In a crying infant (thesaurus synonyms: persistent crying in infant; irritability in infant; prolonged crying in infant; crying child; crying infants; overexcited infant; excessive crying in infant; unusually frequent and severe crying of infant; ICD-10 R68.1: Unspecific Symptoms in Infancy) who cannot be calmed, many different causes come into question.
A distinction is made between “excessive crying” and “normal crying.” A baby cries excessively if this occurs more than three hours a day, on more than three days a week and has been going on for more than three weeks.
Often the cause of excessive crying remains unclear. In the fewest cases, contrary to what is assumed, colic is the reason for the crying. Only about 5-10% of babies do not tolerate cow’s milk proteins (cows’ milk protein). The fact that crying babies often have a distended belly is a consequence of the crying and not its cause. When crying, the baby swallows air, so that the belly inflates. Usually, the baby is organically completely healthy. It is assumed that babies who cry excessively are more sensitive than others and are unable to process the many stimuli from the environment. This is referred to as a regulatory disorder.
If a baby cries “normally,” it can usually be calmed by eliminating the cause, such as a full diaper or hunger.
An infant’s crying can be a symptom of many disorders (see under “Differential diagnoses”).
Frequency Peak: Excessive crying occurs predominantly in the first three months of life.
The prevalence of excessive crying is 5-20% (Western industrialized countries).
Course and prognosis: Every infant statistically follows a universal “crying curve” in which the frequency of crying gradually increases after birth. The peak is reached in the 6th to 8th week of life. Thereafter, the crying frequency decreases until the end of the 3rd month of life and should have improved by the 4th month of life at the latest. On average, an infant cries 2.2 hours per day by the end of the 3rd month of life; there is a large intraindividual variability. In extreme cases, crying episodes continue until the end of the 5th month of life.
If crying continues beyond 3 months of age, there is a risk for psychological abnormalities during childhood. In 5- to 6-year-olds who had been crying consistently at 13 weeks, there was a doubling of the incidence of behavioral problems, hyperactivity, and depressivity. Children whose mothers had felt a great deal of stress from the crying were particularly affected.
When a child cries persistently and cannot be calmed, parents often reach their limits. It is not uncommon for them to feel overwhelmed and exhausted. In such cases, a pediatrician should be consulted. In many places, there are now also so-called “crying outpatient clinics” that help the children and the parents concerned.
Comorbidities (concomitant diseases): associations with the occurrence of maternal postpartum depression are described; these mothers perceive their child’s restlessness as unaffectable, regardless of its severity.
