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Crying, Age 3 and Younger
Crying lets others know when a young child is hungry, wet, tired, too warm, too cold, lonely, or in pain. If your child is crying, try to identify the type of cry. It helps to go through a mental checklist of what might be wrong—but remember that there may be nothing bothering your child—and to make sure your child is safe and cared for. As parents or caregivers respond to the young child's other signals (such as whimpering, facial expressions, and wiggling), the child will usually cry less.
Parents and caregivers become better over time at identifying the young child's cry. A young child will often have different kinds of cries.
Crying related to normal development and behavior
- Hungry cries. Hungry cries start with a whimper and become louder and longer. Your hungry child will eagerly accept feeding and stop crying.
- Upset cries. Upset cries are loud and start suddenly. Your young child may be afraid, bored, or lonely. As your child gets older, upset crying may be a reaction to such things as loud noises, frustration with clothing or toys, or fear of strangers.
- Pain cries. Pain cries start with a high-pitched, strong wail followed by loud crying. These cries sound very irritating and may make you feel anxious. A young child in pain will often have other signs of pain along with crying. Commonly, pain cries may be caused by:
- A recent immunization. Your child may be fussy, cry more than usual, and have a fever after receiving an immunization, especially diphtheria, tetanus, and pertussis (DTaP) shots. But he or she will look well even while continuing to cry.
- Teething. Teething symptoms may begin about 3 to 5 days before a tooth breaks the skin, although symptoms can be present off and on for 1 to 2 months. The most common symptoms of teething include swelling, tenderness, or discomfort in the gums at the site of the erupting tooth; drooling; biting on fingers or toys; irritability; or difficulty sleeping. Teething may cause a mild increase in your child's temperature. But if the temperature is higher than 100.4°F (38°C), look for symptoms that may be related to an infection or illness.
- Constipation. A crying episode that occurs when the child is trying to pass a stool normally will stop when the stool is passed.
- Diaper rash. Irritated skin around the thighs, genitals, buttocks, or abdomen may make a child cry persistently, especially when a diaper is wet or soiled.
- Colic. All babies cry, but sometimes a baby will cry for hours at a time, no matter what you do. This extreme type of crying in a baby who is between 3 weeks and 3 months of age is called colic. While it is upsetting for parents and caregivers, colic is normal for babies. Doctors usually diagnose colic when a healthy baby cries harder than expected in a "3" pattern: more than 3 hours a day at least 3 days a week for at least 3 weeks in a row. The crying is usually worst when babies are around 6 to 8 weeks of age, and it goes away on its own between 8 and 14 weeks of age. Doctors are not sure what causes colic. It may be related to gas in the belly, an immature nervous system, or your baby's temperament.
- Abdominal cramps from overfeeding or milk intolerance. Overeating or swallowing too much air during feeding can cause abdominal cramps, which in turn can make a baby cry. Crying also may occur if your child is sensitive to milk protein. The baby will often spit up some of the feeding and may have loose stools.
- A minor illness, such as a cold or stomach flu (gastroenteritis). Crying related to an illness often begins suddenly. In most cases, there are other signs of illness such as fever, looking sick, and decreased appetite.
- Minor injuries. Your child is likely to cry when he or she has an injury, such as an eyelash in the eye, an insect bite, an open diaper pin in the skin, or a strand of hair wrapped around a finger, toe, or the penis.
- Overtired or overstimulated cries. Crying can be your young child's way of releasing tension when there is too much noise, movement, or activity in his or her environment or when he or she is overtired.
Crying related to a serious illness or injury
On rare occasions, crying may point to a serious illness or injury. Crying caused by a serious illness or injury usually lasts much longer than normal and your baby may not be acting normally.
- Some illnesses may cause persistent crying. These include common infections, such as ear infections (otitis media) or urinary tract infections, and rarer infections, such as meningitis, encephalitis, or sepsis with dehydration. A persistent cry in a newborn may be the first sign of a serious illness, such as sepsis.
- A serious injury from a fall, being shaken, or abuse may cause a child to cry for a long time. Other signs of injury, such as swelling, bruising, or bleeding, are usually present.
Crying and shaken baby syndrome
Crying can be very frustrating for a parent or caregiver. Do not get angry at your child for crying. Never shake or harm your child. Shaking a child in anger or playing rough, such as throwing him or her into the air, can injure the brain. Shaken baby syndrome needs to be reported to your doctor. If you find that you are losing patience or are afraid that you may hurt your child:
- Place your child in a safe place while you go into another room, relax, and calm yourself.
- Ask someone to help you. If you cannot find someone to take over for you and you still feel out of control, call your doctor.
Crying related to medical conditions
Check your child's symptoms to decide if and when your child should see a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Symptoms of difficulty breathing can range from mild to severe. For example:
- You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example:
- The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
- The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).
Severe trouble breathing means:
- The child cannot eat or talk because he or she is breathing so hard.
- The child's nostrils are flaring and the belly is moving in and out with every breath.
- The child seems to be tiring out.
- The child seems very sleepy or confused.
Moderate trouble breathing means:
- The child is breathing a lot faster than usual.
- The child has to take breaks from eating or talking to breathe.
- The nostrils flare or the belly moves in and out at times when the child breathes.
Mild trouble breathing means:
- The child is breathing a little faster than usual.
- The child seems a little out of breath but can still eat or talk.
A baby that is extremely sick:
- May be limp and floppy like a rag doll.
- May not respond at all to being held, touched, or talked to.
- May be hard to wake up.
A baby that is sick (but not extremely sick):
- May be sleepier than usual.
- May not eat or drink as much as usual.
You can use a small rubber bulb (called an aspirating bulb) to remove mucus from your baby's nose or mouth when a cold or allergies make it hard for the baby to eat, sleep, or breathe.
To use the bulb:
- Put a few saline nose drops in each side of the baby's nose before you start.
- Position the baby with his or her head tilted slightly back.
- Squeeze the round base of the bulb.
- Gently insert the tip of the bulb tightly inside the baby's nose.
- Release the bulb to remove (suction) mucus from the nose.
Don't do this more than 5 or 6 times a day. Doing it too often can make the congestion worse and can also cause the lining of the nose to swell or bleed.
Colic is an extreme type of crying in a baby between 3 weeks and 3 months of age. All babies cry, but a colicky baby will cry for hours at a time, no matter what you do.
During a crying episode, a colicky baby may cry loudly and continuously and be hard to comfort. The baby may get red in the face, clench the fists, and arch his or her back or pull the legs up to the belly.
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Babies and young children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Being very sleepy or hard to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused. The child may not know where he or she is.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
- Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.
Pain in children 3 years and older
- Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
- Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
- Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Crying is a normal part of your child's life. Stay as calm as possible during crying episodes. There are many different ways to approach your child's crying, and over time you will understand your child's needs and know how to care for him or her.
It may be helpful to keep a record of your child's crying to see whether there is a pattern that you can discuss with your child's doctor.
Checklist of common reasons a child cries
Use this checklist to help you figure out the reason for your child's crying and take action to eliminate the cause of the crying. Remember that the crying may be normal for your child. Ask yourself whether your child:
- Is hungry. Does he or she need to be burped? Does he or she need to suck (on a finger, pacifier, bottle, or breast)?
- Needs a diaper change.
- Needs to be moved to a more comfortable position.
- Is afraid, bored, or lonely.
- Is too warm (feels warm) or too cold. Young children usually have cool hands and feet. When they are cold, their hands and feet will be colder than usual. If you think your child may be cold, check the arms, thighs, or back of the neck for skin cool to the touch.
- Is hurting from something pinching or poking the skin.
- Is overstimulated. Crying can be a young child's way of releasing tension when there is too much noise, movement, or activity in his or her environment or when he or she is overtired.
- Is uncomfortable from teething. Young children who are teething can be fretful and cry more than usual because their gums are swollen and sore. Children who are teething drool more than usual and may try to rub their gums with toys or fingers.
- Had a recent immunization. If you think your child is uncomfortable from a recent immunization, acetaminophen or ibuprofen may help. Do not give aspirin to anyone younger than age 20.
Illness or injury that may cause a child to cry
Young children may turn red or purple in the face when crying. A sick child may have pale, blue, or spots of bluish (mottled) skin and may be listless, unusually sleepy, or irritable. A sick child's cry may be weak and feeble or (in rare cases) high-pitched and piercing. If you think your child may be sick or hurt:
- Check for a fever. For information on how to take a temperature, see the topic Body Temperature.
- Look for other signs of illness, such as crying during feeding, vomiting, or diarrhea.
- Check for other signs of pain.
- Does your child have colic? You may want to limit visitors and activity during those times when he or she is most fussy.
- Is something causing your child pain, such as an open pin sticking the skin, a red spot that may be an insect bite, or a strand of hair wrapped around a finger, a toe, or the penis?
- Does your child have pain in the groin area? Check his groin area and scrotum or her groin area for a bulge that may be an inguinal hernia.
- Does your young boy have scrotal swelling or tenderness (testicular torsion)? Testicular torsion can cause severe pain.
- Has your child fallen or been dropped? Undress your child and look for swelling, bruises, or bleeding.
If you don't find a reason for your child's crying, try comforting techniques, such as rocking your baby, breastfeeding, or offering a pacifier after breastfeeding is going well (usually after 3 or 4 weeks). If your child continues to cry after you have tried home treatment, place him or her in a safe, quiet place and leave him or her alone for 10 to 15 minutes. Sometimes children can relax and soothe themselves. Be sure to stay close by.
Talk with your child's doctor before giving your child any nonprescription medicines or herbal remedies as a comfort measure. Products with alcohol or sugar in them are not recommended.
Do not get angry at your child for crying. Never shake or harm your child. Shaking a child in anger or playing rough, such as throwing a baby up into the air and catching him or her, can cause shaken baby syndrome. If you find that you are losing patience or are afraid that you may hurt your child:
- Place your child in a safe place while you go into another room, relax, and calm yourself.
- Ask someone to help you. If you cannot find someone to take over for you and you still feel out of control, call your doctor.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Changes in the level of consciousness develop.
- Your child is not acting normally and cries in a way that is not usual for him or her.
- Crying continues longer than 30 minutes, and the child appears to be in pain.
- Crying continues longer than 30 minutes after an injury.
- Symptoms become more severe or frequent.
The following tips may help you care for your child and lessen the amount he or she cries.
- Recognize and respond to your child's cry and other signals (whimpering, wiggling, and facial expressions). Do not worry about spoiling your child. Young children cry for a reason and are not trying to manipulate parents or caregivers. It is harder to find the cause of crying and takes longer to soothe your child when he or she has been crying for a long time. Babies younger than 6 months use crying as their way to communicate. As a young child learns other ways to communicate, he or she may use crying for attention. If you think your child's crying is related to behavior problems, many parenting books and classes offer suggestions for behavior modification in these situations.
- Keep a regular routine for your child's meals, naps, and play times. This will prevent your child from getting overtired or overstimulated.
- Carry your child in your arms or in a soft pouch infant carrier so your child is close to your chest. Studies have shown that young children carried for about 3 hours each day cry much less than those who are carried less. Being carried gives your child the pleasure of physical closeness and may help you be more in tune with his or her needs.
- If you breastfeed your child, watch how your own diet affects your child's behavior. For example, does your child have gas or cry more after you have eaten certain foods? The medicines you take can pass in your breast milk to your child and affect him or her. If you smoke cigarettes or chew tobacco, the nicotine can pass through your breast milk and may make your child fussy or irritable.
- Make sure your child is getting enough to eat but is not overfed. Make sure the nipple opening of the bottle is not too large or too small.
- If your baby gulps during bottle feedings, the nipple hole may be too large, causing your baby to swallow air when sucking.
- If your baby struggles with the bottle during feedings, the nipple hole may be too small, causing air to be swallowed when sucking. When a baby struggles for nourishment, he or she may become frustrated and may even stop eating before being satisfied.
- Burp your child often during feedings. Adding solid foods to your baby's diet at a young age (unless you have been told to do so by your doctor) may cause problems. Solid foods are harder for a young child to digest and may cause a food intolerance. This might make you think your baby has a food allergy when he or she does not. You may be able to avoid some food intolerances if you wait to add solid foods until your baby is 6 months old.
- Make sure your child's sucking needs are satisfied. Sucking can help a child relieve stress without crying. Some young children need to suck as much as 2 hours a day. If feedings are not enough to satisfy sucking, use a pacifier. If your baby is breastfed, experts recommend waiting 3 or 4 weeks after birth until breastfeeding is going well before offering a pacifier.
- If you think the formula may be the problem, talk to your child's doctor before changing formulas or brands of formulas.
- Do not leave your child unattended in a place where an injury may occur, such as on a changing table, in a high chair, or in a crib with a side rail down.
- Keep tobacco smoke out of the home and away from your baby. Even secondhand smoke may make your child fussy. Secondhand smoke increases a child's risk for respiratory problems compared with young children who are not exposed.
- Try to stay calm. Young children are very sensitive to their parents' frustration and fatigue. Try to sleep whenever your child does, even during the day, so you will have more energy for those times when he or she is fussy. Take some breaks from the care of your child. Ask a friend or neighbor to babysit some evening while you enjoy some free time.
- Never shake your baby! Place your child in a safe place while you go into another room, relax, and calm yourself. Or ask someone to help you.
Check with your doctor about giving your child acetaminophen before immunizations are given. Some doctors suggest this to decrease discomfort after a shot.
Preparing For Your Appointment
You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:
- Has your child been feeding and sucking normally? Have you recently changed formulas or added a new food? Does your child have any known food allergies, or is there a family history of food allergies? Has your child been vomiting? If yes, how often, how long has it been going on, and what color is the vomit?
- How often does your child have a bowel movement? Are the stools hard or soft? Has there been any blood in the stools?
- Has your child received any recent immunizations?
- Has your child had any recent illnesses or injuries?
- Did the crying develop suddenly, especially in a child who normally does not cry a lot?
- Does your child cry like this every day at a certain time?
- How long has your child been crying, what does the cry sound like (painful or high-pitched), and has it changed or been continuous?
- What do you think is causing your child's continuous crying?
- Does your child have any symptoms indicating a problem, such as an ear infection? Does your child have a fever?
- Does your child have any signs of a medical problem, such as a bulge in the groin, or does your young boy have swelling in his scrotum?
- How is your child's crying affecting you and your family? Are you feeling out of control, and are you afraid that you may hurt your child?
- What comforting techniques have you tried to soothe your child?
- What medicine have you given your child?
- Does your child have any health risks?
Current as of: October 19, 2020
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
John Pope MD - Pediatrics
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
H. Michael O'Connor MD - Emergency Medicine
David Messenger MD
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