The following symptoms and complaints may occur together in an excessive crying infant:
Leading symptom
- Excessive crying infant
Associated symptoms
- Refusal to drink
- Fever
- Drooling
- Difficulty with bowel movements
- Restlessness
- Distended abdomen
Caveat.
- Exclude child abuse!
Rule of three from Wessel et al
Excessive crying occurs when a healthy infant exhibits restlessness, whining, or crying:
- During more than 3 h/day
- During more than 3 days/week and
- For more than 3 weeks.
Warning signs (red flags)
- Lethargic child who previously cried a lot → think of: Presence of a serious illness
- Fever (> 38.5 °C)
- Persistent vomiting
- Diarrhea (diarrhea)
- Refusal to drink
- No weight gain
- Protrusion in the inguinal region (visible or palpable) → think of: Inguinal hernia (hernia), possibly incarcerated hernia (hernia with critical entrapment of hernial contents in the hernial orifice).
- Persistent stiffness as well as flaccidity → think of: Presence of a neurological disease
- Fontanelle permanently bulging → Immediate referral to a pediatrician required.
