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Crying Child - 3 Months and Older

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Does this describe your child's symptoms?

 

Definition

  • Excessive crying, irritability or fussiness

  • Child is too young to tell us or show us the cause for his crying

  • Crying is the only symptom

  • Crying from an illness or physical symptom should be triaged using that topic

Causes

  • Main cause: coming down with an illness. Young children cry about being sick, even if they don't have any pain.

  • Physical pain: Painful causes include earache, sore throat, mouth ulcers, raw diaper rash, meatal ulcer on tip of penis, constipation.

  • Behavioral causes: overtired, stressed, whining, tantrums, separation anxiety. This topic detects many infants with sleep problems. Crying also occurs during sleep habit re-training programs. Some preverbal children (before 2 years) cry for everything.

  • Teething: Teething generally doesn't cause crying.

  • Gas: Gas in the intestines does not cause crying.

  • Hunger: Not caused by hunger, since by this age you can recognize hunger.

  • Decongestants (pseudoephedrine or phenylephrine) also can cause jitteriness and crying in some children. (Note: FDA does not recommended cough and cold medicines for children under 4 years.)

If not, see these topics

  • FEVER or any symptom of illness (e.g., diarrhea or constipation), see that topic

  • Crying from an injury, see specific INJURY topic

  • Immunization(s) within the last 4 days, see IMMUNIZATION REACTIONS

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When to Call Your Doctor

call 911

Call 911 Now (your child may need an ambulance) If

  • Not moving or very weak

call now

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick

  • Stiff neck or bulging soft spot

  • Won't move one arm or leg normally

  • Cries every time if touched or moved

  • Possible injury (especially head or bone injury)

  • Very irritable, screaming child for over 1 hour

  • You are afraid you or someone might hurt or shake your baby

  • Crying continuously (cannot be comforted) for more than 2 hours

  • Refuses to drink or drinking very little for more than 8 hours

  • You think your child needs to be seen urgently

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently

  • Pain (eg. earache) suspected as cause of crying

  • Crying intermittently (can be comforted) BUT child not acting normally when not crying

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Mild, off-and-on fussiness (acts normal when not crying) continues over 2 days

  • Excessive crying is a chronic problem

home care

Parent Care at Home If

  • Mild fussiness of unknown cause present less than 2 days and you don't think your child needs to be seen

  • Normal protest crying

  • Temper tantrum crying

  • Sleep problem crying

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HOME CARE ADVICE FOR MILD CONSOLABLE CRYING

Mild Fussiness of Unknown Cause

  1. Reassurance:

    • Your child is crying and fussing more than usual, but acting normal when not crying.

    • He could be coming down with an illness and that will usually become clear in a day or so.

    • He could be reacting to some changes in your home or child care setting. See if you can come up with some ideas.

    • Children can also temporarily go through a "clingy phase" without an explanation.

    • If the crying responds to comforting, it's not serious.

  2. Comforting: Try to comfort your child by holding, rocking, massage, etc.

  3. Sleep: If your child is tired, put him to bed. If he needs to be held, hold him quietly in a horizontal position or lie next to him. Some overtired infants need to cry themselves to sleep.

  4. Undress Your Child: Sometimes part of the clothing is too tight or uncomfortable. Also check the skin for redness or swelling (e.g., insect bite).

  5. Discontinue Medicines:

    • If your child is taking a cough or cold medicine, stop it.

    • The crying should stop within 4 hours.

    • Antihistamines (e.g., Benadryl) can cause screaming and irritability in some children.

    • Pseudoephedrine (decongestant) can cause jitteriness and crying.

    • The FDA does not approve any of these medicines for children under 4 years old.

  6. Expected Course: Most fussiness with illnesses resolves when the illness does. Most fussiness due to family stress or change (e.g., new child care) lasts less than 1 week.

  7. Call Your Doctor If:

    • Constant crying lasts over 2 hours

    • Intermittent crying lasts over 2 days

    • Your child becomes worse

Normal Protest Crying

  1. Reassurance:

    • Normal children cry when they don't get their way.

    • Normal children cry when you make changes in their routines.

    • Crying is their only form of communication in the first years of life.

    • Crying can mean, "I don't want to".

    • This is called normal protest crying and is not harmful.

    • Do not assume that crying means pain.

  2. Call Your Doctor If:

    • You have other questions or concerns

Temper Tantrum Crying

  1. Reassurance:

    • Crying is the most common symptom of a temper tantrum.

    • This is likely the cause if most of the crying occurs when your child is angry, upset or trying to get his way.

    • All kids have some temper tantrums, starting at about 9 months of age.

  2. Tips for Responding to Temper Tantrums:

    • Ignore most tantrums (e.g., demanding something the child doesn't need).

    • For tantrums from frustration (e.g., when something doesn't work), help your child.

    • For aggressive (hitting) or destructive (throwing) tantrums, put in timeout until your child calms down.

    • Don't give in to tantrums. No means No.

    • Be a good role model. Avoid yelling or screaming at others (adult tantrums).

  3. Call Your Doctor If:

    • You have other questions or concerns

Sleep Problem Crying

  1. Reassurance:

    • Your child may have a sleep problem if most of your child's crying occurs when you put him in his crib (or bed) and at night. Suspect a sleep problem if your child acts normal during the day.

    • Sleep problems are common in childhood.

  2. Tips for Treating the Sleep Problem:

    • Re-train your child to be a good sleeper at bedtime and naptime.

    • Place your child in the crib "drowsy but awake".

    • Once placed in the crib, don't take out again.

    • Visit your child as often as needed until asleep.

    • For night awakenings, however, it's fine to hold your child.

    • Do all of this in a loving way with a calm voice.

    • Never feed until asleep.

    • Never sleep in the same bed with your child.

  3. Call Your Doctor If:

    • You have other questions or concerns

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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