The Crying Baby: What to Do?

Crying in infancy is normal and varies by age and time of day and from child to child. However, because excessive crying can be a symptom of serious disease, an evidence-based approach to diagnostic evaluation of crying infants would be helpful. Researchers retrospectively reviewed the charts of 238 consecutive afebrile infants younger than 12 months (median age, 2.4 months) who presented to a pediatric emergency department (ED) in Toronto with a chief complaint of crying. Diagnoses that would constitute potentially serious underlying etiologies for crying were determined a priori. The general appearance of 95% of the infants was described as “well.”

Diagnosis was based on history and physical examination findings alone in 66.0% of all infan…