Our newborn's cries all sound the same. How can we tell if she's hungry or sleepy?


We are first time parents.  Our baby is healthy and growing, but even so she often cries.  We don’t know if she’s hungry, sleepy, in pain, or . . .?  We want to do the right thing, and sometimes we don’t have a clue. How can we tell?


You probably can't--because babies aren’t designed to be predictable. The first three months of a baby’s life are sometimes called the “fourth trimester”.  In the beginning, there are no "usual" patterns--every baby is different. It’s a period of adjustment, not just for parents but for your baby as well. 

Before your baby was born, she didn't know night from day. She was always held and rocked in a nice warm environment, and she never even knew that she was hungry.  Her life was a holiday of constant pampering.  Now she's out in the bright world with lots of strange sounds, sights, motion and unpredictability.  Is it any wonder that she is sometimes frustrated and tearful about her chaotic new life?

It's not surprising that you can't figure out the “meaning” of her cries, because at this point she can't figure out the reason she's unhappy. Just like older children and adults, babies are sometimes content, sometimes not.  You will gradually find good ways to soothe her, at least some of the time. You’ll try feeding her, whispering to her, singing to her, holding her, walking with her, swaddling her-- sometimes you will be able to tell when you've guessed correctly, and she will respond more quickly to your efforts.  Sometimes she won’t, because she’s just in an unsettled state. In the next few months her behavior will become more predictable and her cries will have more meaning to both of you.

For now, if your baby is breast feeding you can assume that crying may mean that she is hungry.  A nursing baby may need as many as ten to twelve nursing periods a day, since she is nursing to support her rapid weight gain. The frequent nursing acts to give your breasts the stimulation to produce more and more milk. She might be hungry an hour after a previous feeding! However, if your baby is nursing frequently and doesn’t seem soothed, maybe she doesn’t need to feed.  Again, trial and success or error will help you to read her cues.

If your baby is taking formula, you'll know how much milk she drank at her last feeding but that doesn’t mean that she’ll take the same amount at each feeding or at the same time every day.  It’s best to offer a bottle and let her suck until she ends the feeding, even if there is still formula left in the bottle.

Sometimes you can try everything and nothing works.  At that point, many new parents find that their own moods are deteriorating! You may want to hold her, but you may find that holding doesn’t help. If you have tried to nurse or feed your crying baby and she's not interested, she probably just needs to sleep. Going for a walk can get you some exercise, and many overtired babies will nap when they are ouside in motion. Even if your baby is still crying, if you get out you won’t feel quite so overwhelmed.  

But staying home and letting your baby sleep is O.K. too.  Swaddle her in a blanket if she likes that, offer her some soothing, and put her in her bassinet. That may not immediately stop the fussing, but she is likely to drift off to sleep. You can keep patting singing to her. At that point, you have begun the process of helping your baby to fall asleep when she is sleepy, and you'll have a preview of the times when her crying really does mean "I'm sleepy."

One way of thinking about this transition time is that getting used to not knowing what to do is an important skill for all parents.  We would love to feel as though we are always going to be in tune with our babies and children.  We might always want to do the right thing.  But life with a baby isn’t like that--and the ups and downs of your baby’s moods is probably the best preparation for being a good parent as anyone can have.  You don’t have to be right all the time, you don’t have to fix everything.  Just being there for her and hanging in there when it’s tough is what makes a family!



Meg Zweiback, R.N., CPNP, is pediatric nurse practitioner and infant sleep consultant in Oakland, California