Dear doctor;

My sister has a two-months-old baby who cries a lot at night. Sometimes we try to breastfeed and sing for her in vain. We are finding it hard to sleep even for two hours. Is the child okay? Stavia

Dear Stavia,

Babies usually cry a lot in the night. Most of the time, one does not know a precise reason, because they are not able to tell by themselves as to what is the problem. But a number of causes have been postulated based on experiences and observations of people based on bringing up babies. 

Hunger is one main cause why a baby would cry at night. Babies have a small tummy and small intake and at 2 months she is just on milk. Just an hour or so after a feed, she may be hungry again, more so if she has passed stool or urine. This happens more in case of a baby who does not feed adequately. Rolling tongue over lips, trying to grope for breast if held are some signs that they need to feed. Usually after 3 or 4 months when the baby is put on solid feed, this problem stops.

A baby may cry at night due to gas being formed in the stomach causing uncomfortable bloating or colicky. Being exclusively on milk, babies tend to get flatulence and at times also constipation which causes and aggravates the discomfort making them cry. Warm fomentation over the abdomen with a soft lukewarm clean cloth helps in reducing the discomfort. If a baby has not passed stool for more than 2 days or so, a glycerine wick or a clean finger can be put in rectum lightly to evacuate the bowels. It is important to burp the baby after each feed to prevent flatulence. 

It is said that babies also cry if they are exhausted and wish to sleep. Try holding the baby close and say something soothingly. She may fall asleep instantly. New places, bright lights, loud noise and travelling may also cause a baby discomfort and they cry.

For few months till after birth, the sleep/wake cycle of a child is not established as in adults. Therefore a child may feel alert and active at night when elders are tired and wishing to sleep. The crying may simply be a call to seek attention and demand for somebody to play and talk with them. 

Any acute sickness in a child like fever, sepsis, diarrhoea, vomiting, itching due to a mosquito bite can also make a baby cry. One has to be vigilant to look for signs of sickness if crying is excess. The best way to ensure that the baby does not cry much is to see that she is well fed, clean and dry, not moved out in crowded places much and never left alone. 

Just be patient with the baby.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital