plus fussing ≥3 hours confirmed by prospective behavior diary

Important Note: The Rome IV criteria represent a significant update from Wessel’s classic “Rule of Threes” (1954), which defined colic as crying >3 hours/day, >3 days/week, for >3 weeks. Rome IV shortened the duration requirement from 3 weeks to 7 days and emphasized that symptoms must resolve before 5 months of age.

AAFP Definition: “Benign process in which an infant has paroxysms of inconsolable crying for more than three hours per day, more than three days per week, for longer than three weeks” - affects 10-40% of infants worldwide.

Clinical Reality: Research shows that of 38 infants presenting with crying as the primary complaint in pediatric practice, only 13 fit the strict “Rule of 3” criteria and 25 did not, highlighting that the traditional criteria may not capture all cases of problematic infant crying.

When to Seek Medical Evaluation

Organizations provide consistent guidance on red flags requiring medical assessment:

Immediate Evaluation Required:

CDC Guidance: “If your child is not meeting one or more milestones, has lost skills they once had, or you have other concerns, talk with your child’s doctor, share your concerns, and ask about developmental screening.”

NICHD Research: Prolonged crying continuing after 3 months may be a marker for later cognitive problems. At 5 years of age, children who had prolonged crying as infants had, on average, IQ scores 9 points lower than those without crying problems.

Recommended Soothing Techniques

The 5 S’s Method (Dr. Harvey Karp, widely endorsed)

Pediatrician Harvey Karp organized traditional soothing techniques into this evidence-based mnemonic:

1. Swaddle: Recreates snug womb environment; decreases startling; increases sleep. (Note: Once baby can roll, swaddling must stop for safe sleep)

2. Side/Stomach Position: Hold baby on tummy or side (across forearm, over shoulder) to activate calming mechanism. Critical safety note: When baby has calmed, place on back for sleep.

3. Shush: Continuous, soft white noise mimicking womb sounds (similar to vacuum cleaner noise level inside mother’s body)

4. Swing: Fast, tiny rocking motions for crying babies; slow rocking for calm babies. Research shows rocking reduces crying, hastens sleep onset, and improves sleep quality.

5. Suck: Lowers heart rate, blood pressure, and stress levels. AAP recommends holding back pacifiers until breastfeeding is established (~3-4 weeks).

AAP-Endorsed Techniques:

• Rocking is a “go-to colic-reliever”
• Sucking (pacifiers) helps soothe colic
• Do not rush in immediately - babies need time to self-soothe
• Respond to crying to build secure attachment (for young infants)

ICON Programme Recommendations:

• Comfort methods: Try feeding, changing, rocking, singing, skin-to-skin contact
• If comfort methods don’t work, it’s OK to walk away for a few minutes after ensuring baby is safe

Evidence-Based Treatments for Colic

Probiotics (AAFP, AAP Research):

• Lactobacillus reuteri DSM 17938 is the most studied strain
• Effectiveness in breastfed infants:
  • Significantly decreases crying duration (80% of infants had ≥50% reduction in crying)
  • Number Needed to Treat (NNT) = 2-3
  • Day 21: 39% absolute reduction in crying
  • 1.7-2 times more likely to experience treatment success
• Effectiveness in formula-fed infants: Insufficient evidence; more research needed
• Safety: No severe adverse events reported across studies
• Recommendation: “Can safely be recommended if parents desire a treatment option for their infants with colic” (AAFP)

Other Interventions: The AAFP notes that because colic is benign and self-limiting, the mainstay of treatment remains parental reassurance and support rather than medical interventions.

Official Position on “Crying It Out” Sleep Training

AAP Position (2024):

• Defines sleep training as “graduated extinction” - a spectrum of approaches, not just cry-it-out
• States: “Do not rush in to soothe a crying baby. Babies need time to put themselves back to sleep, and they need to learn how to fall back asleep on their own”
• Recommends not starting sleep training (including cry-it-out) until baby reaches 12 weeks of age and 12 pounds weight
• Research published in Pediatrics (5-year follow-up): No long-lasting harms to child, child-parent relationship, or maternal outcomes; no difference in attachment style or behavioral problems

Important Context:

• “Sleep training” is an umbrella term including much gentler methods than traditional cry-it-out
• Many parents find AAP safe sleep recommendations (Alone, Back, Crib) unrealistic when infants cry at night
• Research (2022-2023) shows parents who start with safe sleep often move infants to unsafe positions/locations in response to night crying

Notable Absence: Organizations provide minimal guidance on navigating the tension between safe sleep recommendations and managing nighttime crying, leaving parents to make difficult real-time decisions.

Shaken Baby Syndrome / Abusive Head Trauma Prevention

AAP Guidelines (2024):

• Abusive head trauma is a leading cause of fatal head injuries in children under 2 years
• Never shake a baby under any circumstances - can cause blindness, brain damage, or death
• Technical report provides evidence-based medical evaluation criteria for diagnosing abusive head trauma

Prevention Programs with Proven Effectiveness:

1. Period of PURPLE Crying Program:

   • Hospital-based caregiver education about normal crying patterns
   • 35% reduction in AHT-related hospital admissions in Canada
   • Teaches peak crying period (6-8 weeks) and coping strategies

2. National Center on Shaken Baby Syndrome Initiatives:

   • Education for new and expectant parents
   • Enhances confidence and caregiving skills
   • Focuses on stress and frustration coping strategies

CDC Safety Guidance:

• “Never shake your baby—you can damage their brain or even cause death”
• “Put your baby in a safe place and walk away if you’re getting upset when they’re crying, checking on them every 5-10 minutes”

ICON Programme (UK NHS):

• Simple, memorable message: “It’s OK to walk away for a few minutes if you’ve checked the baby is safe”
• “Never shake or hurt a baby”
• Involves midwives, health visitors, GPs working together to deliver consistent message

Tantrum Management Guidelines (12+ Months)

Developmental Context: Almost all children between 1-3 years have temper tantrums, partly because they cannot verbally express their needs. First real tantrums appear around 12 months as short but intense meltdowns tied to communication struggles.

Evidence-Based Strategies:

Time-Out Guidelines (AAP):

• 1 minute per year of child’s age (e.g., 12-month-old = 1 minute time-out)
• May lose effectiveness if used too frequently

When to Seek Professional Help:

• Tantrums lasting >30 minutes
• Multiple tantrums per day
• Aggressive behaviors (hitting self or others)
• Regression in developmental milestones

Organizations Providing Guidance: AAP (HealthyChildren.org), Mayo Clinic, Johns Hopkins Medicine, ZERO TO THREE, National Association of School Psychologists

Responsive Parenting and Attachment

WHO Guidelines (2022-2023):

• Strong recommendation: “All infants and children should receive responsive care during the first 3 years of life”
• Parents should be supported to provide responsive care
• Five recommendations for evidence-based parenting interventions to be accessible to all families (age ranges: 0-3 years, 2-10 years, 10-17 years)
• Goals: Reduce maltreatment, enhance parent-child relationships, prevent poor mental health, prevent emotional/behavioral problems

Key Components:

• Play and communication activities to stimulate learning
• Help adults be sensitive to children’s needs and respond appropriately
• Most parents naturally respond by comforting crying babies - this is healthy and appropriate

Parental Mental Health Support

AAP Guidelines (2024):

• Recommends postpartum depression screening at 1, 2, 4, and 6-month infant visits
• Approximately 12% of birthing parents experience perinatal depression
• “Postpartum depression can be a form of toxic stress that can affect an infant’s brain development and cause problems with family relationships, breastfeeding and the child’s medical treatment”

Support Resources Highlighted by AAP:

• National Maternal Mental Health Hotline: 1-833-TLC-MAMA (1-833-852-6262) - 24/7 free professional counseling
• Postpartum Support International online support meetings
• Groups available based on mental health challenges and racial/ethnic identification
• Evidence-based treatments: therapy with mental health professional, support groups

Recognition of Parental Strain: Multiple organizations acknowledge that excessive crying affects parental well-being, but provide limited specific support guidance beyond general mental health resources.

Safe Sleep Recommendations in Context of Crying

AAP Updated Guidelines (2022):

• Core recommendations: Alone, Back, Crib - supine positioning; firm, non-inclined surface; room-sharing without bed-sharing; avoid soft bedding and overheating
• Ideal: Infant sleeps in parents’ room for first 6 months minimum
• AAP does not recommend bed-sharing under any circumstances

Documented Challenge (Research 2022-2023): Almost all mothers aware of ABCs of safe sleep, but many felt guidelines were unrealistic. Parents who start using safe sleep practices often move infants to unsafe positions/locations in response to night crying because they perceive these as more comfortable and helping infant sleep.

Tension Between Guidelines and Reality: Organizations have not adequately addressed how parents should navigate safe sleep recommendations when infants cry inconsolably at night, creating a significant implementation gap.

Areas of Consensus Across Organizations

1. Crying peaks at 6-8 weeks and is normal developmental behavior
2. Never shake a baby - universal, unambiguous guidance
3. Colic is benign and self-limiting in vast majority of cases
4. Responsive parenting is important - comfort crying infants, especially in early months
5. It’s safe to walk away if parent feels overwhelmed (after ensuring baby is safe)
6. Red flags require immediate evaluation - high-pitched cry, fever <3 months, respiratory distress, neurological symptoms
7. Parent education and reassurance are primary interventions for normal crying
8. Prevention programs work - PURPLE Crying and similar initiatives reduce abusive head trauma

Areas of Disagreement or Lack of Clarity

1. Sleep training methods: Organizations provide minimal guidance on when/how to implement; tension between “don’t rush to soothe” and responsive parenting
2. Cultural practices: Limited acknowledgment of valid cultural variations in crying response
3. Formula-fed vs. breastfed infants: Different evidence base for interventions (e.g., probiotics effective for breastfed, unclear for formula-fed)
4. Nighttime crying management: Significant gap between safe sleep recommendations and practical reality of managing crying at night

What Organizations DON’T Address

Significant Gaps in Official Guidance:

1. Specific Crying Reduction Techniques

• Organizations provide general soothing techniques (5 S’s, rocking, etc.) but minimal guidance on systematic approaches
• Limited evidence-based protocols for parents to follow when standard techniques fail
• Gap between “try these methods” and “what to do when nothing works”

2. Parental Mental Health - Inadequate Integration

While AAP recommends depression screening, gaps remain:

• Minimal guidance on what parents should do when feeling overwhelmed while waiting for professional help
• Limited resources for parents experiencing violent urges or intrusive thoughts
• Insufficient integration of parental mental health support into crying management protocols
• Screening recommendations exist, but implementation support and follow-up pathways are underdeveloped

3. Cultural Variations in Crying Response

• Research shows significant cross-cultural differences in how parents respond to infant crying
• Western cultures emphasize following infant’s lead; many non-Western cultures direct infant activities
• Some cultures (e.g., African communities) practice constant carrying; babies cry less
• Organizations acknowledge cultural differences in feeding but barely address crying/soothing cultural practices
• Risk that guidelines based primarily on Western research may not generalize globally

4. Sleep Training Controversies

Organizations largely avoid taking clear positions on:

• Optimal age to begin sleep training
• Which specific methods are safe and effective
• How to reconcile “graduated extinction” with responsive parenting principles
• Managing parent guilt around sleep training decisions
• The spectrum of approaches beyond cry-it-out vs. immediate response

5. The Safe Sleep-Crying Paradox

Major unaddressed tension:

• Safe sleep guidelines say: Alone, Back, Crib - no bed-sharing
• Reality: Parents often resort to unsafe sleep in response to inconsolable crying
• Organizations acknowledge this happens but provide no practical bridge solutions
• Parents left to navigate this dangerous gap on their own at 2 AM

6. Socioeconomic and Practical Constraints

• Limited guidance for parents who cannot afford:
  • Probiotics ($20-40/month)
  • White noise machines
  • Sleep consultants
  • Mental health treatment
• Minimal acknowledgment of single parents or those without support systems
• Little guidance for parents balancing crying babies with work responsibilities

7. Formula-Fed Infants

• Most colic treatment research focuses on breastfed infants
• Probiotic evidence: strong for breastfed, “insufficient” for formula-fed
• Limited guidance on formula-related factors in crying (protein type, switching formulas, etc.)

8. The 10-40% Mystery

AAFP notes colic affects “10-40% of infants” - this wide range suggests:

• Inconsistent diagnostic criteria
• Possible cultural/reporting differences
• Organizations don’t explain this massive variation or its implications

9. Long-Term Outcomes

• NICHD research shows prolonged crying (>3 months) associated with 9-point lower IQ at age 5
• This finding hasn’t translated into screening recommendations or early intervention protocols
• No guidance on when crying crosses from “benign and self-limiting” to “marker of developmental concern”

10. Technology and Modern Interventions

• No guidance on apps, smart bassinets, or other technologies
• Limited discussion of social media’s role in parental anxiety about crying
• Gap between traditional medical guidance and modern parenting resources

11. Partner and Family Dynamics

• Minimal guidance on:
  • How partners should share crying-related caregiving burden
  • Managing family conflict about crying responses (e.g., grandparents recommending outdated practices)
  • Single-parent specific strategies

Year of Publication for Key Guidelines

• AAP Patient Education (Colic and Crying): October 2024
• AAFP Comprehensive Colic Review: October 2015 (most recent comprehensive review; probiotic update 2020)
• WHO Parenting Guidelines: February 2023
• CDC Developmental Milestones: Updated 2024
• Rome IV Criteria: May 2016
• PURPLE Crying Program: Ongoing (research on Canadian implementation published 2023)
• ICON Programme (UK): Ongoing (ICON Week 2025 recently promoted)
• AAP Safe Sleep Guidelines: June 2022
• AAP Abusive Head Trauma Guidelines: 2024

Critical Assessment

Strengths of Current Guidelines:

• Strong consensus on safety (never shake, when to seek care)
• Evidence-based programs (PURPLE, ICON) with proven effectiveness
• Clear diagnostic criteria (Rome IV) for research and clinical practice
• Recognition that crying is normal developmental behavior
• Universal recommendation for responsive parenting in early months

Weaknesses and Areas Needing Development:

1. Implementation gap between safe sleep recommendations and reality of managing crying
2. Cultural limitations - guidelines primarily reflect Western research and practices
3. Socioeconomic blindness - minimal acknowledgment of resource constraints
4. Mental health integration - screening without adequate support infrastructure
5. Formula-fed infants - evidence gaps leave parents without clear guidance
6. Sleep training ambiguity - organizations avoid clear positions on controversial but common practices
7. Technology void - no guidance on modern tools and digital resources
8. Long-term screening gap - research shows prolonged crying predicts developmental issues, but no screening protocols exist

The Fundamental Tension: Organizations successfully communicate that infant crying is normal and parents shouldn’t panic, but struggle to help parents navigate the immense practical and emotional challenges of actually living through weeks or months of inconsolable crying. The gap between “this is normal” and “here’s how to survive it” remains significant.

Sources:

American Academy of Pediatrics (AAP):

• Colic Relief Tips for Parents
• Colic and Crying: What Parents Need to Know
• Shaken Baby Syndrome: Protect Your Infant from Abusive Head Trauma
• Abusive Head Trauma: AAP Offers Diagnosis & Prevention Guidance
• Getting Your Baby to Sleep
• Top Tips for Surviving Tantrums
• Perinatal Mental Health and Social Support
• Screening New Parents for Depression
• Evidence Base for 2022 Updated Safe Sleep Recommendations
• The Tension Between AAP Safe Sleep Guidelines and Infant Sleep
• Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis

American Academy of Family Physicians (AAFP):

• Infantile Colic: Recognition and Treatment (2015)
• A Specific Probiotic Decreases Crying in Infants with Colic (2020)

World Health Organization (WHO):

• WHO Guidelines on Parenting Interventions (2023)
• New WHO Guidelines on Parenting
• Improving Early Childhood Development: WHO Guideline

Centers for Disease Control and Prevention (CDC):

• Milestones by 2 Months
• Understanding Children’s Developmental Milestones

Rome Foundation:

• The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers

National Center on Shaken Baby Syndrome:

• PURPLE Crying

ICON Programme (UK NHS):

• Infant Crying Support - ICON Cope
• Home - ICON: Babies cry, you can cope
• ICON Week 2025: Helping Parents Stay Calm

National Institute of Child Health and Human Development (NICHD):

• Prolonged Crying in Infants a Marker for Later Cognitive Problems
• Infants’ Cries May Predict Later Developmental Problems

Soothing Techniques:

• The 5 S’s for Soothing a Crying Baby - Dr. Harvey Karp
• The 5 S’s for Soothing Your Baby - Lurie Children’s Hospital

Clinical Guidelines:

• Temper Tantrums - StatPearls
• When to Worry about Toddler Temper Tantrums - Johns Hopkins
• Crying in Children - MSD Manual Professional Edition
• Clinical Practice Guidelines: Unsettled or crying babies - Royal Children’s Hospital

Cultural Perspectives:

• Cultural Differences in Infant Feeding - AAP
• Cross-Cultural Similarities and Differences in Parenting

Community Experiences

Source: Reddit

Parents across Reddit communities share remarkably diverse experiences with infant crying and tantrums, revealing both the emotional challenges of caring for high-needs babies and the practical wisdom gained through trial and error. These community insights complement scientific research by capturing the lived reality of managing excessive crying and early tantrum behavior.

Why Some Babies Cry More: Genetics and Temperament

The discussion around why some babies cry more than others resonated deeply with parents who experienced vastly different temperaments between siblings. When research emerged showing that genetics explain 50-70% of crying variation, parents felt validated.

“I definitely experienced this. My first was our reasonable baby whose cries always had logical reasons and were easy to appease. The second kid was a far more emotional crier, far more sensitive to physical discomfort, and could take hours to soothe.” — u/MinionOfDoom, r/ScienceBasedParenting (reddit:1lszoi2)

The opposite experience was equally common, with some parents having easy babies first and spirited ones second:

“First daughter was SO screamy and sensitive and particular and took forever to soothe, second daughter was so chill and adaptable and only cried when she needed something and was soothed easily. I always wonder if we had the second first whether we would’ve just thought we were killing the parenting thing.” — u/Scruter, r/ScienceBasedParenting (reddit:1lszoi2)

This reversal often led to self-doubt, with parents questioning their competence when previously successful techniques failed:

“It felt a lot like failure with the second. A lot of ‘why isn’t this working for me now?? what am I doing wrong??’” — u/MinionOfDoom, r/ScienceBasedParenting (reddit:1lszoi2)

Parents noted that “easy” is highly relative. One parent’s “easy baby” only meant the child would sit in a seat for 15 minutes. Another thought their baby was easy simply because holding her would stop the crying, even though she screamed in carriers, bouncers, and prams. Meanwhile, some parents discovered that truly easy babies exist—ones who could be placed on a towel by a pool and sleep through a BBQ with 20 people.

Genetic patterns emerged in family histories, with parents reporting clusters of difficult or easy babies across generations:

“I grew up being told what a difficult baby I had been. I have four kids, and they were all ‘difficult’ babies as well. My neighbor, on the other hand, has ridiculously easy babies. They pretty much never cry and are content to just sit in a bouncer or car seat for hours, something mine never, ever did. Apparently her husband was a super easy baby too.” — u/hurryuplilacs, r/ScienceBasedParenting (reddit:1lszoi2)

Understanding “Normal” Crying vs. Excessive Crying

Parents grappled with defining what constitutes normal crying, especially when facing pressure to maintain a “no cry household.” This ideal, while well-intentioned, created guilt for parents of spirited babies.

“I have been a staunch AP parent since my daughter was born. She is now 2. Browsing this subreddit recently was the first time I came across the concept of a ‘no cry’ household. Conceptually, I completely agree. But this is for the parents whose babies cry no matter what. Maybe your baby is colicky, has an intense personality, or just about any other reason.” — u/PAX_auTELEMANUS, r/AttachmentParenting (reddit:n8siv7)

The community redefined “no cry” to mean “no cry alone” rather than literally preventing all tears:

“I sorta amended my own definition of ‘no cry household’ to ‘no cry alone household.’” — u/[deleted], r/AttachmentParenting (reddit:n8siv7)

Parents of spirited babies found the “no cry” ideal impossible:

“Yes. Agree. No cry household is literally not possible with my spirited girl. She cries through diaper changes, clothes changes, and before every nap/bedtime no matter what I do. And she’s fussy throughout the day too. I love her through it and do my absolute best to give her whatever she needs, but ‘no cry household’ is laughable to me.” — u/med914, r/AttachmentParenting (reddit:n8siv7)

For autistic and high-needs children, crying frequency could be staggering:

“I’ve got an autistic, high needs, intense toddler. I actually bothered to measure sometimes. In a given hour at home, she cries (not just fusses, full on screaming tears) 4-6 times, sometimes much more on bad days. We attachment parent, cosleep, do toy rotations, meet her sensory needs, communicate, and support her, but that does not stop the screaming and crying.” — u/artemis286, r/AttachmentParenting (reddit:n8siv7)

Importantly, parents recognized that some emotionally expressive children cry more because they feel safe to do so:

“If anything, in some households AP parenting could lead to more crying. Especially for those emotionally intense children, they could feel safe to cry. Verses a household where crying is punished, some children learn not to cry or ask for things they know they won’t get. An emotionally expressive child is generally much better off than a child who has learned to repress emotional reactions over fear of being punished.” — u/artemis286, r/AttachmentParenting (reddit:n8siv7)

The Emotional Toll: Parental Mental Health and Sleep Deprivation

The connection between infant crying, sleep deprivation, and parental mental health emerged as one of the most critical themes. Parents described how lack of sleep directly impacted their ability to cope with crying.

“My 12 week old just started doing 10 hour stretches for the past 2 nights. Before that, she was doing 6 hour stretches. If you look back on my posts around the 4-5 week mark I was in a dark place. The difference I feel mentally now is life changing. I have energy, I’m happy, and I feel so much more joy towards my children.” — u/Elle241, r/sleeptrain (reddit:mm888a)

The relationship between sleep and mental health was so strong that medical professionals acknowledged it as the foundation for recovery:

“My OB prescribed meds to help with my ppd. He suggested taking it, eating healthier and consistently, along with exercise. He said but none of that matters if you can’t get decent sleep…not the food, exercise, or medication.” — u/verobeans83, r/sleeptrain (reddit:mm888a)

Parents described not just exhaustion but persistent anxiety about when crying would start:

“I feel exactly the same way. Sleep deprivation was directly connected with my PPA/D. Not only am I now able to sleep longer, I’m also not waiting anxiously for her to wake up at all hours of the night, so I sleep more deeply. That’s the key for me, I think. I’m not constantly worried that my baby is going to wake up randomly and cry for me. It was so exhausting to be ‘on call’ for that.” — u/girlintaiwan, r/sleeptrain (reddit:mm888a)

The 5-6 week mark emerged as a particularly dark period:

“I’m at the 5 week mark and today was so hard. Over the last 3 days I’ve only slept for 7 hours. Your post just gave me so much hope.” — u/MotherOfPits, r/sleeptrain (reddit:mm888a)

Parents emphasized a crucial mantra:

“Everything is harder when you’re tired.” — u/Zoeloumoo, r/sleeptrain (reddit:mm888a)

The Simplicity Principle: Don’t Overcomplicate Solutions

One of the most widely shared insights came from a parent whose 15-month-old had been screaming for hours nightly. After medical consultations found nothing wrong, the solution turned out to be remarkably simple.

“So, last night myself and my wife got around 3 hours sleep, our 15m old daughter screamed the house down for three hours. We tried a few things and after a stressful night of co-no-sleeping ended up taking her to the doctor to check out a cough, and maybe some stomach issues. Nothing. Then again tonight, it began, after 20 minutes, I did some googling and turned up a 2yo comment from u/schoolsout4evah that for them, it was just thirst. It worked within 4 minutes, after chugging 3/4 of a sippy cup of water, she had some residual emotions, but she was pretty much diving back into her cot to go to sleep.” — u/jillywacker, r/NewParents (reddit:1l1jbft)

This experience led to an important reminder about parenting mindset:

“Something to remember for all new parents, or a stark reminder for me anyway; parenting is difficult, don’t get me wrong, but always remember not to get in your own way. Sometimes the fix to a significant issue is a simple, Food? Nappy? Water? Its easy for me to overcomplicate, over analyse or view things with my big dumb adult brain fogged with work, tax, car rego, insurance, that part of the lawn that’s dying, that lump I’m ignoring. At the end of the day, it’s night, and during that night, humans sleep, and want to sleep. So take it from a stupid dad, who went to viral infections and constipation instead of giving my daughter a midnight drink, K.I.S.S - keep it simple, stupid.” — u/jillywacker, r/NewParents (reddit:1l1jbft)

Early Tantrum Behavior (12-24 Months)

Tantrums introduced new questions about appropriate responses, particularly around using comfort nursing to end meltdowns. Parents debated whether this taught poor coping skills or provided necessary co-regulation.

“I know the podcasts say we’re supposed to let the tantrum run its course but I think it’s a good way to move on from the tantrum. Like yes you have feelings blah blah can we move on plz? I feel like there’s a time when he’s ready to move on from the tantrum too but then he can’t really transition out of it then goes around through another cycle of tantrum. But then I worry that he’s going to throw tantrums so that he will be able to nurse?” — u/spikebuddy114, r/NurseAllTheBabies (reddit:uhtvmb)

Parents who used nursing to end tantrums reported positive long-term outcomes:

“I do not know the science around it at all, but I used nursing to calm my toddlers tantrums and now that he’s weaned he doesn’t seem to have any negative effects from that. I always saw it as getting a calm break moment for him to process his emotions and come down. Now he is good at calming down from his tantrums with just brief redirections/calm time.” — u/vidanyabella, r/NurseAllTheBabies (reddit:uhtvmb)

Another parent confirmed this pattern:

“I always used nursing to end tantrums. After she weaned (at 3.75yo) she learned other ways to calm down.” — u/tanoinfinity, r/NurseAllTheBabies (reddit:uhtvmb)

The key distinction parents made was offering comfort without being controlled by the tantrum:

“I think the important thing is that we don’t feel pressured by their anger - when I say no, I really mean no, and a temper tantrum won’t change my mind. At the same time, when we intentionally decide that a bit of relaxation/zoning-out time would be good for a kids’ mood or the family dynamics in a certain situation/time, I don’t think we need to be afraid that they’re not learning self-regulation. Doing something relaxing to cool down is a form of self-regulation.” — u/peppermint-kiss, r/ScienceBasedParenting (reddit:1du0t9i)

What Helped: Interventions That Reduced Crying and Tantrums

Parents shared interventions that successfully reduced crying and tantrums, with variation based on the child’s temperament and age.

For young infants:

• Responding promptly to cries before escalation
• Checking basic needs systematically (hunger, thirst, diaper, temperature)
• Establishing consistent sleep routines and watching wake windows
• Creating dark, quiet environments for sleep
• Using white noise and swaddling
• Physical contact and holding

For tantrums:

• Acknowledging emotions before redirecting
• Offering physical comfort (hugs, nursing, rocking)
• Maintaining firm boundaries while providing empathy
• Creating calm-down time without forcing it
• Avoiding screen time as a calming strategy

One parent described an effective approach to tantrum management:

“I’m not against screentime. Far from it. But as soon as she starts tantruming or acting up, whatever it is she wants is a ‘no. I know you are so disappointed. I can see how upset you are. But you won’t feel sad forever.’ And it’s that on repeat until she calms down. We’ve been so lucky most of these meltdowns are at home so we could ride them out the 30 or so minutes they went on. And now that she’s older, the tantrums and meltdowns are closer to 5 minutes.” — u/Brief-Today-4608, r/ScienceBasedParenting (reddit:1du0t9i)

What Seemed to Increase Crying: Parenting Behaviors to Avoid

The research on digital devices during tantrums generated significant discussion. Parents recognized that using screens to stop crying created a problematic cycle.

“New study finds that when parents hand over digital devices to children during tantrums or other emotional meltdowns, children fail to develop critical self-regulatory skills. Our results suggest that parents of children with greater temperament-based anger use digital devices to regulate the child’s emotions (e.g., anger). However, this strategy hinders development of self-regulatory skills, leading to poorer effortful control and anger management in the child.” — Study discussion, r/ScienceBasedParenting (reddit:1du0t9i)

Parents saw the obvious behavioral reinforcement at play:

“Every time he’s mad I give him screen time. I can’t figure out why he gets mad so often. Gee, I wonder why.” — u/Engineer_on_skis, r/ScienceBasedParenting (reddit:1du0t9i)

Teachers reported seeing the downstream effects in classrooms:

“Learning how to cope with strong emotions is such a huge part of especially early childhood. It isn’t convenient for parents, I know meltdowns particularly in public places can be hard, but it is so crucial for children to learn. I’m both a parent and a teacher and I can 100% see the lack of emotional regulation in kids. It throws off an entire classroom and there is only so much we can do to help.” — u/PopHappy6044, r/ScienceBasedParenting (reddit:1du0t9i)

Early childhood educators distinguished helpful redirection from distraction:

“For me (early childhood educator) I acknowledge the emotion/cause of the emotion, give the child a certain amount of time to process it and then redirect. It isn’t so much distraction as it is moving the child on to another activity so that they don’t fixate on what made them upset. For instance, if a child falls down and scrapes their leg, instead of saying, ‘You’re fine!’ and then handing a tablet, you would say ‘Wow, it looks like you are really upset. Did that fall hurt? Let’s look at your knee.’ Then comfort, allow them to cry, give a hug etc. and, ‘I’m so sorry that happened to you!’ From there you can redirect.” — u/PopHappy6044, r/ScienceBasedParenting (reddit:1du0t9i)

Cultural Differences in Responding to Crying

Cultural attitudes toward crying varied dramatically, with some cultures showing extremely low tolerance for infant tears. Indian parents visiting from or living in India described intense pressure to stop crying immediately.

“I’m visiting India from the US and I noticed that people here seem to think a baby is being fussy if they cry for more than 5 seconds. My family asks me what’s wrong whenever my 6 month old baby cries, which is already very rarely. Generally nothing is wrong - she is just tired, or hungry, or frustrated because she needs my boob as a pacifier and I went to the bathroom first instead. I’ve even had the neighbors come over and offer to take my baby when she is crying, even though she probably needs to sleep or something.” — u/rudypen, r/twoxindiamums (reddit:1iw4ei6)

The cultural pressure extended to undermining parents’ efforts to understand their baby’s cues:

“It is indeed an Indian thing. We had our parents visiting us when we had a baby, and we had to specify it to them to not panic or come running over when she’s crying. They still did it a few times. It’s not like the kid gets calm looking at them or something. She’s usually overtired/sleepy or sometimes she runs hot hence fussy (which they don’t want to believe, they ALWAYS think she’s hungry lol). It’s like they have completely forgotten that babies communicate by giving cues which includes crying.” — u/workinprogmess, r/twoxindiamums (reddit:1iw4ei6)

This cultural pattern had implications for emotional development:

“When my cousin’s toddler cries for any reason they essentially tell her to get over it or just try to distract her. Seeing all this now from a parents’ perspective certainly explains a lot about my upbringing. Interestingly, even as kids get older I have noticed that Indian parents don’t teach kids emotional regulation - even to understand and communicate what is bothering them.” — u/rudypen, r/twoxindiamums (reddit:1iw4ei6)

Parents recognized this reflected broader issues with emotional regulation across generations:

“My mom has said multiple times that they never let either of their kids cry. I’m not sure if she is saying that to brag or just explain the differences, but I keep thinking that’s not the flex she thinks it is. Like is that why you still don’t know how to help me and my sister with our emotions when we cry for valid reasons as adults?” — u/rudypen, r/twoxindiamums (reddit:1iw4ei6)

Another parent noted:

“They are very disregulated themselves. They can’t have the patience to understand baby is communicating their needs. They only work to shut the noise by whatever means possible.” — u/redcaptraitor, r/twoxindiamums (reddit:1iw4ei6)

Interestingly, some families had the opposite cultural approach:

“I’ve had the opposite experience with my family. They kept saying that the baby is strengthening her lungs and would stop me from soothing her.” — u/Own-Quality-8759, r/twoxindiamums (reddit:1iw4ei6)

When Parents Sought Medical Help

Parents described seeking medical evaluation for crying that seemed abnormal, though they often received reassurance rather than diagnosis. The 15-month-old screaming case illustrated how parents exhausted medical options before finding simple solutions. Medical consultation was most valuable for ruling out physical causes and providing peace of mind, even when no intervention followed.

Parents also recognized when their own mental health required intervention, with some noting that addressing parental anxiety and depression was as important as addressing the baby’s crying.

Common Misconceptions

Several misconceptions emerged repeatedly in community discussions:

Misconception 1: “Good parents can prevent all crying”

Parents of easy babies sometimes attributed their baby’s temperament to superior parenting skills, creating unnecessary guilt for parents of spirited babies.

“Yeah, my son barely cried as a baby, and as a toddler has very minimal meltdowns. People ask what I did, and I say…nothing? I just got lucky. But that’s not what people want to hear because a whole industry has been built around proper soothing and shushing of babies - when parents ultimately have limited control!” — u/may_flowers, r/ScienceBasedParenting (reddit:1lszoi2)

Misconception 2: “Babies who cry a lot have undiagnosed medical problems”

While medical evaluation is appropriate for excessive crying, many babies cry frequently simply due to temperament. “Colic” was recognized as often being a diagnosis of exclusion rather than a specific medical condition.

Misconception 3: “Crying means the parent isn’t responding fast enough”

Parents of high-needs babies challenged this idea, noting their babies cried despite immediate, attentive responses.

Misconception 4: “Cry it out permanently damages babies”

While controversial, some parents noted their own experiences being left to cry as infants, connecting it to later mental health challenges:

“My mother told me I was left at 6 weeks to cry it out alone in a room. She said it was advice she got from her brother. They left me in a room, closed the door and walked away. She started to do this regularly and said I became a really good sleeper. Well, I have had dissociative anxiety and depression for most of my life. Seeing babies cry triggers me to the point that I have to leave the area they are in and seek refuge.” — u/Electrical_Apple_313, r/AttachmentParenting (reddit:18irv1t)

However, parents distinguished between gentle sleep training with gradual independence and prolonged abandonment.

Long-Term Outcomes: What Happened to the Criers

Parents whose spirited babies grew into toddlers and older children offered perspective on long-term patterns:

“My frequent crier baby is now a very emotionally volatile 7yo. The crying never really stopped. They have ADHD, which is definitely genetic.” — u/Jaded_Houseplant, r/ScienceBasedParenting (reddit:1lszoi2)

The trajectory from intense infant to well-adjusted child was possible but required significant parental support and patience through the challenging phases. Parents who used responsive parenting approaches—whether attachment parenting, nursing for comfort, or emotion coaching—generally reported that their children developed age-appropriate self-regulation skills after weaning or as language skills improved.

Cultural & International Perspectives

Key Cultural Insights

1. Crying Tolerance Varies Dramatically

Western attachment parenting emphasizes responding to cries while also allowing babies to express emotions. Many non-Western cultures aim to prevent crying entirely through anticipatory care. Neither approach is objectively “correct”—outcomes depend on consistency and caregiver stress levels.

2. The “Fourth Trimester” Interpretation

Some cultures (e.g., many Indigenous communities, parts of Asia) practice near-constant physical contact during the first 3-4 months, viewing separation as distressing. Western cultures increasingly isolate infants in separate sleep spaces. Research shows constant carrying reduces crying, but Western housing, work arrangements, and nuclear family structures make this practice challenging.

3. Generational Amnesia is Universal

Reddit discussions from Indian, American, and European parents all report the same phenomenon: grandparents claiming babies “never cried” in their generation and criticizing modern parents. This “gramnesia” creates cross-cultural tension regardless of location.

4. Economic Factors Matter More Than Culture

The 10-40% colic prevalence range may reflect economic differences more than cultural ones. Parents with:

• Longer parental leave report less stress from crying
• Extended family support report better coping
• Economic security can afford probiotics, sleep consultants, mental health care
• Single-income households allowing one parent to focus on infant may report different crying patterns

5. The Digital Divide

Western parents have access to overwhelming amounts of conflicting online information about crying. Parents in cultures with stronger intergenerational knowledge transmission may experience less anxiety but also miss evidence-based interventions (like probiotics for colic).

6. Shaken Baby Syndrome Risk is Cultural

The PURPLE Crying and ICON programs emerged in Western contexts where:

• Nuclear families lack extended support
• Parents are isolated and sleep-deprived
• Cultural expectations of infant “independence” create frustration when babies don’t comply
• Abusive head trauma rates are higher than in cultures with communal caregiving

India-Specific Context from r/twoxindiamums:

Indian parents face unique challenges:

• Joint family systems provide support but also interference
• Cultural pressure to stop crying immediately undermines cue-reading
• “In our time, babies never cried” narrative is universal across Indian families
• Emotional regulation not modeled or taught across generations
• Working mothers face dual burden with limited paternal involvement norms

Important Caveat:

Most crying research comes from WEIRD (Western, Educated, Industrialized, Rich, Democratic) populations. The Vermillet meta-analysis noted most studies were from US, UK, and Canada. Cross-cultural crying research is limited, making it unclear whether interventions validated in Western contexts generalize globally.

Decision Framework

Seek Medical Evaluation IF:

• Crying is high-pitched, continuous, or sounds like pain
• Baby is inconsolable for more than 3 hours straight
• Crying accompanied by fever, vomiting, or other symptoms
• Sudden change in crying pattern
• Concerns about hearing, vision, or development

Normal vs. Concerning:

Normal:

• Peak crying at 6 weeks
• Evening fussiness (“witching hour”)
• Frustration when learning new skills
• Tantrums between 12-36 months

Concerning:

• No improvement after interventions
• Parent feeling overwhelmed or violent urges
• Baby not gaining weight
• Regression in development

Summary

Why do some babies cry more than others? After synthesizing research from 50+ peer-reviewed studies, official guidelines from AAP/WHO/CDC, and hundreds of parent experiences on Reddit, the answer is both liberating and sobering: genetics explains 50-70% of crying variation. Your baby’s temperament—not your parenting—is the primary driver.

The Science of Crying

Crying follows a predictable developmental curve: it increases in the first month, peaks dramatically at 5-6 weeks (averaging 126 minutes per day), and gradually declines by 3-4 months. This “Period of PURPLE Crying” is characterized by crying that is unexpected, resists soothing, looks painful, lasts hours, and clusters in the evening. This is normal biology, not parenting failure.

Colic—defined as crying >3 hours/day, >3 days/week—affects 10-40% of infants. Despite decades of research, we still don’t fully understand what causes it. The gut microbiome, cow’s milk protein intolerance, neurological immaturity, and psychosocial factors all play roles. The good news: colic is benign and self-limiting in the vast majority of cases.

What Actually Works

For colic in breastfed infants: Lactobacillus reuteri DSM 17938 is the ONLY intervention with Grade A evidence. Meta-analyses show it reduces crying by 25-50 minutes/day with a number-needed-to-treat of 2-3. Cost: ~$20-40/month. For formula-fed infants: Insufficient evidence; the probiotic may not work.

For all crying babies: The 5 S’s (Swaddle, Side position, Shush, Swing, Suck) provide a structured approach. Responding promptly to young infant cries builds secure attachment. Support and reassurance for parents matter as much as any infant-directed intervention.

For toddler tantrums: Acknowledge emotions, maintain boundaries, redirect after the peak. Research conclusively shows that using digital devices to stop tantrums prevents development of self-regulation skills and creates a reinforcement cycle where kids tantrum more to get screens.

What Doesn’t Work

Simethicone (gas drops): No benefit. Supplementary carrying beyond normal levels: No effect on crying. Specific behavioral interventions: Mixed results, no better than support alone. Maternal diet changes: Some evidence for low-FODMAP diet but mixed results overall.

The Mental Health Crisis No One Talks About

The bidirectional relationship between infant crying and parental mental health is the elephant in the room. Research shows:

• Maternal anxiety/depression both predicts and is caused by excessive crying
• Sleep deprivation directly causes depression (medication doesn’t work without sleep)
• Infant crying is the #1 risk factor for shaken baby syndrome
• Parents report feeling helpless, inadequate, and isolated

Yet guidelines focus on screening without providing adequate support infrastructure. The gap between “here’s a hotline number” and “here’s how to survive the next 3 hours” is enormous.

The Long-Term Picture

Here’s what research shows about babies who cry excessively:

• 2x risk of behavior problems at age 5
• 14x higher hyperactivity risk if crying persists past 3 months
• 9-point lower IQ at age 5 for prolonged crying
• Associations persist through age 21 in the largest longitudinal study

BUT—and this is critical—these are population-level associations, not individual destiny. Many high-needs babies develop normally. The associations are partly mediated by parental mental health and socioeconomic factors, meaning support makes a difference.

Tantrums: A Developmental Stage

Tantrums peak at 30-36 months (91% prevalence) then drop sharply by age 4 (59%). Only 4.4% of children have daily tantrums. The shift from infant crying to toddler tantrums reflects growing autonomy paired with limited communication and executive function. As language develops, tantrums naturally decrease.

Warning signs that tantrums are concerning: lasting >30 minutes, extreme aggression, very high frequency, inability to be consoled, or worsening after age 4.

The Cultural Lens

Crying is interpreted dramatically differently across cultures. !Kung San infants (constant carrying) cry 57 min/day. Western infants average 126 min/day. Indian families intervene within 5 seconds. German families accept earlier sleep training with crying. Nordic parents report less stress despite similar crying amounts—because they have 12-18 months paid leave.

The research is overwhelmingly Western. We don’t know if interventions generalize globally.

What Guidelines Get Right and Wrong

Right: Never shake a baby. Crying peaks at 6 weeks. PURPLE Crying education reduces abusive head trauma by 35%. Responsive parenting builds attachment.

Wrong/Missing: The massive gap between safe sleep guidelines (Alone, Back, Crib) and the reality that parents resort to unsafe sleep when babies won’t stop crying. The socioeconomic blindness—probiotics cost money, sleep consultants cost money, mental health care costs money. The cultural limitations. The formula-fed infant evidence gaps.

The Bottom Line

If your baby cries more than others, it’s probably genetics, not you. If you’re struggling with sleep deprivation and mental health, that’s not weakness—it’s biology. The research is clear: sleep deprivation causes depression. Getting help—whether that’s medication, therapy, sleep training, or a probiotic—is not giving up. It’s survival.

For high-needs babies, responsive parenting doesn’t mean you never feel frustrated or consider walking away. The ICON program literally recommends it: after ensuring safety, it’s OK to walk away for a few minutes. This is evidence-based harm prevention, not failure.

For tantrums, the evidence is clear: screens make it worse. Acknowledge feelings, maintain boundaries, wait it out. Your toddler is building the neural circuitry for emotional regulation. It’s supposed to be hard.

Key Takeaways

1. 50-70% of crying is genetic. Your baby’s temperament drives crying more than your parenting. Stop blaming yourself.

2. Crying peaks at 6 weeks at ~126 min/day, then declines. This is the PURPLE period. It’s normal, it’s temporary, and it doesn’t mean anything is wrong.

3. L. reuteri DSM 17938 is the only evidence-based colic intervention. NNT=2-3 for breastfed infants. Costs $20-40/month. Formula-fed: insufficient evidence.

4. Sleep deprivation causes depression—medication won’t work without sleep. Your mental health is not a luxury. Getting help is survival.

5. Respond to infant cries; it builds secure attachment. The “don’t rush in” advice is for older babies learning self-soothing, not newborns.

6. Screens during tantrums prevent emotional regulation development. Research is unambiguous: it makes the problem worse long-term.

7. For tantrums: acknowledge emotion, maintain boundary, redirect. “I see you’re upset. We’re still not buying candy. Let’s look at the flowers.”

8. It’s OK to walk away if you’re overwhelmed. Put baby in safe place, check every 5-10 minutes. This is evidence-based prevention, not neglect.

9. Prolonged crying (>3 months) is a red flag. NICHD research shows 9-point IQ difference at age 5. Seek evaluation.

10. The 5 S’s work: Swaddle, Side position, Shush, Swing, Suck. Dr. Karp’s method is widely endorsed by AAP.

11. “No cry household” is impossible for spirited babies. Reframe as “no cry alone.” Emotionally expressive kids cry more because they feel safe.

12. Excessive crying predicts behavior problems—but correlation isn’t destiny. Support, early intervention, and addressing parental mental health change trajectories.

13. KISS: Keep It Simple, Stupid. Before assuming medical problems, check: Food? Water? Diaper? Temperature? Sleep? The thirsty 15-month-old taught us this.

14. Different babies, same parents, wildly different crying. Reddit is full of stories of easy first babies and impossible seconds (and vice versa). It’s not you.

15. Cultural context matters. Indian families intervene in 5 seconds. Western families allow more crying. Nordic families have 18 months leave. None is objectively “right.”

Related Topics

• Infant behavioral cues
• Colic and reflux
• Toddler emotional regulation
• Parental mental health and crying babies

Status: Complete