So Many Baby Tears: Colic or PURPLE Crying Explained

Babies cry, and they cry a lot — when they are hungry, cold, hot, uncomfortable, overstimulated, lonely, or in need of a diaper change. But sometimes, they just cry. Periods of crying in healthy babies may seem never-ending, and this requires a lot of support and patience. This is called the period of PURPLE crying, sometimes also called colic. Learn to recognize patterns of crying in your infant.

Colic and PURPLE crying

Healthy babies may go through a developmental stage of increased crying from 2 weeks old through 3–4 months of age. It may look like they are in pain, but no matter how you try to soothe them, they continue to cry. Doctors often refer to this as “colic”, but that doesn’t mean an infant is abnormal or has an illness.

Studies show that in these episodes of increased crying, babies are not in pain even though they are crying loudly for long periods. Experts came up with the acronym PURPLE to identify this stage, but not because babies change color when they cry.

Why is it called purple crying?

Coping with frequent, long periods of crying requires lots of support for parents. It can make parents feel hopeless, frustrated, and angry. In response, the National Center on Shaken Baby Syndrome developed the Period of PURPLE Crying to help parents understand early increased infant crying and reduce incidences of the shaken baby syndrome and abusive head trauma. The acronym means:

• Peak of crying. Babies may cry more each week, the most in month 2 and less in months 3-5.
• Unexpected. Waves of crying may come and go without warning.
• Resists soothing. Babies may not stop crying no matter how you try to comfort them.
• Pain-like face. A crying baby may look like they are in pain, even when they’re not.
• Long-lasting. Persistent episodes of crying can last as long as 5 hours a day or more.
• Evening. Babies may cry more in the late afternoon and evening.

It is a period of time with a beginning and an end when your baby may cry the most. Crying episodes are frustrating and distressing, but it does not mean parents are incompetent. Remember, crying during this stage is normal – even when it seems endless.

What if something is wrong?

It’s important to make sure your baby isn’t crying for a health reason. Call your doctor if you notice the following symptoms:

• Temperature. Fever over 100F;
• Responsiveness. Change in activity or alertness;
• Appetite. Less feeding than usual;
• Vomit. Vomiting more than usual;
• Stools. Loose stools or blood in stool;
• Weight. Weight loss or poor weight gain.

Soothing tips for PURPLE crying

If your baby begins crying without any of those signs there are some soothing tips you can try which might help:

Coping with extended periods of crying requires support. You don't have to do everything alone, it's okay to reach out to family and friends. If nothing you try works to soothe your baby, you should:

• Rest. Take a break! Call a friend or family member to take over for you.
• Calm. If you are feeling so angry or frustrated that you feel you could hurt your baby, put them on their back in a crib until you feel calmer. Never shake your baby.

Do not blame yourself. This stage is hard! Your baby will outgrow this. When your baby starts crying, and you can’t find a health reason for it, the PURPLE acronym is a tool you can use to assess their crying and think through what to do next. If your baby doesn’t stop crying and you are getting frustrated, it is ok to safely place them on their back in a crib and step away until you feel calmer. PURPLE crying is a stage – babies will outgrow it. If you are concerned that their increased crying is due to a health reason, call their doctor for further evaluation.