INFANT AND TODDLER

EXCESSIVE CRYING

Normally all infants cry for some or the other reason. In the first month of life, crying is most important as infants have quite few effective methods for communicating their requirements. Studies have shown that infants typically show an increase in their crying level across first three months, with a peak around 6-8 weeks of age. Since crying is considered as normal communicative signal of a child, developmental changes in children who cry within the normal range is common. However, some infants exceed the usual pattern of crying, such as crying for long, hard and inconsolable during their growth period.

Excessive crying refers to the crying that continues for longer than usual time for a given child after every possible attempt to meet routine need of an infant or toddler.

CAUSES

Colic: Excessive crying infants are often at risk leading to developmental problems. Unexplained, excessive or persistent crying in the first 3 months of life that occurs in a healthy infant is labeled as infant colic. Colic is extremely common and occurs in up to 40 percent of all infants. It usually starts somewhere between the third and sixth week after birth and ends when a baby is three to four months of age.

Immunization: Your child may be fussy, cry more than usual, and have a fever after receiving an immunization, especially diphtheria, tetanus, and pertusis.

Teething:  

Teething symptoms may begin about 3 to 5 days before a tooth breaks the skin, although symptoms are present for 1 to 2 months. The most common symptoms of teething include swelling, tenderness, or discomfort in the gums at the site of the erupting tooth, drooling, biting fingers or toys, irritability or difficult in sleeping.

Constipation:  A crying episode that occurs when passing a stool normally will stop when the stool is passed, but in severe case crying period extends.

Diaper rash:  Irritated skin around the thighs, genitals,buttocks, or abdomen makes a child cry persistently, especially when the diaper is wet or soiled.

Medical disorders: Some disorders are uncomfortable but not immediately dangerous to the child. 

Such less serious causes of crying include

·    Gastro-esophageal reflux

·    Hair wrapped around a finger or toe (hair tourniquet),

·   A scratch on the surface of the eye (corneal abrasion), insect bite, anal fissure and Otitis.

Serious disorders include:  

·   A blocked intestine caused by intussusception ( part of the intestine folds into another section of intestine)

·   volvulus (twisting of the intestine),

·   Heart failure,

·   Meningitis and

·   Head injuries that causing bleeding into the skull.

Infants with such severe disorders often have other symptoms (vomiting or fever), which alert parents regarding presence of serious problem. However, sometimes excessive crying is itself the first sign.

COMFORTING MEASURES

· Comforting techniques, such as swing your baby, breast-feeding, or using pacifier after breast-feeding.

·  Place a child in a safe, quiet place and leave alone for 15 to 20 minutes. Sometimes children can relax and soothe themselves. Be sure to stay close by.

·  Talk child to doctor before giving any nonprescription medicines or herbal remedies as a comfort measure. Products including alcohol or sugar in them are not recommended to infants and toddlers.

·  Don’t get angry at your child for crying. Never shake or harm child. Shaking a child in anger or playing rough, such as throwing a baby up into the air and catching can cause shaken baby syndrome.

MEDICAL ATTENTION:

Call /visit pediatrician during the day or night if any of the following occur:

•     The baby has cried for more than two hours.
•           If crying could be the result of an injury or fall.
•      The baby has a fever of ≥100.4ºF (38ºC).
•      The infant refuses to eat or drink anything for more than a few hours, vomits excessively, is not urinating well, has bloody stools, or has a change in behavior, including lethargy or decreased responsiveness.

Persistence of crying beyond the first 3 months predicts a higher prevalence of behavioral and emotional disorders in children with excessive crying than in children without excessive crying. It is therefore important to offer timely help through developmental counseling, physiotherapy, or even parent-infant psychotherapy.