II. General
- "Not all crying is hunger"
- Infants who stop crying when picked up or held
- Do not usually need food, only need to be held
- Inconsolable Infant despite being held
- Needs evaluation for other causes
- See Inconsolable Crying in Infants
- Infants who stop crying when picked up or held
- Infant cries are distinguishable
- By 3 days, a mother can tell her own babies' cry
- By 3 weeks, mothers distinguish the 6 types of cries
III. Precautions
-
Inconsolable Infant presenting to the emergency department
- Potential red flag and requires thorough history and examination
- Causes may be as benign as colic and as serious as Sepsis, Meningitis or Intussusception
IV. Signs
- See Inconsolable Crying in Infants
- See Trained Night Crier
- See Trained Night Feeder
- Painful cry
- Piercing, painful sounding cry
- Hunger cry
- Demanding, urgent cry
- Not receiving enough milk at each feeding
-
Colic cry
- See Infant Colic
- Boredom cry
- Bored, hollow cry
- Discomfort cry
- Too much or uncomfortable clothing
- Wet or Soiled clothing
- Swallowed air (gas)
- Environment too hot or too cold
- Illness
- Fussy
- Rhythmic, but not urgent cry
- Associated with some thrashing moves
- May regularly occur at the end of the day
- Letting off steam after a busy day
V. Management: Soothing the Crying Infant
-
General Measures
- Swaddling
- Holding
- Rocking
- Music
- Pacifiers
- Educate Caregivers on Nonaccidental Trauma
- Shaking, smothering, striking or otherwise applying force can irreversibly injure or kill a child
- Encourage Caregivers to take breaks, maximize assistance and social support
- Attend to specific needs
- Hunger
- Tiredness
- Diaper change
- Treat specific pain or fever when the cause is known
- Avoid continuous Analgesic use when source of pain is unknown (e.g. masking Fever Without Focus)
- Acetaminophen
- Ibuprofen
- Avoid other non-specific OTC Medications, herbal preparations or supplements
- See Infantile Colic regarding the lack of evidence and potential harm from these agents
- Avoid changing formula or discontinuing Breast Feeding due to crying alone
VI. References
- Kosoko and Abraham (2021) Crit Dec Emerg Med 35(8): 3-9