Definition

Crying is an important way for infants to communicate. But, when a baby cries a lot, it may be a sign of something that needs treatment.

Alternative Names

Infants - excessive crying; Well child - excessive crying

Considerations

Infants normally cry about 1 to 3 hours a day. It is perfectly normal for an infant to cry when hungry, thirsty, tired, lonely, or in pain. It is also normal for a baby to have a fussy period in the evening.

But, if an infant cries too often, there might be a health problem that needs attention.

Causes

Infants may cry because of any of the following:

• Boredom or loneliness
• Colic
• Discomfort or irritation from a wet or dirty diaper, excessive gas, or feeling cold
• Hunger or thirst
• Illness
• Infection (a likely cause if the crying is accompanied by irritability, lethargy, poor appetite, or fever. You should call your baby's health care provider)
• Medicines
• Normal muscle jerks and twitches that disturb the sleep
• Pain
• Teething

Home Care

Home care depends on the causes. Follow your provider's advice.

If the infant seems constantly hungry despite short, frequent feedings, talk to your provider about normal growth and feeding times.

If crying is due to boredom or loneliness, it may be helpful to touch, hold, and talk to the infant more and place the infant within sight. Place baby-safe toys where the child can see them. If crying is due to sleep disturbance, wrap the baby firmly in a blanket before putting the infant to bed.

For excessive crying in infants due to cold, dress the infant warmly or adjust the temperature of the room. If adults are cold, the baby is also likely cold.

Always check for possible causes of pain or discomfort in a crying baby. When cloth diapers are used, look for diaper pins that have become loose or loose threads that have become tightly wrapped around fingers or toes. Diaper rashes also can be uncomfortable.

Take your baby's temperature to check for fever. Check your baby head-to-toe for any injuries. Pay particular attention to the fingers, toes, and genitalia. It is not uncommon for a hair to get wrapped around part of your baby, such as a toe, creating pain.

When to Contact a Medical Professional

Contact your child's provider if:

• A baby's excessive crying remains unexplained and does not go away in 1 day, despite attempts at home treatment
• The baby has other symptoms, such as fever, along with the excessive crying

What to Expect at Your Office Visit

The provider will examine your baby and ask about the child's medical history and symptoms. Questions may include:

• Is the child teething?
• Is the child bored, lonely, hungry, thirsty?
• Does the child seem to have a lot of gas?
• What other symptoms does the child have? Such as, difficulty waking up, fever, irritability, poor appetite, or vomiting?

The provider will check the infant's growth and development. Antibiotics may be prescribed if the baby has a bacterial infection.

References

Marcdante KJ, Kliegman RM, Schuh AM. Crying and colic. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 11.

Onigbanjo MT, Feigelman S. The first year. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 22.

Pomeranz AJ, Sabnis S, Busey SL, Kliegman RM. Irritable infant (fussy or excessively crying infant). In: Pomeranz AJ, Sabnis S, Busey SL, Kliegman RM, eds. Pediatric Decision-Making Strategies. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.