Crying, Age 3 and Younger

Topic Overview

Crying is your child's first way of communicating. The amount of time your baby spends crying usually increases from birth until your baby is about 6 weeks old, when your baby may cry between 1 and 5 hours out of 24. After 6 weeks of age, your baby will gradually cry less as he or she finds other ways of communicating or consoling himself or herself. However, some young children seem to cry for no obvious reason. About 1 in 5 children have daily crying spells of 15 minutes to an hour, often in the evening.

Crying lets others know when a young child is hungry, wet, tired, too warm, too cold, lonely, or in pain. If your child is crying, try to identify the type of cry. It helps to go through a mental checklist of what might be wrong—but remember that there may be nothing bothering your child—and to make sure your child is safe and cared for. As parents or caregivers respond to the young child's other signals (such as whimpering, facial expressions, and wiggling), the child will usually cry less.

Parents and caregivers become better over time at identifying the young child's cry. A young child will often have different kinds of cries.

Crying related to normal development and behavior

• Hungry cries. Hungry cries start with a whimper and become louder and longer. Your hungry child will eagerly accept feeding and stop crying.
• Upset cries. Upset cries are loud and start suddenly. Your young child may be afraid, bored, or lonely. As your child gets older, upset crying may be a reaction to such things as loud noises, frustration with clothing or toys, or fear of strangers.
• Pain cries. Pain cries start with a high-pitched, strong wail followed by loud crying. These cries sound very irritating and may make you feel anxious. Often, a young child in pain will have other signs of pain along with crying. Commonly, pain cries may be caused by:
  • A recent immunization. Your child may be fussy, cry more than usual, and have a fever after receiving an immunization, especially diphtheria, pertussis, and tetanus (DTaP) shots. However, he or she will look well even while continuing to cry.
  • Teething. Teething symptoms may begin about 3 to 5 days before a tooth breaks the skin, although symptoms can be present off and on for 1 to 2 months. The most common symptoms of teething include swelling, tenderness, or discomfort in the gums at the site of the erupting tooth; drooling; biting on fingers or toys; irritability; or difficulty sleeping.
  • Constipation. A crying episode that occurs when the child is trying to pass a stool normally will stop when the stool is passed.
  • Diaper rash. Irritated skin around the thighs, genitals, buttocks, or abdomen may make a child cry persistently, especially when a diaper is wet or soiled.
  • Colic. All babies cry, but sometimes a baby will cry for hours at a time, no matter what you do. This extreme type of crying in a baby who is between 3 weeks and 3 months of age is called colic. While it is upsetting for parents and caregivers, colic is normal for babies. Doctors usually diagnose colic when a healthy baby cries harder than expected in a "3" pattern: more than 3 hours a day at least 3 days a week for at least 3 weeks in a row. The crying is usually worst when babies are around 6 to 8 weeks of age and goes away on its own between 8 and 14 weeks of age.
  • Abdominal cramps from overfeeding or milk intolerance. Overeating or swallowing too much air during feeding can cause abdominal cramps, which in turn can make a baby cry. Crying also may occur if your child is sensitive to milk protein. The baby will often spit up some of the feeding and may have loose stools.
  • A minor illness, such as a cold or stomach flu (gastroenteritis). Crying related to an illness often begins suddenly. In most cases, there are other signs of illness such as fever, looking sick, and decreased appetite.
  • Minor injuries. Your child is likely to cry when he or she has an injury, such as an eyelash in the eye, an insect bite, an open diaper pin in the skin, or a strand of hair wrapped around a finger, toe, or the penis.
• Overtired or overstimulated cries. Crying can be your young child's way of releasing tension when there is too much noise, movement, or activity in his or her environment or when he or she is overtired.

Crying related to a serious illness or injury

On rare occasions, crying may indicate a serious illness or injury. Crying caused by a serious illness or injury usually lasts much longer than normal.

• Some illnesses may cause persistent crying. These include common infections, such as ear infections (otitis media) or urinary tract infections, and rarer infections, such as meningitis, encephalitis, or sepsis with dehydration. A persistent cry in a newborn may be the first sign of a serious illness, such as sepsis.
• A serious injury from a fall, being shaken, or abuse may cause a child to cry for a long time. Other signs of injury, such as swelling, bruising, or bleeding, are usually present.

Crying related to medical conditions

Certain medical conditions can cause a young child to cry, such as gastroesophageal reflux, inguinal hernia, or intussusception.

Children with genetic conditions, such as cri du chat ("cat's cry") syndrome or phenylketonuria (PKU), may have a different-sounding cry but one that is normal for them.

Crying and shaken baby syndrome

Crying can be very frustrating for a parent or caregiver. Do not get angry at your child for crying. Never shake or harm your child. Shaking a child in anger or playing rough, such as throwing him or her into the air, can injure the brain. Shaken baby syndrome needs to be reported to your health professional. If you find that you are losing patience or are afraid that you may hurt your child:

• Place your child in a safe place while you go into another room, relax, and calm yourself.
• Ask someone to help you. If you cannot find someone to take over for you and you still feel out of control, call your health professional.

Review the Emergencies and Check Your Symptoms sections to determine if and when your child needs to see his or her health professional.

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Author:	Jan Nissl, RN, BS	Last Updated: March 15, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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