Crying Child Over 3 Months of Age - Irritability - Fussiness

DEFINITION

• Excessive crying, irritability or fussiness
• Child is too young to tell us or show us the cause for his crying
• Crying from an illness or physical symptom should be triaged using that topic

• Not caused by hunger, since by this age parents can recognize hunger.
• Main cause: coming down with an illness
• Other common causes: overtired, stressed, whining, tantrums, separation anxiety. This guideline detects many infants with sleep problems.
• Painful causes include earache, blocked nose from cold, sore throat, mouth ulcers, raw diaper rash, meatal ulcer on tip of penis, constipation. Teething generally doesn't cause crying.

See More Appropriate Topic (instead of this one) If

• FEVER or any symptom of illness (e.g., diarrhea or constipation), see that topic
• Crying from an injury, see specific INJURY topic

WHEN TO CALL YOUR DOCTOR

HOME CARE ADVICE FOR MILD CONSOLABLE CRYING

1. Reassurance: Most infants/toddlers become somewhat irritable and fussy when sick or overtired. Crying tells us your child is not feeling well. If the crying responds to comforting, it's probably not serious.
2. Comforting: Try to comfort your child by holding, rocking, massage, etc.
3. Sleep: If your child is tired, put him to bed. If he needs to be held, hold him quietly in a horizontal position or lie next to him. Some overtired infants need to cry themselves to sleep.
4. Undress Your Child: Sometimes part of the clothing is too tight or uncomfortable. Also check the skin for redness or swelling (e.g., insect bite).
5. Discontinue Medicines: If your child is taking a cough or cold medicine, stop it. The crying should stop within 4 hours. Antihistamines (e.g., Benadryl) can cause screaming and irritability in some children. Pseudoephedrine (decongestant) can cause jitteriness and crying.
6. Expected Course: Most fussiness with illnesses resolves when the illness does. Most fussiness due to stress or change (e.g., new day care) lasts less than 1 week.
7. Call Your Doctor If:
   • Constant crying lasts over 2 hours
   • Intermittent crying lasts over 2 days
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.