Paediatrics clinic

The crying baby. Excessive or inconsolable crying in infants

WILLIAM GARVEY, VALERIE SUNG

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Abstract

Infant colic is a challenging presentation for clinicians who are busy and time constrained. However, caregivers are often stressed and worried about a sinister problem in their child. GPs can best manage both caregiver and infant through a structured approach to excessive or inconsolable crying, including how to determine normal presentations from those requiring investigations, targeted treatments and additional input from other clinicians.

Article Extract

Although crying is a normal physiological behaviour for infants, concern over excessive crying in the first few months of life is one of the most common presentations to a health service.1 Unsettled infants are associated with the use of multiple health services in Australia, and worldwide estimates indicate a prevalence of about 20% across multiple societies.1,2 An unsettled infant causes significant distress to the entire family and has strong associations with postnatal depression, poor attachment, early cessation of breastfeeding and risk of nonaccidental injury.3-5 Although only about 5% of infants with excessive or inconsolable crying have an underlying organic cause, it is essential to correctly identify those who require investigation and/or targeted treatment.6 All infants who present to a health service for excessive or inconsolable crying require assessment, and caregivers require education and counselling, along with follow up to monitor progress and provide ongoing support.

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