Crying Baby

Question 1

What are the causes of a crying baby

Answer 1

Colic
Hunger

Pathological:
Sepsis
Infections: UTI, middle, otitis media, meningitis, hydrocephalus
Bowel obstruction: strangulated hernia, testicular torsion
Intussusception, appendicitis, peritonitis, pyloric stenosis
Fracture
CMPA, GORD
Constipation or anal fissures

Question 2

What are the red flags for a pathological cause of a crying baby

Answer 2

Weak, abnormally high-pitched or continuous cry
Fever
Apnoeic episodes
Cyanosis
Abnormal breathing pattern
Bilious or projectile vomiting
Weight loss or faltering growth
Blood in stool

Question 3

Define colic

Answer 3

paroxysms of irritability or crying lasting >3 hours per day and occurring >3 days per week for at least 1 week in infants <5 months of age

Question 4

What is the epidemiology of colic

Answer 4

Affects 40% of babies
Typically occurs in the first few weeks of life, resolving gradually from 3-12 months

Question 5

What are the symptoms of colic

Answer 5

Prolonged, incessant crying where the baby draws up their knees and arches their back when crying
- Usually in the late afternoon or evening
Passage of excessive flatus several times a day
Clenching of fists

Question 6

What is the management for colic

Answer 6

Re-assure
Ensure baby is sucking well, at least 6 nappies a day, gaining weight, offer breastfeeding support
Advise on manoeuvres:
- Carrying in a sling, kangaroo care
- Swaddling
- Talking, singing, white noise (hairdryer, vacuum)
- Infant massage
- Rocking or gentle motion (stroller or car)
- Keep upright after feeding, good winding/burping
Advise to seek support from others
Screen for maternal depressino
Resources: NHS choices, Cry-sis self-help support

+ follow up (crying should be reduced by 3-4 months of age)