Crying Baby Less Than 3 Months Old (Includes Colic)

CRYING BABY LESS THAN 3 MONTHS OLD (INCLUDES COLIC)

Symptom Definition

  • A child less than 90 days of age has the sudden onset of unexplained crying.
  • The younger the child, the harder it is to identify the cause of the crying.

Causes

  • Common causes of new crying: hunger, sleepy, pain, too cold, too hot, clothing too tight
  • Main cause of recurrent crying: normal fussy crying. When this occurs over 3 hours/day, it is called colic.
  • Gas does not cause crying. All crying babies pass lots of gas and their intestines make lots of gassy noises. The gas comes from swallowed air. The gas is normal and it does not become trapped nor cause any pains.

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WHEN TO CALL YOUR DOCTOR FOR CRYING BABY LESS THAN 3 MONTHS OLD

Call 911 Now (your child may need an ambulance)

  • Not moving or very weak

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick.
  • Age under 1 month old and looks or acts sick in any way
  • Age under 12 weeks with fever above 100.4°F (38°C) rectally. (CAUTION: Do NOT give your baby any fever medication before being seen)
  • Low temperature below 96.8° F (36.0°C) rectally that doesn't respond to warming.
  • Injury suspected.
  • Pain suspected as cause of crying
  • Bulging or swollen soft spot.
  • Swollen scrotum
  • Vomiting.
  • You are afraid you or someone might hurt or shake your baby.
  • Your baby cannot be comforted after trying for more than 2 hours.

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen.
  • Not gaining weight or seems hungry.
  • You are exhausted from all the crying.

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns.
  • Your baby has never been examined for excessive crying.
  • Crying began after 1 month of age.  
  • Crying occurs 3 or more times per day.

Parent Care at Home If

  • Normal crying or colic and you don't think your child needs to be seen.
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HOME CARE ADVICE FOR NORMAL CRYING OR COLIC

  1. Reassurance:
  2. Normal Crying: All babies cry when they are hungry. In addition, the average baby has 1 to 2 hours of unexplained crying scattered throughout the day. As long as they are happy and content when they are not crying, this is normal.
  3. Colic: Some babies cry excessively (over 3 hours/day) or are very difficult to comfort. If they are growing normally and have a normal medical exam, the crying is called colic. Remind yourself that colic is due to brain immaturity and has nothing to do with your parenting or any medical disease.
  4. Hold and Comfort: Hold and soothe your baby whenever he cries without a reason. The horizontal position is best for helping a baby relax, settle down, and go to sleep.
    • Provide a gentle rocking motion in a cradle or rocking chair
    • Dance with your baby to some slow music
    • Place in a front pack or sling (which frees up your hands)
    • Place in a wind-up swing or a vibrating chair
    • Give a stroller (or buggy) ride - outdoors or indoors
    • Sucking on pacifier (if breastfeeding is well-established)
    • Warm Bath: If crying continues, take a warm bath with your baby.
    • Feedings: Feed your baby, if more than 2 hours since the last feeding (1 ½ hours for breast fed).
    • Sleep and Swaddling:
    • Put your baby down to sleep, if more than 3 hours have passed since the last nap and you have tried quiet holding for more than 30 minutes. Some overtired infants need to cry themselves to sleep.
    • Swaddling often helps. Wrap your child in a light blanket with the arms tucked close to the body. Place on the back in the crib.
    • Warning: Never shake a baby. It can cause bleeding on the brain and severe brain damage. Also never leave your baby with anyone who is immature or has a bad temper. If you are frustrated, put your baby down in a safe place and get help.
    • Expected Course: Once you find the right technique, the crying should decrease to 1 hour per day. Colic improves after 2 months of age and is usually gone by 3 months.
    • Call Your Doctor If:
    • Your baby starts to look or act sick
    • Cries constantly over 2 hours using this advice
    • Cannot be comforted using this advice
    • Your child becomes worse

And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.

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REFERENCES

  1. American Academy of Pediatrics, Committee on Child Abuse and Neglect Shaken baby syndrome: rotational cranial injuries technical report. Pediatrics. 2001;108:206-210.
  2. Committee on Child Abuse and Neglect. Shaken baby syndrome: Inflicted cerebral trauma. Pediatrics. 1993;92:872-874.
  3. Fleisher DR. Coping with colic. Contemp Pediatr.1998;15(6):144-155.
  4. Garrison MM and Christakis DA. A systemic review of treatments for infant colic. Pediatrics. 2000;106:184-190.
  5. Herman M, Nelson R. Crying infants: What to do when babies wail. Critical Decisions in Emerg Med. 2006;20(5):1-10.
  6. Karp H. The fourth trimester: A framework and strategy for understanding and resolving colic. Contemp Pediatr. 2004;21(2):92-114.
  7. Markestad T. Use of sucrose as a treatment for infant colic. Arch Dis Child. 1997;76:356-358.
  8. Metcalf TJ, Irons TG, Sher LD, Young PC. Simethicone in the treatment of infantile colic: a randomized, placebo-controlled, multicenter trial. Pediatrics. 1994; 94: 29-34.
  9. Salvatore S, Vandenplas Y. Gastroesophageal reflux and cow milk allergy: Is there a link? Pediatrics. 2002;110: 972-984.
  10. Schmitt BD. Colic: Excessive crying in newborns. Clin Perinat. 1985;12:441-451.
  11. Taubman B. A new answer to the old question of colic. Contemp Pediatr. 1991; 8(11):44-63.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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