During first few days, most babies sleep throughout the day while they are awake, noisy and troublesome during the night. This is due to continuation of in-utero pattern of their activity. It seems that during waking hours, while mother is walking or working, the baby is rocked in the water-filled amniotic sac. He, therefore, sleeps during the day, while at night when mother goes to bed, the baby wakes up and plays by actively moving his limbs. Moreover, the baby has no perception of day and night and he exhibits identical pattern of activity round-the-clock. The babies are less likely to be fed at night and they often cry due to hunger. The crying at night, to some extent, may be apparent because episodes of crying sound louder in the solitude of night and they are more disturbing to the tired and sleepy mother and intolerant neighbours. It usually takes about 6 to 8 weeks before the baby establishes the routine of sleeping more at night and playing during the day-time.
No two babies are alike, some babies cry more readily than others and would scream vigorously without any patience for a minor reason. The babies. usually cry when they are hungry or in discomfort. Crying may be due to unpleasant sensation of full bladder before passing urine, painful evacuation of hard stools or mere soiling by the urine and stools. An experienced mother or physician can distinguish between the cry used as a signal for food and the cry of discomfort. The spells of crying unrelieved either by feeding, changing the soiled napkins or by rocking the baby may be due to abdominal colic. Such a baby. may produce audible gurgling sounds and feels comfortable in a prone position which facilitates the expulsion of gas from below and above. The otitis media causes intractable, continuous, uninterrupted crying. Diagnosis may be suspected if there is associated fever or nasal catarrh. The insect bites should also be kept in mind as an important cause of night crying. The baby may cry due to loneliness and boredom. Night crying with arching of back is a symptom of gastroesophageal reflux. Excessive crying is associated with inflammatory painful conditions, cerebral irritability, narcotic-withdrawal syndrome, thyrotoxicosis and ephedrine toxicity. Most babies are cranky and fussy while dozing off to sleep. The crying baby should be handled with patience, common sense and good humor.