Topic Overview

Crying is a child's first way of communicating. Parents and caregivers become better over time at identifying their child's cry. Along with crying, a child may not act normally when something is wrong with him or her. Infection, illness, injury or pain, or a medical problem may cause a child to not act normally.

If your baby has colic, you may be concerned that a health condition is causing the excessive crying. Usually a baby with colic isn't crying because of pain or physical discomfort. But it is important to be aware that health problems or injuries can cause a baby to cry excessively. And it's important to watch for related signs.

Here are a few things to look for that may mean your baby has a health problem.

Signs of not acting normally

• Looks or acts different, such as a change in balance or coordination
• Appears confused or doesn't interact with people or objects in his or her environment. Look for a change in the level of consciousness.
• Sleeps more or appears to have no energy
• Cries more than usual or cries during sleep
• Has refused two feedings in a row or is vomiting
• A baby older than 1 month has a different type of cry than you have identified as usual for him or her.
• Cries and is fussy after 24 hours of home treatment
• Has swelling over a body part and cries (pain cry) when the area is touched or moved
• Refuses to use an arm or leg or refuses to walk or stand. (This is for children who are old enough to walk. Children usually start to walk when they are 9 to 15 months of age.)

If your child isn't acting normally, check for a fever. For information on how to take a temperature, see the topic Body Temperature.

Medical treatment is needed for a fall or injury that causes more serious symptoms, such as a head injury or severe bleeding. Medical evaluation may also be needed for injuries that cause swelling and pain in the affected area.

Signs of pain

A baby who is in pain may:

• Have a furrowed brow, wrinkled forehead, or closed eyes.
• Have a change in his or her daily activities or behaviour (such as decreased appetite, irritability, restlessness, or agitated behaviour).
• Sleep more or less than usual. He or she may suddenly start waking up during sleeping, appearing to be in pain. Even if a baby is having severe pain, the baby may take short naps because he or she is exhausted.
• Grunt when breathing or hold his or her breath.
• Have clenched fists and pull his or her legs up or kick.
• Cling to whoever holds him or her, or the baby may be limp and not move at all.
• Flinch and move to protect a painful area of his or her body when touched.

Minor injuries or illnesses that can cause a child to cry

• An open diaper pin in the skin
• A piece of hair wrapped around a finger, a toe, or the penis
• Bumping the child's head when putting him or her in a car seat
• A fall (or being dropped) that causes a small bruise or scratch
• A broken collarbone (fractured clavicle)
• An eyelash or other object in the eye. Look for one eye that is red and tearing more than the other eye. An eyelash in the eye may scratch the clear covering (cornea) over the coloured part of the eye, causing a corneal abrasion.
• An insect bite. Look for a reddened area on the skin, and look for any insects, such as mosquitoes or spiders. If you suspect a dangerous spider (a brown recluse or black widow) or scorpion bite, capture the insect and seek medical care right away. These insects can cause serious reactions (especially in young children), such as coma and death.
• A foreign object stuck in the skin or an opening, such as an ear. Young children can put small things—such as beads, rocks, popcorn, plastic toy pieces, or small batteries—in their body openings. It may be hard to see these small things and remove them.
• Pink eye (conjunctivitis). If other children you know have pink eye and there has been no injury to your child, consider that the redness may be pink eye.

Infections

Common infections in babies that may cause crying are:

• Ear infections.
• Urinary tract infections.
• Pneumonia.
• Stomach flu (gastroenteritis).

If you aren't able to identify the cause of your child's behaviour, medical evaluation may be needed.