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What is a “high need baby”? And do I have one?

by Holly Klaassen; edited by Macall Gordon, M.A.


High-need baby looking surprised

If you’re like most parents of high-need babies, your story to date probably looks a lot like this:

When your baby was born, you realized pretty much right away that something was…different. He likely cried, fussed and screamed from the day he was born, had troubles feeding and had very unpredictable sleep habits.

While your friends’  babies sat quietly in strollers, fell asleep in their cribs, and cried only from distinguishable causes, your little one as waking every hour at night, often feeding frantically, crying most of the day and pretty much inconsolable most evenings.

While other parents gushed, “Don’t you love being a mom?”, you harbored the silent fear that maybe, just maybe, you weren’t meant to be a mom. You had a deep fear that you were doing something wrong…”What kind of a mom doesn’t know what’s wrong with her baby?”, you thought.


You may have even felt like your baby hated you. Strong word, I know, but ones I’ve heard from more than a few parents. And ones I’ve felt myself.


What is a High Need Baby?

While “difficult” babies have been around forever, the term high need baby was coined by Dr. William Sears. Dr. Sears and his wife, Martha, began to specialize in fussy babies when their fourth baby, Hayden, was born. While their first three children had been generally easy babies, Hayden was only happy when being held or fed. It was then that they realized that some babies are just truly high need.


Dr. Sears describes 12 features of high need babies, based on both what they experienced with their daughter, and what they have seen over the years in their pediatric practice. They note that all babies will exhibit some of these traits, some of the time.


He writes:

“All babies will show some of these features some of the time, and these features are descriptive only. As you will see, each of these personality traits has its blessings and its trials. These personality traits should not be judged as “good” or “bad.” They are just differences between babies, but these differences do make high need babies challenging to parent. Ultimately, what matters is how the child learns to use these special gifts. Our goal is to help parents identify these unique features in their infant and child and channel these traits to work to the child’s advantage.”

While my son was most of these things, I’m thankful that he wasn’t ALL of them! I know some of you are struggling with babies who meet all of these criteria, and I applaud you! By the way, at 7 years old, the only characteristic he still displays is being super-sensitive.


Following is a brief summary of the 12 traits of high need babies.

12 Characteristics of High Need Babies

Intense. Make their needs known in a very loud, definitive way. Are passionate about what they want and don’t want, and if you’re not quick to meet their needs, they’ll let you have it. They cry loudly, but the flip side is that they also voice their pleasure loudly.

Highly active. In constant motion, may have stiff or tense muscles, seldom quiet or still, and may even resist being held or cuddled. May resist being swaddled or wrapped, and may be difficult to breastfeed because of their constant movement.

Draining. High needs babies wear you down! They definitely keep you on your toes, and may leave little time for you to recharge your batteries. Because they often don’t sleep well, there is no consistent or predictable down time for you, the parent. This can be extremely tiring and frustrating.

Feeds frequently. High needs babies may desire to nurse or bottle feed more frequently. And you may also wish to feed more frequently to pacify your baby. I have heard from many parents that their high needs baby was in the top percentile for weight due to the high frequency of feedings.

Demanding. This is the child that lets you know, very loudly, what he needs. If you don’t get to him right away, he is quick to voice his displeasure. He feels his needs very strongly and knows how to get them met.

Awakens frequently. Sleeps in short stretches and may also have trouble falling asleep.

Unsatisfied. No matter what you do, your baby may still be grumpy, unhappy, or discontent, even if you’ve tried every calming technique you can think of. Dr. Sears encourages parents to realize when they’ve done all they can, and that the rest is up to their baby.

Unpredictable. One day she falls asleep when you rock her, the next she doesn’t. You’re able to calm her by feeding her one night, but the next night she shrieks when you try to feed her. He sleeps through the night for a few days, and then is up 3+ times the next few nights.

Super-sensitive. Extremely sensitive to their environment and external stimuli. They are constantly observing the world around them, and prefer to be at home, or in a calm and familiar environment. They may startle easily, and are very sensitive to pain or discomfort.

Can’t put baby down. These babies prefer to be held and in constant motion. They may resist sleeping alone, or being relegated to their stroller or bouncy chair. They prefer human touch and movement. High Needs babies tend to do very well when being ‘worn’ in slings or baby carriers.

Not a self-soother. These are the babies that need help to fall asleep. While other babies may be able to drift peacefully off to sleep in their cribs, some babies need to be gently taught how to relax and fall asleep on their own. This may not come until a little later in infancy.

Separation sensitive. Some babies definitely prefer the company of their primary caregivers. It may be difficult to leave them with babysitters or even have someone else hold them. They are deeply attached to their parents as they know that these are the people who meet their needs.

Additional Traits of High Need Babies

In talking to many other parents, I have found several other traits that appear to be quite common in these high need babies:

Difficulty entertaining themselves. Many babies need parents’ help to keep them entertained, particularly before they are able to sit up on their own. However, what I hear from many parents of high need babies is that their baby continues to have trouble playing on their own even into toddlerhood. These babies are often not able to sit on the floor contentedly, even with age appropriate toys, without adult interaction. These babies seem to need the stimulation of interaction more than other babies.

Loves to be around people, noise and activity. While some high need babies do best in quiet, calm environments, what I hear from many, many parents is that their baby actually prefers being in crowds, surrounded by people and activity. They may cry and fuss significantly more in the quiet of their own homes. The activity and drone of crowds or traffic seem to soothe them, and they may even fall asleep. Friends and family may not believe your stories of crying and fussing because these babies appear so easy-going and content when in public.


So, Is it Colic, Fussiness, High Need/Spirited Temperament, or Something Else?

Ah, this is really the question, isn’t it? This is pretty much the goal of this entire site – to help you figure out why your baby is fussy and crying, and how you can cope with it.


The "Normative Crying Curve"

All human babies experience a period of inconsolable crying that tends to happen in the late afternoon/early evening (this is also called "the witching hour"). This phenomenon peaks at six weeks and then subsides.


Colic

If this witching hour period goes on for longer than the six weeks without subsiding, we may be looking at colic. Colic is defined by the "Rule of Threes"—three or more hours of crying, three or more days a week, for three weeks or more. I like the Mayo Clinic‘s description of colic, in particular. It acknowledges that there is more we DON’T know about colic than what we DO know:

“The cause of colic is unknown. Researchers have explored a number of possibilities, including allergies, lactose intolerance, an immature digestive system, maternal anxiety, and differences in the way a baby is fed or comforted. Yet it’s still unclear why some babies have colic and others don’t.”

Most typically, colic begins around 2-3 weeks of age (2-3 weeks adjusted age for babies born prematurely), and is largely gone by 4 months. Parents in China call it "the hundred-day cry."


Despite a wealth of existing research, the root causes of colic are far from clear.

Typically, colic is diagnosed when there is a lack of other symptoms that may indicate conditions such as reflux (GERD) or a sensitivity to dairy. Birth trauma, physiological responses to birth (including torticollis or other muscle tightness), prematurity are also possible culprits. Some babies also may just have a difficult time transitioning to being outside the womb. No definitive "cause" has yet been identified.


It's also important to mention that when doctors say "Oh, it's just colic," it's like saying, "Oh, it's just a head wound." Colic is a serious event and challenges parents in ways that are hard to cope with. I (Macall) have said that I would rather go through my 27-hour hard labor than go through colic again. It will pass. . . eventually, but getting there is a major parenting lift.


Temperament

Many infants who have had colic often go on to have a more reactive, sensitive temperament.


Feeding issues/Silent reflux

Oral ties, poor latch, food intolerance and silent reflux can all be culprits of inconsolable crying. "Silent" reflux means that stomach acid bubbles up into the esophagus and causes pain without causing spit-up. Arching while nursing, "nibble" nursing, hating lying flat, nursing/feeding best while drowsy are common symptoms. Oral ties can make feeding exhausting and then babies are not eating enough.


Colic and/or temperament

Unless a child’s high need behaviours are caused by physical conditions such as reflux or a dairy sensitivity, we are more likely talking about a "spirited" temperament. This term was coined by Mary Sheedy Kurcinka, and is described in detail in her wonderful books, Raising Your Spirited Child and Raising Your Spirited Baby.


Macall Gordon, author and researcher, calls these children "livewires" because they simply seem to have more "current" running through their wiring. This high level of alertness is often seen at birth and is the culprit of many challenges including crying and sleep.

Both "spirited" and "livewire" describe children who are "more" of particular set of temperament traits derived by temperament researchers Alexander Thomas and Stella Chess. (These also overlap with Sears' high-need baby description).


These include:

  • Intensity

  • Persistence

  • Sensitivity

  • High activity level

  • Perceptiveness

You may also notice some ‘bonus’ characteristics such as:

  • Being slow to adapt

  • Being irregular in terms of routines and patterns

  • Being slow to ‘warm up’

  • Being perfectionistic or extremely serious


Many of these children are extremely alert from birth, are early on milestones, appear to fight sleep in order to stay awake and engaged. Parents will routinely say, "It's like she has FOMO. She just does not want to sleep."


Unfortunately, you’ve probably already discovered that there aren’t a lot of good resources online regarding these babies and parents don't always make the connection between their baby's level of alertness and their challenges with crying and colic.


How Do I Cope With my High Need Baby?

This article, written in 2011, gives a great overview of the realities of life with a high need baby. Interviewing both parents and professionals, it gives parents a good idea of what others are going through, and how they can balance their own needs with those of their babies.


I was interviewed for this post, and I still hold fast to my quote from years ago:

“There is hope! I often tell people I wouldn’t trade Sammy for anything. The temperament traits we saw in him as a baby are what make him such a fun, charming, exuberant little boy now. You can’t help but laugh when you’re with him!”

Half the battle is adjusting your thinking and accepting your baby as he or she is. Realize that some babies just have a different temperament, and just need more attention right now.


Try to put aside the expectations and hopes you had for your baby when you were pregnant. Embrace the fact that your baby is who he is, but this isn’t how he will always be.

When your baby is screaming, strap her into the stroller, get yourself a coffee, and go for a long walk.


Don’t worry about your house looking perfect. In a few months, you’ll have more time for that. Arrange to have a babysitter a couple of times a week; don’t worry about your baby’s crying bothering the sitter. This is one day in her life, this is your every day. Order in dinner; homemade meals can wait a while.


But most of all, be gentle with yourself.


The expectations you may have had for what kind of mother you would be probably didn’t take into account having a high-need baby. Don’t expect that you’ll always have warm, fuzzy feelings towards your little one. This is a big hill to climb. You will have all kinds of feelings about it. They are all okay.


Don't hesitate to reach out.

The Fussy Baby Network is a center for training, but they also offer a Warmline staffed by Fussy Baby professionals. You can call or text 1-888-431-2229 or send a message through their website.


Keep an eye on your mental health. Having a fussy baby can take a toll on your physical and mental stamina. Postpartum Support International has a Warmline, as well as online support groups. Call 800-944-4773 or fill out their online contact form.

Find ways to get through it.


I promise, it will get easier.


Holly Klaassen, M.A., founded The Fussy Baby Site in 2007. Her kiddo is now an adolescent, and she's moved into a new field of work. Macall Gordon, M.A., now owns The Fussy Baby Site and Little Livewires LLC. She is the author of the book "Why Won't You Sleep?!" (with Kim West, MSW).

 

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