II. General

  1. "Not all crying is hunger"
    1. Infants who stop crying when picked up or held
      1. Do not usually need food, only need to be held
    2. Inconsolable Infant despite being held
      1. Needs evaluation for other causes
      2. See Inconsolable Crying in Infants
  2. Infant cries are distinguishable
    1. By 3 days, a mother can tell her own babies' cry
    2. By 3 weeks, mothers distinguish the 6 types of cries

III. Precautions

  1. Inconsolable Infant presenting to the emergency department
    1. Potential red flag and requires thorough history and examination
    2. Causes may be as benign as colic and as serious as Sepsis, Meningitis or Intussusception

IV. Signs

  1. See Inconsolable Crying in Infants
  2. See Trained Night Crier
  3. See Trained Night Feeder
  4. Painful cry
    1. Piercing, painful sounding cry
  5. Hunger cry
    1. Demanding, urgent cry
    2. Not receiving enough milk at each feeding
  6. Colic cry
    1. See Infant Colic
  7. Boredom cry
    1. Bored, hollow cry
  8. Discomfort cry
    1. Too much or uncomfortable clothing
    2. Wet or Soiled clothing
    3. Swallowed air (gas)
    4. Environment too hot or too cold
    5. Illness
  9. Fussy
    1. Rhythmic, but not urgent cry
    2. Associated with some thrashing moves
    3. May regularly occur at the end of the day
    4. Letting off steam after a busy day

V. Management: Soothing the Crying Infant

  1. General Measures
    1. Swaddling
    2. Holding
    3. Rocking
    4. Music
    5. Pacifiers
  2. Educate Caregivers on Nonaccidental Trauma
    1. Shaking, smothering, striking or otherwise applying force can irreversibly injure or kill a child
    2. Encourage Caregivers to take breaks, maximize assistance and social support
  3. Attend to specific needs
    1. Hunger
    2. Tiredness
    3. Diaper change
  4. Treat specific pain or fever when the cause is known
    1. Avoid continuous Analgesic use when source of pain is unknown (e.g. masking Fever Without Focus)
    2. Acetaminophen
    3. Ibuprofen
  5. Avoid other non-specific OTC medications, herbal preparations or supplements
    1. See Infantile Colic regarding the lack of evidence and potential harm from these agents
    2. Avoid changing formula or discontinuing Breast Feeding due to crying alone

VI. References

  1. Kosoko and Abraham (2021) Crit Dec Emerg Med 35(8): 3-9

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Related Studies

Ontology: Crying infant (C0581876)

Concepts Finding (T033)
SnomedCT 162214009
English infant crying, Crying;infant, crying infant, crying infants, cry infants, infant cry, Crying in infants, Crying infant, Crying infant (finding)
Spanish lactante que llora (hallazgo), lactante que llora

Ontology: Fussy infant (baby) (C1135254)

Concepts Disease or Syndrome (T047)
ICD9 780.91
ICD10 R68.12
English Fussy infant/baby, Fussy infant (baby)