Excessive Crying and Medical Causes
Steven Poole and David Magilner remind the reader to always take into account the possibility that a child with intense excessive crying might have a medical condition. Actually, the authors describe their experiences in evaluating babies who are brought to the emergency room of a hospital with a complaint of excessive cry. This is particularly important in the child who has cried for several hours and cannot be soothed. They warn that some of these infants are misdiagnosed as “ having colic” and sent home when there may be an infection, encephalitis, urinary tract infection, or the effects of an insect bite. One of the most frequent cause they found in their review of previous cases in a large emergency room was an infection of the middle ear, followed by a viral infection leading to dehydration. Another cause may be constipation leading to difficulties with the passing of stools. Their advice is to perform a careful physical examination of the baby, including the skin and to obtain a careful history searching for clues. In some cases they recommend observation in the Emergency Room and further laboratory studies. This is one of the rare accounts of medical conditions leading to excessive cry. There is an long list of conditions the reader will want to keep in mind as much as possible so as to take these factors into account when faced with a baby who cries excessively. The piece is a chapter of a great book on crying, that refers mostly to research findings, rather than clinical material, but is a great resource nonetheless.
Poole, S., Magilner D. Crying complaints in the emergency department. In: Barr, R.G., Hopkins, B., Green, J.A. Crying as a sign, a symptom and a signal. 2000. London. Mac Keith Press.