Pediatrics, Crying Child



Harold K Simon, MD, MBA, Professor of Pediatrics and Emergency Medicine, Associate Division Director of Pediatric Emergency Medicine, Director of Research, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta at Egleston

Nothing to disclose.

Specialty Editor(s)

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

Nothing to disclose.

Kirsten A Bechtel, MD, Associate Professor, Department of Pediatrics, Yale University School of Medicine; Attending Physician, Department of Pediatric Emergency Medicine, Yale-New Haven Children's Hospital

Nothing to disclose.

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine

Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Wayne Wolfram, MD, MPH, Clinical Associate Professor, Departments of Pediatrics, Children's Hospital and University of Cincinnati

Nothing to disclose.

Chief Editor

Richard G Bachur, MD, Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston

Nothing to disclose.


One of the most challenging aspects of pediatric medicine is dealing with a child (usually < 1 y of age) presenting with nonspecific symptoms, such as crying and irritability.

Because of the child's inability to localize complaints, these symptoms can indicate a spectrum of disease ranging from a benign process, such as colic, to a life-threatening illness, such as meningitis.[1, 2]




Causes of crying and irritability in the young child can vary greatly from relatively benign conditions, such as colic (a diagnosis of exclusion), to life-threatening conditions, such as meningitis or even abuse.[3]

The following is a partial listing, by systems, of potential causes of crying and irritability.

Laboratory Studies

Emergency Department Care


In all cases in which one is not absolutely comfortable with the diagnosis and treatment of a particular child, consult someone comfortable with the emergency care of children or a physician who knows the patient or family.

Medication Summary

No single medication for the treatment of the broad spectrum of illnesses that can cause crying and irritability can be recommended. Specific therapy can be prescribed only after efforts at obtaining a diagnosis are successful. For example, a corneal abrasion would be treated by the appropriate topical ophthalmic antibiotic, while otitis media can be treated by any number of appropriate oral antibiotics.

Further Inpatient Care

Further Outpatient Care



  1. Brazelton TB. Crying in infancy. Pediatrics. Apr 1962;29:579-88.[View Abstract]
  2. Henretig FM. Crying and colic in early infancy. In: Fleisher GR, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 1993:144-6.
  3. King WK, Kiesel EL, Simon HK. Child abuse fatalities: are we missing opportunities for intervention?. Pediatr Emerg Care. Apr 2006;22(4):211-4.[View Abstract]
  4. Freedman SB, Al-Harthy N, Thull-Freedman J. The crying infant: diagnostic testing and frequency of serious underlying disease. Pediatrics. Mar 2009;123(3):841-8.[View Abstract]
  5. Pawel B, Henretig F. Crying and colic in early infancy. In: Fleisher G, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 4th ed. Philadelphia, Pa: Lippincott Williams and Wilkins; 2000:193-195.