Introduction:

Crying is a response by which infants indicate their displeasure to an unpleasant stimulus. Persistent inconsolable crying is referred to as excessive crying. The inability of the parents in localizing the cause of crying poses a major problem.

What are the causes of excessive crying in children?

The causes can range from most trivial ones to a very serious disease. The common causes include:

Crying without disease:

  1. hunger, thirst
  2. discomfort-wind,cold,heat,wet nappy etc
  3. cow’s milk allergy
  4. irritability on the breast
  5. personality
  6. crying on passing urine
  7. habitual crying
  8. Food forcing.

Crying with disease:

  1. infection
  2. headache, earache
  3. torsion testis
  4. intestinal obstruction,intussusception
  5. autism

In older children:

  1. personality,insecurity,habit
  2. hunger
  3. fatigue
  4. illness
  5. child abuse
  6. autism
  7. drugs
  8. chorea

Cry of a child can be the sign of a serious underlying disorder. So it is the duty of the attending doc to look carefully into many of the associated parameters to rule out any serious abnormality.

First of all the nature of the cry is important, it can give a clue about the underlying disease. Few examples are cited below:

  1. Bleating lamb cry-Cornelia de lange syndrome.
  2. cat like cry-cri du chat syndrome
  3. grunting cry-pneumonia
  4. high pitched/shrill cry-meningitis, cerebral irritability,hydrocephalus,kernicterus
  5. hoarse cry-laryngitis
  6. hoarse gruff cry-hypothyroidism
  7. Weak cry-myasthenia gravis, werdnig-hoffman disease.
  8. Whimper cry-seriously ill child.

Most important of all is the history given by the parents one should look into the age of the kid, the pattern of onset of the cry, duration of the cry, associated symptoms, aggravating and relieving factors.

As in any other case clinical examination plays a very important role. General examination of the kid to look for fever, restricted painful movements, respiratory distress is important, systemic examination should include a detailed examination of the abdomen, respiratoy system and the cns.

Investigations include CBC, stool and urine routine, radiological investigations and lumbar puncture.

Treatment:

Largely symptomatic .the challenge lies in recognizing the underlying disorder and treating it.Counselling of parents is important ,they need to be educated.