#paeds see also: [[Postnatal depression]] (because sometimes bub crying associated with postnatal depression) see: [RCH - crying baby](https://www.rch.org.au/clinicalguide/guideline_index/Crying_Baby_Infant_Distress/) > generally doesn't need many ix besides urine sample **Mnemonic** TIMSCRIES Trauma Infectious Maternal/paternal stress Strangulation Cardioresp disease Reflux, med reaction, formula reaction, rectal Intracranial HTN, immunisation, intolerance of lactose or cow's milk Eye (corneal abrasions, ocular foreign bodies ) Surgical (volvulus, intussusception, inguinal hernia, testicular torsion) # normal crying - 1h 45 min /day a 2 weeks, peak 2h 45 min/day at 6 weeks, down to <1h at 12 weeks - infants cry more during first 4 months than at any other time - highly variable - colic most common in first four months > Peak crying around 6-8 weeks of age, often improves by 3-4 months, and is a normal part of development. Worse in evenings. ## colic - dx of exclusion - \>3 hr/day of irritability, fussing, and crying on at least 3 days/week for at least 3 weeks. - The infant is otherwise healthy, active, thriving, and has no other features to suggest underlying disease - generally in afternoon and evening - a/w infant going red in face, flexing legs, or passing wind - aetiology likely multifactorial ; poorly understood - *no definitive management of infantile colic*; caregiver support foundation of mgmt - explain time-limited nature and worsening advise - review caregivers level of support ## GORD - all infants spill a bit eating; keeping them upright on shoulder 15 minutes after feed helps this; no role for 'burping' the bub - ==GORD is not usually a cause of crying infants== **management** - conservative - positioning - smaller more frequent feeds - thickened feeds - antacids, H2 antagonists, PPI if significant symptoms - avoid anticolic medications # Acute crying - broad ddx - asses history and timing, duration, specific concerns, etc **specific investigations:** - digits and genitalia (hair tourniquet) - palpate long bones (fractures, osteomyelitis) - skin beneith clothing (bruising) - flurescein staining of cornea (if hx suggests corneal abrasion) - retinal exam by opthal if working up [[Non-accidental injury|NAI]] ![[Pasted image 20250327004543.png|hair tourniquets compromising circulation to toes]] ![[Pasted image 20250204193919.png]] # OSCE - [Cabrini 2025 station 1](x-devonthink-item://9915983E-9405-4E3A-B6BA-1490CCA5E98B)