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Topic Overview

Crying lets others know when a young child is hungry, wet,
tired, too warm, too cold, lonely, or in pain. If your child is crying, try to
identify the type of cry. It helps to go through a mental checklist of what
might be wrong-but remember that there may be nothing bothering your child-and
to make sure your child is safe and cared for. As parents or caregivers respond
to the young child’s other signals (such as whimpering, facial expressions, and
wiggling), the child will usually cry less.

Parents and caregivers
become better over time at identifying the young child’s cry. A young child
will often have different kinds of cries.

Crying related to normal development and behavior

  • Hungry cries. Hungry
    cries start with a whimper and become louder and longer. Your hungry child will
    eagerly accept feeding and stop crying.
  • Upset cries. Upset cries are loud and start suddenly. Your young child may be
    afraid, bored, or lonely. As your child gets older, upset crying may be a
    reaction to such things as loud noises, frustration with clothing or toys, or
    fear of strangers.
  • Pain cries. Pain cries
    start with a high-pitched, strong wail followed by loud crying. These cries
    sound very irritating and may make you feel anxious. A young child in
    pain will often have
    other signs of pain along with crying. Commonly, pain
    cries may be caused by:

    • A recent immunization. Your child may be
      fussy, cry more than usual, and have a fever after receiving an immunization,
      especially diphtheria, tetanus, and pertussis (DTaP) shots. But he or she
      will look well even while continuing to cry.
    • Teething. Teething symptoms may begin about 3 to 5
      days before a tooth breaks the skin, although symptoms can be present off and
      on 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 on fingers or toys; irritability; or difficulty
      sleeping. Teething may cause a mild increase in your child’s temperature. But if the temperature is higher
      than 100.4°F (38°C), look for symptoms that may be related to an infection or illness.
    • Constipation. A crying episode that
      occurs when the child is trying to pass a stool normally will stop when the
      stool is passed.
    • Diaper rash. Irritated skin around the
      thighs, genitals, buttocks, or abdomen may make a child cry persistently,
      especially when a diaper is wet or soiled.
    • Colic. All
      babies cry, but sometimes a baby will cry for hours at a time, no matter what
      you do. This extreme type of crying in a baby who is between 3 weeks and 3
      months of age is called colic. While it is upsetting for parents and
      caregivers, colic is normal for babies. Doctors usually diagnose colic when a
      healthy baby cries harder than expected in a “3” pattern: more than 3 hours a
      day at least 3 days a week for at least 3 weeks in a row. The crying is usually
      worst when babies are around 6 to 8 weeks of age, and it goes away on its own
      between 8 and 14 weeks of age. Doctors are not sure what causes colic. It may be related to gas in the belly, an immature nervous system, or your baby’s temperament.
    • Abdominal cramps from
      overfeeding or
      milk intolerance. Overeating or swallowing too much
      air during feeding can cause abdominal cramps, which in turn can make a baby
      cry. Crying also may occur if your child is sensitive to milk protein. The baby
      will often spit up some of the feeding and may have loose stools.
    • A
      minor illness, such as a cold or
      stomach flu (gastroenteritis). Crying related to an
      illness often begins suddenly. In most cases, there are other signs of illness
      such as fever, looking sick, and decreased appetite.
    • Minor
      injuries. Your child is likely to cry when he or she has an injury, such as an
      eyelash in the eye, an insect bite, an open diaper pin in the skin, or a strand
      of hair wrapped around a finger, toe, or the penis.
  • Overtired or overstimulated cries. Crying can be your young child’s way of releasing tension when
    there is too much noise, movement, or activity in his or her environment or
    when he or she is overtired.

Crying related to a serious illness or injury

On rare
occasions, crying may point to a serious illness or injury. Crying caused by a
serious illness or injury usually lasts much longer than normal and your baby may not be acting normally.

  • Some illnesses may cause persistent crying.
    These include common infections, such as ear infections (otitis media) or
    urinary tract infections, and rarer infections, such
    as
    meningitis,
    encephalitis, or
    sepsis with
    dehydration. A persistent cry in a newborn may be the
    first sign of a serious illness, such as sepsis.
  • A serious injury
    from a fall, being shaken, or
    abuse may cause a child to cry for a long time. Other
    signs of injury, such as swelling, bruising, or bleeding, are usually
    present.

Crying and shaken baby syndrome

Crying can be very
frustrating for a parent or caregiver. Do not get angry at your child for
crying. Never shake or harm your child. Shaking a child in anger or playing
rough, such as throwing him or her into the air, can injure the brain.
Shaken baby syndrome needs to be reported to your
doctor. If you find that you are losing patience or are afraid that you may
hurt your child:

  • Place your child in a safe place while you go
    into another room, relax, and calm yourself.
  • Ask someone to help
    you. If you cannot find someone to take over for you and you still feel out of
    control, call your doctor.

Crying related to medical conditions

Certain medical
conditions can cause a young child to cry, such as
gastroesophageal reflux,
inguinal hernia, or
intussusception.

Check your child’s symptoms to decide if and when
your child should see a doctor.

Check Your Symptoms

Are you concerned about your child’s crying?
Yes
Concern about child’s crying
No
Concern about child’s crying
How old are you?
Less than 3 months
Less than 3 months
3 months to 3 years
3 months to 3 years
4 years or older
4 years or older
Are you male or female?
Male
Male
Female
Female
Has your child had a head injury?
Yes
Head injury
No
Head injury
Does your child have a respiratory problem?
Respiratory problems can affect the nose, mouth, sinuses, and throat (upper respiratory system) or the bronchial tubes and lungs (lower respiratory system).
Yes
Respiratory problem
No
Respiratory problem
Do you think your child has a fever?
Yes
Fever
No
Fever
Does your child have symptoms of shock?
Yes
Signs of shock
No
Signs of shock
Does your baby seem sick?
A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat.
Yes
Baby seems sick
No
Baby seems sick
How sick do you think your baby is?
Extremely sick
Baby is very sick (limp and not responsive)
Sick
Baby is sick (sleepier than usual, not eating or drinking like usual)
Is your baby having trouble breathing?
Sometimes babies may have trouble breathing because of a stuffy nose. If your baby’s nose is stuffy, clearing the nose with a rubber bulb may help.
Yes
Difficulty breathing
No
Difficulty breathing
Would you describe the breathing problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Is your child having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than stuffy nose
No
Difficulty breathing more than stuffy nose
Would you describe the breathing problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Has your baby refused 2 or more feedings in a row?
Yes
Refused 2 or more feedings in a row
No
Refused 2 or more feedings in a row
Does your child have pain?
Yes
Pain
No
Pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has your child been crying for more than 30 minutes without stopping?
Yes
Crying continuously for more than 30 minutes
No
Crying continuously for more than 30 minutes
Did your child have (or could your child have had) a recent fall or injury?
Yes
Possible injury or fall
No
Possible injury or fall
Does comforting your child seem to help with the crying?
Yes
Able to console child
No
Unable to console child
Does your child refuse to use an arm or leg or refuse to stand or walk (for children who are old enough to walk)?
Not wanting to use an arm or leg or not wanting to stand could be a sign of pain.
Yes
Refusing to use an arm or leg
No
Refusing to use an arm or leg
Do you think that your child’s crying may be caused by abuse?
Yes
Crying may be caused by abuse
No
Crying may be caused by abuse
Are you concerned that the crying may make you lose control and hurt your child?
Yes
Concern about possibly harming child
No
Concern about possibly harming child
Is your child not acting the way he or she usually does?
This could include crying more than usual, sleeping more, not eating, or crying with a different type of cry than what you are used to.
Yes
Child acting differently
No
Child acting differently
Do you have concerns about your child’s repeated crying or possible colic?
Yes
Concerns about recurrent crying or colic
No
Concerns about recurrent crying or colic

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

  • Your age. Babies and older
    adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
    disease, you may need to pay closer attention to certain symptoms and seek care
    sooner.
  • Medicines you take. Certain
    medicines, herbal remedies, and supplements can cause symptoms or make them
    worse.
  • Recent health events, such as surgery
    or injury. These kinds of events can cause symptoms afterwards or make them
    more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
    use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

  • Try home treatment to relieve the
    symptoms.
  • Call your doctor if symptoms get worse or you have any
    concerns (for example, if symptoms are not getting better as you would expect).
    You may need care sooner.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example:

  • The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
  • The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).

Severe trouble breathing means:

  • The child cannot eat or talk because he or she is
    breathing so hard.
  • The child’s nostrils are flaring and the belly
    is moving in and out with every breath.
  • The child seems to be
    tiring out.
  • The child seems very sleepy or confused.

Moderate trouble breathing means:

  • The child is breathing a lot faster than
    usual.
  • The child has to take breaks from eating or talking to
    breathe.
  • The nostrils flare or the belly moves in and out at times
    when the child breathes.

Mild trouble breathing means:

  • The child is breathing a little faster than usual.
  • The child seems a little out of breath but can still eat or talk.

A baby that is extremely sick:

  • May be limp and floppy like a rag
    doll.
  • May not respond at all to being held, touched, or talked
    to.
  • May be hard to wake up.

A baby that is sick (but not extremely
sick):

  • May be sleepier than usual.
  • May not eat
    or drink as much as usual.

You can use a small rubber bulb (called an aspirating bulb)
to remove mucus from your baby’s nose or mouth when a
cold or allergies make it hard for the baby to eat, sleep, or breathe.

To use the bulb:

  1. Put a few saline nose drops in each side of the
    baby’s nose before you start.
  2. Position the baby with his or her
    head tilted slightly back.
  3. Squeeze the round base of the
    bulb.
  4. Gently insert the tip of the bulb tightly inside the baby’s
    nose.
  5. Release the bulb to remove (suction) mucus from the
    nose.

Don’t do this more than 5 or 6 times a day. Doing it too often
can make the congestion worse and can also cause the lining of the nose to
swell or bleed.

Colic is an extreme type of crying in
a baby between 3 weeks and 3 months of age. All babies cry, but a colicky baby
will cry for hours at a time, no matter what you do.

During a
crying episode, a colicky baby may cry loudly and continuously and be hard to
comfort. The baby may get red in the face, clench the fists, and arch his or
her back or pull the legs up to the belly.

Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury.

Symptoms of shock in a child may include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard
    to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused.
    The child may not know where he or she is.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The
    pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
    constantly no matter what you do. The baby may kick, make fists, or
    grimace.
  • Moderate pain (5 to 7): The baby is
    very fussy, clings to you a lot, and may have trouble sleeping but responds
    when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
    when you try to comfort him or her.

Pain in children 3 years and older

  • Severe pain (8 to 10): The pain
    is so bad that the child can’t stand it for more than a few hours, can’t sleep,
    and can’t do anything else except focus on the pain. No one can tolerate severe
    pain for more than a few hours.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and
    sleep, but the child can tolerate it for hours or days.
  • Mild pain (1 to 4): The child notices and may complain of the pain,
    but it is not bad enough to disrupt his or her sleep or activities.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms
    and arrange for care.
  • If you cannot reach your doctor or you don’t
    have one, seek care today.
  • If it is evening, watch the symptoms and
    seek care in the morning.
  • If the symptoms get worse, seek care
    sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and
    arrange for care.
  • If you cannot reach your doctor or you don’t have
    one, seek care in the next hour.
  • You do not need to call an
    ambulance unless:

    • You cannot travel safely either by driving
      yourself or by having someone else drive you.
    • You are in an area
      where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need
emergency care.

Call 911 or other emergency services now.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

  • Make an appointment to see your doctor in the
    next 1 to 2 weeks.
  • If appropriate, try home treatment while you
    are waiting for the appointment.
  • If symptoms get worse or you have
    any concerns, call your doctor. You may need care sooner.
Fever or Chills, Age 11 and Younger
Head Injury, Age 3 and Younger
Respiratory Problems, Age 11 and Younger

Home Treatment

Crying is a normal part of your
child’s life. Stay as calm as possible during crying episodes. There are many
different ways to approach your child’s crying, and over time you will
understand your child’s needs and know how to care for him or her.

It may be helpful to keep a record of your child’s crying to see whether
there is a pattern that you can discuss with your child’s doctor.

Checklist of common reasons a child cries

Use this
checklist to help you figure out the reason for your child’s crying and take
action to eliminate the cause of the crying. Remember that the crying may be
normal for your child. Ask yourself whether your child:

  • Is hungry. Does he or she need to be
    burped? Does he or she need to suck (on a finger,
    pacifier, bottle, or breast)?
  • Needs a diaper
    change.
  • Needs to be moved to a more comfortable
    position.
  • Is afraid, bored, or lonely.
  • Is too warm
    (feels warm) or too cold. Young children usually have cool hands and feet. When
    they are cold, their hands and feet will be colder than usual. If you think
    your child may be cold, check the arms, thighs, or back of the neck for skin
    cool to the touch.
  • Is hurting from something pinching or poking the
    skin.
  • Is overstimulated. Crying can be a young child’s way of
    releasing tension when there is too much noise, movement, or activity in his or
    her environment or when he or she is overtired.
  • Is uncomfortable
    from teething. Young children who are teething can be fretful and cry more than
    usual because their gums are swollen and sore. Children who are teething drool
    more than usual and may try to rub their gums with toys or
    fingers.
  • Had a recent immunization. If you think your child is
    uncomfortable from a recent immunization,
    acetaminophen or
    ibuprofen may help.
    Do not give aspirin to anyone younger than age 20.

Illness or injury that may cause a child to cry

Young
children may turn red or purple in the face when crying. A sick child may have
pale, blue, or spots of bluish (mottled) skin and may be listless, unusually
sleepy, or irritable. A sick child’s cry may be weak and feeble or (in rare cases)
high-pitched and piercing. If you think your child may be sick or hurt:

  • Check for a
    fever. For information on how to take a temperature,
    see the topic
    Body Temperature.
  • Look for other signs of
    illness, such as crying during feeding, vomiting, or
    diarrhea.
  • Check for
    other signs of pain.

    • Does your child have
      colic? You may want to limit visitors and activity
      during those times when he or she is most fussy.
    • Is something
      causing your child pain, such as an open pin sticking the skin, a red spot that
      may be an insect bite, or a strand of hair wrapped around a finger, a toe, or
      the penis?
    • Does your child have pain in the groin area? Check his
      groin area and scrotum or her groin area for a bulge that may be an
      inguinal hernia.
    • Does your young boy have
      scrotal swelling or tenderness (testicular torsion)? Testicular torsion
      can cause severe pain.
    • Has your child fallen or been dropped?
      Undress your child and look for swelling, bruises, or bleeding.

Comforting measures

If you don’t find a reason for your child’s crying, try comforting techniques, such as rocking your baby, breastfeeding, or offering a pacifier after breastfeeding is going well. If your child continues to
cry after you have tried home treatment, place him or her in a safe, quiet
place and leave him or her alone for 15 to 20 minutes. Sometimes children can
relax and soothe themselves. Be sure to stay close by.

Talk with
your child’s doctor before giving your child any nonprescription medicines or
herbal remedies as a comfort measure. Products with alcohol or sugar in them
are not recommended.

Do not get angry at your child for crying. Never shake or
harm your child. Shaking a child in anger or playing rough, such as throwing a
baby up into the air and catching him or her, can cause
shaken baby syndrome. If you find that you are losing
patience or are afraid that you may hurt your child:

  • Place your child in a safe place while you go
    into another room, relax, and calm yourself.
  • Ask someone to help
    you. If you cannot find someone to take over for you and you still feel out of
    control, call your doctor.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Changes in the
    level of consciousness develop.
  • Your child
    is not acting normally and cries in a way that is not
    usual for him or her.
  • Crying continues longer than 30 minutes, and
    the child appears to be in pain.
  • Crying continues longer than 30
    minutes after an injury.
  • Symptoms become more severe or
    frequent.

Prevention

The following tips may help you care for
your child and lessen the amount he or she cries.

General tips

  • Recognize and respond to your child’s
    cry and other signals (whimpering, wiggling, and facial expressions). Do not
    worry about spoiling your child. Young children cry for a reason and are not
    trying to manipulate parents or caregivers. It is harder to find the cause of
    crying and takes longer to soothe your child when he or she has been crying for
    a long time. Babies younger than 6 months use crying as their way to
    communicate. As a young child learns other ways to communicate, he or she may
    use crying for attention. If you think your child’s crying is related to
    behavior problems, many parenting books and classes offer suggestions for
    behavior modification in these situations.
  • Keep a regular routine
    for your child’s meals, naps, and play times. This will prevent your child from
    getting
    overtired or overstimulated.
  • Carry your
    child in your arms or in a soft pouch infant carrier so your child is close to
    your chest. Studies have shown that young children carried for about 3 hours
    each day cry much less than those who are carried less. Being carried gives
    your child the pleasure of physical closeness and may help you be more in tune
    with his or her needs.

Feeding tips

  • If you breastfeed your child, watch how your own
    diet affects your child’s behavior. For example, does your child have gas or
    cry more after you have eaten certain foods? The medicines you take can pass in
    your breast milk to your child and affect him or her. If you smoke cigarettes
    or chew tobacco, the nicotine can pass through your breast milk and may make
    your child fussy or irritable.
  • Make sure your child is getting
    enough to eat but is not overfed. Make sure the nipple
    opening of the bottle is not too large or too small.

    • If your baby gulps during bottle feedings,
      the nipple hole may be too large, causing your baby to swallow air when
      sucking.
    • If your baby struggles with the bottle during feedings,
      the nipple hole may be too small, causing air to be swallowed when sucking.
      When a baby struggles for nourishment, he or she may become frustrated and may
      even stop eating before being satisfied.
  • Burp your child
    often during feedings. Adding solid foods to your baby’s diet at a young age
    (unless you have been told to do so by your doctor) may cause problems. Solid
    foods are harder for a young child to digest and may cause a
    food intolerance. This might make you think your baby
    has a
    food allergy when he or she does not. You may be able
    to avoid some food intolerances if you wait to add solid foods until your baby
    is 6 months old.
  • Make sure your child’s sucking
    needs are satisfied. Sucking can help a child relieve stress without crying.
    Some young children need to suck as much as 2 hours a day. If feedings are not
    enough to satisfy sucking, use a
    pacifier.
  • If you think the formula may be
    the problem, talk to your child’s doctor before changing formulas or brands of
    formulas.

Safety tips

  • Do not leave your child unattended in a place
    where an injury may occur, such as on a changing table, in a high chair, or in a crib with a side rail down.
  • Keep tobacco smoke out of the home and away from your baby. Even secondhand smoke may make your child fussy. Secondhand smoke increases a child’s risk for
    respiratory problems compared with young children who are not
    exposed.
  • Try to stay calm. Young children are very sensitive to
    their parents’ frustration and fatigue. Try to sleep whenever your child does,
    even during the day, so you will have more energy for those times when he or
    she is fussy. Take some breaks from the care of your child. Ask a friend or
    neighbor to babysit some evening while you enjoy some free
    time.
  • Never shake your baby! Place your
    child in a safe place while you go into another room, relax, and calm yourself.
    Or ask someone to help you.

Check with your doctor about giving your child
acetaminophen before immunizations are given. Some
doctors suggest this to decrease discomfort after a shot.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your
doctor diagnose and treat your child’s condition by being prepared to answer
the following questions:

  • Has your child been feeding and sucking normally?
    Have you recently changed formulas or added a new food? Does your child have
    any known food allergies, or is there a family history of food allergies? Has
    your child been vomiting? If yes, how often, how long has it been going on, and
    what color is the vomit?
  • How often does your child have a bowel
    movement? Are the stools hard or soft? Has there been any blood in the
    stools?
  • Has your child received any recent
    immunizations?
  • Has your child had any recent illnesses or
    injuries?
  • Did the crying develop suddenly, especially in a child
    who normally does not cry a lot?
  • Does your child cry like this
    every day at a certain time?
  • How long has your child been crying,
    what does the cry sound like (painful or high-pitched), and has it changed or
    been continuous?
  • What do you think is causing your child’s
    continuous crying?
  • Does your child have any symptoms indicating a
    problem, such as an ear infection? Does your child have a
    fever?
  • Does your child have any signs of a medical problem, such as
    a bulge in the groin, or does your young boy have swelling in his
    scrotum?
  • How is your child’s crying affecting you and your family?
    Are you feeling out of control, and are you afraid that you may hurt your
    child?
  • What comforting techniques have you tried to soothe your
    child?
  • What medicine have you given your child?
  • Does your
    child have any
    health risks?

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
John Pope, MD – Pediatrics
Adam Husney, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer H. Michael O’Connor, MD – Emergency Medicine
David Messenger, MD

Current as ofMarch 20, 2017