What is Purple Crying and How Does it Relate to Shaken Baby Syndrome?

By: Cristina Moreno, Bilingual Outreach Specialist, Penfield Children’s Center

Before I could take my son home from the NICU, there was a whole checklist of things that had to be done. Most of them were a variety of tests he had to pass to ensure he would be safe to leave the hospital, but there were also a series of trainings we, his parents, had to complete as well. Among those trainings was one called PURPLE Crying. The term “Purple Crying” can give the impression that it is a child who cries so much that their face becomes purple, but it is actually an acronym to describe a period in an infant’s life that may be characterized by inconsolable crying which can be very frightening and frustrating for parents. PURPLE stands for:

Peak of crying – usually peaks around 2 months of age and lessens by 3 or 4 months
Unexpected – crying can come and go without an apparent reason
Resists soothing – your attempts to comfort your baby may not work
Pain-like face – baby may look like he is in pain even if he is not
Long lasting – crying may persist for 5 hours a day or more
Evening – most often occurs in the late afternoon or evening

The Period of PURPLE Crying is a concept that was developed by developmental pediatrician Dr. Ronald Barr in an effort to help parents understand that this phase of crying does not mean that a child is ill or that the parent is doing something wrong, but rather that it is a normal part of development that will eventually pass. Dr. Barr says this phase, which begins around 2 weeks of age and usually ends at about 3 to 4 months, is something all children go through. Crying is a normal behavior all babies do and is their earliest form of communication. Studies show that this pattern of crying, known as the crying curve or the distress curve, occurs in children all around the world and has nothing to do with parenting styles. All babies experience a period of their life in which crying increases until it peaks and then gradually decreases. However, not all babies experience this crying curve quite the same way, which is why some babies may appear to be more calm and quiet if their crying peak lasts only one hour a day as opposed to a baby who seems to always be upset or uncomfortable if their crying peak lasts 5 hours a day or more. Dr. Barr also divides crying into three different categories, fussing, crying, and inconsolable crying, and infants may experience these three types of crying differently as well. For example, you may have a child who fusses quite often but can usually be soothed or you may have a child who is quite content and not fussy but experiences inconsolable crying for which no soothing techniques seem to help.

Dr. Barr also shares information about PURPLE Crying with parents and caregivers for another important reason, as an effort to draw attention to the dangers of Shaken Baby Syndrome (SBS) and how it relates to PURPLE Crying. Shaken Baby Syndrome is used to describe a series of signs or symptoms that occur as a result of an infant or young child being violently shaken. A few of the symptoms of SBS include neurologic damage, brain swelling, bruising, neck or spinal cord injury, and damage to the eyes, many of which can lead to long-term damage and disabilities, or even death. While SBS is most often seen as a form of child abuse that is related to risk factors such substance abuse, mental health problems, and other individual characteristics, cases in which SBS results from a normally loving caregiver who is tired and frustrated by a child experiencing PURPLE Crying are not unheard of. Understanding both our feelings about PURPLE Crying and the dangers of shaking a baby are very important for parents to ensure the safety of their young children.

The early weeks and months of parenting can be difficult for anyone, but especially those whose children are experiencing extended periods of unexplained and inconsolable crying. If you have a child who is exhibiting signs of PURPLE Crying and are feeling overwhelmed, be sure to accept support from family and friends or seek help from a doctor, counselor, or parenting helpline if you feel that you are struggling to cope with your child’s behavior.

Has your child experienced extended periods of unexplained and inconsolable crying? How did you keep calm and cope with his/her behavior?

You can learn more about PURPLE Crying and Shaken Baby Syndrome here: http://purplecrying.info/what-is-the-period-of-purple-crying.php http://purplecrying.info/sub-pages/crying/why-does-my-baby-cry-so-much.php http://purplecrying.info/sub-pages/crying/why-this-crying-is-normal.php https://www.dontshake.org/learn-more

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