- Mean duration of crying is approximately 2 hrs/day for the first 6 wks
- This decreases to 72 mins/day by age 10-12 wks
- As many as 43% of infants experience excessive crying
- 5% of crying infants are found to have underlying disease
- Crying and inconsolable infant
- Occult infection
- Occult trauma
- Flourescein staining to rule out corneal abrasions
- Fundoscopic exam
- Inspect digits for hair tourniquet
- Inspect GU area
- Examine ears to rule out otitis
- Consider occult sepsis
- Evaluate abdomen to rule out surgical abdomen
- If no underlying cause is found attempt the "5 Ss"
- Side/Stomach position while awake
- Shhhhing to provide soothing sound
- Swinging the baby in parent's arms
- Sucking on breast or pacifier
- 4% benefit from change to soy formula
- rocking, warm compresses to belly feeding, frequent burping, diaper changes
- May discharge home with precautions if infant becomes consolable and has reassuring exam (and studies, if indicated)
- Admit if infant is persistently inconsolable, will not tolerate POs, or has concern for specific pathology
- Wolke D, et al. Meta-analysis of fuss/cry durations and colic prevalence across countries. In: Proceedings of the 11th International Infant Cry Research Workshop. 8-10 June 2011. Zeist, The Netherlands.
- Reijneveld SA, et al. Excessive infant crying: the impact of varying definitions. Pediatrics. 2001; 108(4):893-897.
- Barr, RG. Colic and crying syndromes in infants. Pediatrics. 1998; 102(5):1282-1286.