Merck Manual

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Some Medical Disorders That Cause Excessive Crying in Infants and Young Children

Some Medical Disorders That Cause Excessive Crying in Infants and Young Children

Cause*

Common Features†

Tests

Heart disorders

Difficulty breathing, difficulty feeding, and excessive sweating

Often an abnormal heart sound detected during a doctor's examination

Chest x-ray

ECG

Echocardiography

Digestive disorders

Vomiting

Diarrhea or constipation

Poor feeding

Weight loss, poor growth, or both

Blood in stools

Stool tests

Symptoms that lessen when the formula is changed

Possibly endoscopy, colonoscopy, or both

Hard, less frequent bowel movements that are difficult to pass

Sometimes apparent pain during a bowel movement

Sometimes tears (fissures) in the anus

A doctor’s examination

Symptoms that occur after feeding, including fussiness or crying, spitting up, or arching of the back

Sometimes a cough when lying down or poor weight gain

A doctor’s examination

Sometimes treatment with drugs to suppress acid production (if symptoms are relieved, the cause is probably gastroesophageal reflux disease)

Sometimes x-rays of the upper digestive tract after barium is given by mouth or a test to measure acidity or reflux episodes in the esophagus (called a pH probe or an impedance probe) or endoscopy

Incarcerated hernia

Red, swollen, tender bulge in the groin

A doctor's examination

Intussusception‡ (sliding of one segment of intestine into another)

Crying that occurs in bouts every 15 to 20 minutes with children often drawing their legs up to their chest

Later, tenderness of the abdomen when it is touched and bowel movements that look like currant jelly (because they contain blood)

Typically in children 3 to 36 months old

Ultrasonography of the abdomen

Insertion of air into the rectum (air enema)

Volvulus‡ (twisting of the intestine)

Vomiting, a swollen abdomen, and/or tenderness of the abdomen when it is touched

Possibly blood in stools or no stools

An x-ray of the abdomen

Barium or air enema

Infections

Ear infection (otitis media)

Often cold symptoms (such as a runny nose and cough)

Sometimes fever

Ear pain

A doctor’s examination

Fever and lethargy or listlessness

Bulging of the soft spots (fontanelles) between the skull bones

Fussiness and irritability (especially when held), inconsolability, and poor feeding

A spinal tap (lumbar puncture)

Often fever

Crying or complaints of pain with urination

Examination (urinalysis) and culture of urine

Injury

Broken bone

Swelling or bruising

Unwillingness to use a limb

Pain during bathing, changing, or a doctor's examination

X-rays

Corneal abrasion (a scratch on the surface of the eye)

No other symptoms

Examination of the eye after applying an eye drop that makes abrasions visible (fluorescein test)

Hair tourniquet

Swollen tip of a toe, a finger, or the penis with a hair wrapped below the swelling

A doctor’s examination

A head injury‡

An inconsolable, high-pitched cry

Sometimes a swollen area on the head

CT of the head

Other causes

Drugs used to treat colds

Recent drug treatment for a cold

A doctor’s examination

A tooth erupting or about ready to erupt, drooling

Sometimes sleeplessness or restless sleep at night

Sometimes mild fever

Symptoms that resolve after tooth erupts

Testicular torsion‡ (twisting of a testis)

A swollen, painful, red scrotum

Doppler ultrasonography of the scrotum

A vaccine reaction

Recent vaccination (within 24–48 hours)

A doctor’s examination

* Medical disorders cause fewer than 5% of cases of excessive crying.

† Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present.

‡ These disorders, although rare, are life-threatening and require immediate medical intervention.

CT = computed tomography; ECG = electrocardiography.