Should Your Child See a Doctor?
Crying Child 3 Months and Older – Irritability – Fussiness
- 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.
- Always consider pain as a possible cause of fussiness or crying that is persistent. Inconsolable crying may be the only symptom initially in a young child with ear infection or even appendicitis.
When to Call Your Doctor for Crying Child Over 3 Months of Age - Irritability - Fussiness
Call 911 If…
- Your child is not moving or very weak
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- Stiff neck or bulging soft spot
- Possible injury (especially head or bone injury)
- Very irritable, screaming child for over 1 hour
- You are afraid you or someone might hurt or shake your baby
- Your child cannot be comforted after trying this advice for 2 hours
- Crying interferes with sleeping for over 2 hours
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen
- Pain (eg. earache) suspected as cause of crying
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Mild, off-and-on fussiness (acts normal when not crying) continues over 2 days
- Excessive crying is a chronic problem
Parent Care at Home If
- Mild fussiness present less than 2 days and you don't think your child needs to be seen
Home Care Advice for Mild Consolable Crying
- 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.
- Comforting: Try to comfort your child by holding, rocking, massage, etc.
- 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.
- 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).
- 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.
- 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.
- 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 "When to Call Your Doctor" symptoms.
- Bolte R. The crying child. Contemp Pediatr. 2007; 24 (5):74-81.
- Corwin MJ, Lester BM, Golub HL. The infant cry: What can it tell us? Curr Probl Pediatr. 1996;26:325-334.
- Poole SR. The infant with acute, unexplained, excessive crying. Pediatrics. 1991; 88:450-455.
This information is not intended to 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.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 1/4/2010
Last Revised: 12/11/2009 3:01:11 PM
Copyright 1994-2010 Barton D. Schmitt, M.D.