Crying and fussing in infants

Question 1

Features

Answer 1

Quite normal in first 3 mths.

Crying is excessive if it lasts for long periods when baby should be sleeping or playing (usually 6–9 pm).

Organic causes which are uncommon should be considered.

Question 2

Checklist of common causes

Answer 2

Hunger (usually underfeeding)

Wet or soiled nappy

Loneliness (crying ceases when picked up)

Period of purple crying or ‘colic’ (usually 2–16 wks) 8

Individual temperament

Teething

Question 3

Management

Answer 3

Perform physical examination (include assessment of child’s temperament)

Give parental reassurance and education

Reassure that extra attention (not overstimulation) is okay

Provide soothing alternatives (e.g. use of dummy/pacifier, extra cuddling and carrying, gentle massage)

Question 4

The five S’s

Answer 4

Swaddling—firm clothes

Side or stomach—lie baby on side or stomach

Shush, i.e. ‘sshusshing’ as loud as the child

Swing—sway from side to side

Suckling—nipple, teat or pacifier