Crying infant: Difference between revisions
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*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> | *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> | *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> | ||
==Clinical Features== | |||
*Crying and inconsolable infant | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 9: | Line 12: | ||
{{Crying infant DDX}} | {{Crying infant DDX}} | ||
==Work-Up== | ==Evaluation== | ||
===Work-Up=== | |||
*Rule out badness above including [[shaken baby syndrome]] | |||
*Flourescein staining to rule out [[corneal abrasions]] | |||
*Fundoscopic exam | |||
*Rule out [[otitis media (peds)|otitis]] | |||
*Examine all bones/joints to rule out [[fracture]], [[osteomyelitis]] or [[septic joint]] | |||
*Inspect GU area | |||
*Consider skeletal survey & head CT in suspected [[child abuse]] | |||
==Management== | ==Management== | ||
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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 | ||
==Disposition== | |||
==See Also== | ==See Also== | ||
*[[Colic]] | *[[Colic]] | ||
==External Links== | |||
==References== | ==References== | ||
Revision as of 12:55, 14 May 2022
Background
- Mean duration of crying is approximately 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]
Clinical Features
- Crying and inconsolable infant
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
Evaluation
Work-Up
- Rule out badness above including shaken baby syndrome
- Flourescein staining to rule out corneal abrasions
- Fundoscopic exam
- Rule out otitis
- Examine all bones/joints to rule out fracture, osteomyelitis or septic joint
- Inspect GU area
- Consider skeletal survey & head CT in suspected child abuse
Management
- 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
- 4% benefit from change to soy formula
- rocking, warm compresses to belly feeding, frequent burping, diaper changes
Disposition
See Also
External Links
References
- ↑ 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.