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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 figure out the type of cry. It helps to go through a mental checklist of what might be wrong and to make sure that your child is safe and cared for. But remember that there may be nothing bothering your child. 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 knowing the cause of a young child's cry. A young child will often have different kinds of cries.
Crying related to normal development and behavior
- Hungry cries. These cries start with a whimper and become louder and longer. Your hungry child will eagerly accept feeding and stop crying.
- Upset cries. They 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. These start with a high-pitched, strong wail followed by loud crying. These cries sound very irritating. They may make you feel anxious. A young child in pain will often have other signs of pain along with crying. In many cases, pain cries may be caused by:
- A recent immunization. Your child may be fussy, cry more than usual, and have a fever after getting a vaccine, especially diphtheria, tetanus, and pertussis (DTaP) shots. But your child will look well even while crying.
- Teething. Teething symptoms may start about 3 to 5 days before a tooth breaks the skin. But symptoms can occur 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; crankiness; or trouble 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 belly may make a child cry, 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. It goes away on its own between 8 and 14 weeks of age. Doctors aren't sure what causes colic. It may be related to gas in the belly or an immature nervous system.
- Belly cramps from overfeeding or milk intolerance. Overeating or swallowing too much air during feeding can cause belly cramps. These cramps 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 starts 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 they have an injury, such as an eyelash in the eye, an insect bite, or an open diaper pin in the skin.
- 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 the environment or when they are overtired.
Crying related to a serious illness or injury
In rare cases, crying may point to a serious illness or injury. This type of crying 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. There are usually other signs of injury, such as swelling, bruising, or bleeding.
Crying and abusive head trauma
Crying can be very frustrating for a parent or caregiver. But never shake or harm your child. Shaking a child in anger or playing rough, such as throwing a child into the air, can injure the brain. Abusive head trauma 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 can't find someone to take over for you and you still feel out of control, call your doctor.
Crying related to medical conditions
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 a child's crying. Over time you will understand what your child needs and know how to care for them.
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 your child need to be burped? Do they 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 their environment or when they are 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, talk to your doctor about what medicine may help.
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. If your child continues to cry after you have tried home treatment, place them in a safe, quiet place and leave them alone for 15 to 20 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.
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 them, can cause abusive head trauma. 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.
Illness or injury that may cause a child to cry
If you are concerned that your child's crying is because of a more serious illness or injury, your child may need to be checked by a doctor.
Helping a tired or overstimulated child
Small children sometimes cry to release tension when they are overtired or overstimulated. This happens when they have been held by a lot of people in a short amount of time or exposed to lots of noise, bright lights, loud voices, or music.
You can protect your child from becoming overtired by keeping a regular routine for meals, naps, and play times.
If your child is crying because they are overtired or overstimulated, try the following:
- Reduce the noise in the room.
- Reduce the amount of movement and visual stimulation in the room.
Turn down the lights and ask others not to bother your child.
- Turn on white noise.
Turn on a continuous, monotonous sound, such as a vacuum cleaner or a recording of ocean waves. Sometimes these sounds soothe and relax a child.
- Try letting your child settle down on their own.
Place your child in a safe place, close the door, and set a kitchen timer for 10 to 15 minutes. If your child has not settled down after 10 to 15 minutes, check to see whether there is another reason for their crying.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- Decreased alertness.
- Decreased activity and crying in a way that is not usual.
- New or worse pain.
- Symptoms occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: October 6, 2021
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 - Emergency Medicine, Critical Care Medicine
Current as of: October 6, 2021
Author: Healthwise Staff
Medical Review: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 - Emergency Medicine, Critical Care Medicine
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