What the heck is PURPLE Crying?

For the first few months of Norah’s life, evenings were predictable—and loud.

“It was like clockwork,” Norah’s mom, Jen Monnin , 36, says of her crying. “From about 5 p.m., it just would not stop for even a second until roughly 8 or 9 p.m. Sometimes it would go until 10.”

The routine began about two weeks after Norah’s birth. It was steady, inconsolable crying that seemed to fill their Ottawa home and was immune to the typical new-parent bag of tricks. “We put her in the carrier, bounced her around. We’d of course do the feed-change-burp cycle like a hundred times, do bicycle kicks for gas—pretty much anything we could think of,” says Monnin. “We spoke to our paediatrician a lot. Nothing would help.” 

The bouts were hard on Monnin, and also on her husband, who would typically arrive  home from work just as the crying began. “The only time he spent with her was when she was crying. So he really didn’t get any quality time with her until she was about five months.” 

Traditionally, heavy criers like Norah who lack any other symptoms (such as spitting up or poor weight gain) have simply been said to have colic, which tends to be used as a catch-all diagnosis for babies who cry more than three hours at a time three or more days a week. 

Developmental paediatrician Ronald G. Barr says long crying episodes in the first five months don’t necessarily mean something’s wrong. In fact, he says, to a certain degree, it’s something all babies go through.

Of course, some are sparing in their crying, and some, like Norah, are noise machines. But Barr says all infants have some increase in the duration of their crying in those early months. 

“If you actually do daily diaries of infants, they’ll all have a peak sometime in the first two to three months of life,” says Barr. 

He came up with the concept Period of PURPLE Crying to describe the phase and has spent the past decade using the term to try to help parents understand that prolonged crying fits aren’t necessarily a sign that anything is amiss with a baby. It’s just a normal—but stressful—period of infant development. 

“That’s a major shift for most parents, and for most physicians as well, frankly,” says Barr.

The term is an acronym:

P–Peak of crying (your baby may cry more each week, peaking in month two, and then less in months three to five); U–Unexpected (crying comes and goes, for no apparent reason); R–Resists soothing (your baby may not stop crying, no matter what you try); P–Pain-like face (crying babies may look like they are in pain, even when they are not); L–Long-lasting (crying can last up to five hours a day, or more); E–Evening (your baby may cry more in the later part of the day).

Barr doesn’t consider this concept to be just another name for colic, even though it covers most of the same ground. He sees the PURPLE phase as a stage of development rather than a condition or affliction, which is how people generally think of colic.

The idea is to give parents a better understanding of what their infant is going through and to let them know it eventually will pass.

Of course, any information that can help explain baby behaviour is welcomed by new (and even veteran) parents, but Barr has a specific hope in spreading the word: to reduce instances of abusive head trauma, or what is commonly known as shaken baby syndrome (SBS). Research shows excessive crying is the most common trigger for SBS.

“That’s the concept: having a framework in which to feel and experience these unfortunate irritating cries that your baby has but that nevertheless won’t sort of kick you over the edge so you do something bad that’s going to harm the baby,” he says.

According to the National Center on Shaken Baby Syn­drome, there are about 1,300 cases of SBS every year in the US, but there’s no reliable data on cases in Canada. For the past few years, hospitals in British Columbia, PEI, the Yukon and a handful of US states have implemented programs aimed at educating parents of infants about the Period of PURPLE Crying. 

The effort has already produced some measurable results, though not directly related to SBS: A study conducted at the BC Children’s Hospital found that emergency room visits for crying and colic unrelated to any physical ailment  went down by 29 percent after the Period of PURPLE Crying educational campaign was implemented at the hospital in 2008 and 2009. So, at the very least, understanding what the phase looks like can put some parents’ minds at ease.

Norah’s crying bouts ended abruptly at about four months, right on schedule. “We just got through it. There was really no other dynamic to our relationship at that point besides to just get through it,” Monnin says. “I know that for me, it was really hard.”