Should Your Child See a Doctor?

Crying Child 3 Months and Older – Irritability – Fussiness

Is this your child's symptom?

  • A child more than 3 months old is crying or very fussy
  • You don't know why
  • Your child is too young to tell you why
  • Age: Most of these children are younger than 2 years old
  • Crying is the only symptom
  • For crying with an illness or other symptom, go to that care guide

If not, try one of these:

Causes of Unexplained Crying

  • New Illness. Coming down with an illness is the main physical cause. Young children cry about being sick, even if they don't have any pain.
  • Physical Pain. Painful causes include earache, sore throat, mouth ulcers, or a raw diaper rash. A sore on the penis or constipation may also cause pain or crying.
  • Behavioral Causes. Most crying means the child is upset about something. Crying can occur when a young child is separated from his parents. Other examples are crying with tantrums or when overtired. This guide detects many babies with sleep problems. Crying always occurs during re-training programs for bad sleep habits. Some preverbal children cry any time they want something.
  • Hunger. After the early months, most parents can recognize hunger and feed their child. If they don't, the child may cry.
  • Cold Medicines. Drugs like Sudafed can also cause crying. Note: FDA does not advise cough and cold medicines for children under 4 years.

Myths About Causes of Crying

  • Not Due to Teething. Teething may cause some babies to be fussy. But, in general, it does not cause crying.
  • Not Due to Gas. Gas passing through normal intestines does not cause pain or crying.

Call 911 Now

  • Not moving or very weak
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Could be an injury
  • Nonstop crying lasts more than 2 hours. Your child can't be consoled using this Care Advice
  • You are afraid someone might hurt or shake your child
  • Will not drink or drinks very little for more than 8 hours
  • Not alert when awake "out of it"
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • You think pain such as an earache is causing the crying.
  • New crying but your child can be consoled. Cause of crying is not clear.
  • You think your child needs to be seen, but the problem is not urgent.

Call Doctor During Office Hours

  • Mild, off-and-on fussiness without a cause lasts more than 2 days
  • Crying is a frequent problem
  • You have other questions or concerns

Self Care at Home

  • Mild fussiness without a cause is present less than 2 days
  • Normal protest crying
  • Temper tantrum crying
  • Sleep problem crying

Care Advice

Mild Fussiness of Unknown Cause

  1. What You Should Know:
    • Your child is crying and fussing more than normal. But, if acting normal when not crying, the cause is probably not serious.
    • He could be coming down with an illness. Most often, that will become clear in a day or so.
    • He could be reacting to some changes in your home or child care setting. See if you can come up with some ideas.
    • At times, children can also go through a "clingy phase" without a reason.
    • If the crying stops with comforting, it's not serious.
    • Here is some care advice that should help.
  2. Comfort Your Child:
    • Try to comfort your child by holding, rocking, or massage.
    • Talk in a quiet, calm voice.
  3. Undress Your Child- Check the Skin:
    • Sometimes, part of the clothing is too tight. Loosen it.
    • Also, check the skin for redness or swelling such as an insect bite.
  4. Stop Any Over-the-Counter Medicines:
    • If your child is taking a cough or cold med, stop it.
    • The crying should stop within 4 hours.
    • Allergy meds like Benadryl can cause screaming in a small number of children. Also, may cause some children to be more fussy than normal.
    • Drugs that lessen congestion like Sudafed can cause crying.
    • The FDA does not approve any of these drugs for children under 4 years old.
  5. Sleep - Take a Nap:
    • If your child is tired, put him to bed.
    • If he needs to be held, hold him quietly in your arms. Sometimes, lying next to him will comfort him.
    • Some overtired infants need to cry themselves to sleep.
  6. Warning: Never Shake a Baby
    • It can cause bleeding on the brain. Severe brain damage can happen in a few seconds.
    • Never leave your baby with someone who is immature or has a bad temper.
    • If you are frustrated, put your baby down in a safe place.
    • Call or ask a friend or relative for help.
    • Take a break until you calm down.
  7. What To Expect:
    • Most fussiness with illnesses goes away when the illness does.
    • Fussiness may be due to family stress or change such as new child care. Fussiness due to this cause lasts less than 1 week.
  8. Call Your Doctor If:
    • Nonstop crying lasts more than 2 hours
    • Crying with an illness gets worse
    • Mild crying lasts more than 2 days
    • You think your child needs to be seen
    • Your child becomes worse

Normal Protest Crying

  1. What You Should Know:
    • Normal children cry when they don't get their way.
    • Normal children cry when you make changes in their routines.
    • Crying is how young children communicate in the first years of life.
    • Crying can mean, "I don't want to".
    • This is called normal protest crying and is not harmful.
    • Do not assume that crying means pain.
  2. Call Your Doctor If:
    • You have other questions or concerns

Temper Tantrum Crying

  1. What You Should Know:
    • Crying is the most common symptom of a temper tantrum.
    • Temper tantrums occur when your child is angry or trying to get his way.
    • This is likely the cause of the crying if it occurs at these times.
    • All kids have some temper tantrums, starting at about 9 months of age.
  2. Tips for Dealing with Temper Tantrums:
    • Ignore most tantrums such as wanting something the child doesn't need.
    • Don't give your child an audience. Leave the room.
    • For tantrums from frustration such as when something doesn't work, help your child.
    • For tantrums that involve hitting or throwing objects, put in timeout. Leave your child there until he calms down.
    • Don't give in to tantrums. No means No.
    • Be a good role model. Do not yell or scream at others adult tantrums.
  3. Call Your Doctor If:
    • You have other questions or concerns

Sleep Problem Crying

  1. What You Should Know:
    • Sleep problems can cause crying. Suspect this if most of your child's crying occurs in his crib or bed. The crying mainly occurs when you put him down for naps and at night. Also, suspect a sleep problem if your child acts normal during the daytime.
    • Sleep problems are common in childhood.
  2. Tips for Treating the Sleep Problem:
    • Re-train your child to be a good sleeper at bedtime and naptime.
    • Place your child in the crib "sleepy but awake".
    • Once placed in the crib, don't take your child out again.
    • Visit your child as often as needed until asleep.
    • For waking at night, it's fine to hold your child until calm.
    • Do all of this in a loving way with a calm voice.
    • Never feed until asleep.
    • Never sleep in the same bed with your child.
  3. Call Your Doctor If:
    • You have other questions or concerns

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

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.