Crying infant: Difference between revisions
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==Background== | |||
*Mean duration of crying is approx 2 hrs/day for the first 6 wks<ref>Wolke D, et al. Meta-analysis of fuss/cry durations and colic prevalence across countries. In: Proceedings of the 11th International Infant Cry Research Workshop. 8-10 June 2011. Zeist, The Netherlands.</ref> | |||
*This decreases to 72 mins/day by age 10-12 wks | |||
*As many as 43% of infants experience excessive crying<ref>Reijneveld SA, et al. Excessive infant crying: the impact of varying definitions. Pediatrics. 2001; 108(4):893-897.</ref> | |||
*5% of crying infants are found to have underlying disease<ref>Barr, RG. Colic and crying syndromes in infants. Pediatrics. 1998; 102(5):1282-1286.</ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Crying infant DDX}} | {{Crying infant DDX}} | ||
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# 4% benefit from change to soy formula | # 4% benefit from change to soy formula | ||
# rocking, warm compresses to belly feeding, frequent burping, diaper changes | # rocking, warm compresses to belly feeding, frequent burping, diaper changes | ||
==Treatment== | |||
*If no underlying cause is found attempt the "5 Ss" | |||
**'''S'''waddling | |||
**'''S'''ide/'''S'''tomach position while awake | |||
**'''S'''hhhhing to provide soothing sound | |||
**'''S'''winging the baby in parent's arms | |||
**'''S'''ucking on breast or pacifier | |||
==Source== | ==Source== | ||
<references/> | |||
[[Category:Peds]] | [[Category:Peds]] | ||
Revision as of 18:43, 7 June 2015
Background
- Mean duration of crying is approx 2 hrs/day for the first 6 wks[1]
- This decreases to 72 mins/day by age 10-12 wks
- As many as 43% of infants experience excessive crying[2]
- 5% of crying infants are found to have underlying disease[3]
Differential Diagnosis
Crying Infant
- Occult infection
- GI
- Intussusception
- GERD
- Incarcerated hernia
- Milk protein intolerance
- Anal fissure
- Ophtho
- Occult trauma
- Hair tourniquet (on extremities, penis)
- Non-accidental trauma
- Diaper pin
- Insect bites
- Burns in mouth
- Misc
- Colic
- Scorpion envenomation
- SVT
- Testicular torsion
- Drug exposure/overdose (commonly methamphetamine or cocaine)
- Neonatal abstinence syndrome, drug withdrawal
Work-Up
- rule out badness above including shaken baby
- flourescein staining to r/o corneal abrasions
- fundoscopic exam
- r/o otitis
- examine all bones/joints to r/o fx, osteo or septic joint
- inspect GU area
- Skeletal survey & head CT in suspected child abuse
- 4% benefit from change to soy formula
- rocking, warm compresses to belly feeding, frequent burping, diaper changes
Treatment
- If no underlying cause is found attempt the "5 Ss"
- Swaddling
- Side/Stomach position while awake
- Shhhhing to provide soothing sound
- Swinging the baby in parent's arms
- Sucking on breast or pacifier
Source
- ↑ Wolke D, et al. Meta-analysis of fuss/cry durations and colic prevalence across countries. In: Proceedings of the 11th International Infant Cry Research Workshop. 8-10 June 2011. Zeist, The Netherlands.
- ↑ Reijneveld SA, et al. Excessive infant crying: the impact of varying definitions. Pediatrics. 2001; 108(4):893-897.
- ↑ Barr, RG. Colic and crying syndromes in infants. Pediatrics. 1998; 102(5):1282-1286.