Possible causes of crying
Where to seek help
Babies cry for many reasons – most commonly because they are hungry or need a nappy change.
Sometimes babies cry because they are uncomfortable or are unwell. This may be due to colic, reflux, constipation or infection amongst other things (see below). Sometimes the crying can feel like it’s become too much. If this is the case, click here for parents advice from ICON on what you can do.
Below are some things to look out for if your baby is crying, which may suggest they are unwell.
Check if your child has any red symptoms:
- Your child becomes pale, mottled and feels abnormally cold to touch.
- Pauses in their breathing lasting more than 10 seconds, grunting or going blue around the lips.
- Is stiff or rigid or makes repeated, jerky movements of arms or legs that don’t stop when you hold them (a fit or seizure).
- Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake).
- Develops a rash that does not disappear with pressure (the ‘Glass Test’).
- Is under three months old with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features are present) – how to take your child’s temperature.
- Has fingers or toes that look very red, swollen or painful to touch.
Actions to take if your child has any red symptoms
- Your child may require emergency treatment.
- You should call 999 or take them to your NEAREST Emergency Department where they can be assessed.
If there are no red symptoms, check if your child has any amber symptoms:
- Difficulty breathing – including breathing fast all the time – widening their nostrils or pulling in the muscles below the ribs when breathing
- Not interested in feeding and / or looks dehydrated (dry mouth, sunken eyes, no tears, drowsy, no wet nappies in the last eight hours or sunken fontanelle – soft spot on the head)
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with cuddles, toys, TV or snacks) – especially if they remain drowsy or irritable despite their fever coming down.
- Is getting worse or if you are worried.
Options if your child has any amber symptoms
Your child does not need to be taken to the Emergency Department immediately, but you should seek medical advice today.
- ring your GP surgery during their usual opening hours
- contact the out of hours GP if the surgery is closed
If symptoms continue for four hours or more and you have not been able to speak to your GP or the out of hours GP, consider going to your nearest Emergency Department.
If your child develops any of the red symptoms above, go to your nearest Emergency Department.
If no red or amber symptoms are present:
- your child does not seem to have any symptoms of serious illness or injury
- you can get general advice on the NI Direct website or from your local pharmacy
If your child develops any of the red or amber symptoms above, follow the advice in these sections.
How you can help manage your child’s crying at home
If your child continues to feed well and has plenty of wet nappies, continue providing your child’s care at home (if you are still concerned, contact your health visitor or GP).
ICON also provides additional advice for families trying to cope with babies who otherwise appear well.
Possible causes of crying
The following information is also available on the ICON website.
Crying behaviours peak from two weeks to four months of age. This is a normal developmental process and is unrelated to the diagnosis of ‘colic’ or ‘wind’.
Your baby may be unsettled due to:
- dirty nappy
- wanting a cuddle / reassurance
- abdominal wind
- feeling to hot or too cold
Advice for parents:
- try different winding positions
- skin to skin contact
- rocking / singing or music
- a warm bath (after the first week)
- going for a walk or short drive (do not encourage long periods in a car seat)
Click here to watch a video from ICON on ways to cope.
Click here to watch a video from ICON made specifically to cover ways of coping during COVID-19 lockdowns.
Conditions that can make your baby cry a lot
Video from Best BeginningsIt is normal for babies to have some reflux. This is because the muscle at the end of the food pipe, which keeps food in the stomach, is still developing. Reflux may cause your baby to bring up milk after a feed, and can also give them hiccups. As long as your baby is growing normally and is not showing any marked signs of distress, there is no need to worry.
More severe reflux can cause your baby to cry and be sick, often after feeding. The long name for severe reflux is gastro-oesophageal reflux disease (GORD). This means that when your baby’s tummy is full, food and stomach acid flow back up their food pipe causing discomfort and pain.
If you have tried the measures described above and observed no improvement, see your health visitor. They will review your child’s symptoms and ask you about the formula you have used. They may possibly prescribe an antacid designed for babies.
Your baby may be crying because they have an infection. This is usually associated with a temperature above 38°C / 100.4°F.
Although the most likely cause is a viral infection, other causes include urinary tract infections or very occasionally a more serious illness such as meningitis or sepsis.
Signs of a serious infection include:
- your child becomes pale and floppy, going blue around the lips
- is fretful or excessively miserable when touched
- becomes difficult to rouse
- is finding it hard to breathe
- develops a rash that does not disappear with pressure (the ‘Glass Test’)
If any of these features are present, your child needs to be assessed – check your child for red or amber features above and follow the guidance.
Video from Best BeginningsColic can cause excessive, frequent crying in a baby who appears to be otherwise healthy. It’s a common problem that affects up to one in five babies. Although the cause is unknown, it is likely to be due to intestinal discomfort like bowel cramping.
Colic tends to begin when a baby is a few weeks old. It normally stops by four months of age, or by six months at the latest.
Looking after a colicky baby can be very frustrating and distressing, but the problem will eventually pass and is usually nothing to worry about.
Signs and symptoms of colic include:
- your baby often starts crying suddenly – the cry is high-pitched and nothing you do seems to help
- crying that begins at the same time each day, often in the afternoon or evening
- your baby drawing their legs up when they cry
- clenching their hands
- a flushed face
- crying that can last for minutes or hours (a baby with colic cries for three hours a day or more)
- crying that often winds down when your baby is exhausted or when they have passed wind or poo
Difficulty having a poo (constipation) can be a cause of excessive crying in babies. However, the crying tends to stop once your baby has had a poo.
Formula-fed babies are more prone to constipation because formula can be harder to digest than breastmilk. A breastfed baby is far less likely to get constipated.
Signs of constipation may include:
- crying and discomfort, irritability or pain before doing a poo
- Dry, hard, pellet-like poo that is hard to pass
- Foul-smelling wind and poo
- A hard belly
Try not to worry too much if your baby becomes constipated. It’s likely to happen now and then. Simple things you can try at home if your baby is constipated:
- Gently move your baby’s legs in a cycling motion to help move the hard poo along.
- If your baby is drinking formula, give them extra water in between feeds, but don’t dilute the formula. Make sure you are using the recommended amount of milk powder when making up a bottle. Too much powder can dehydrate your baby, causing constipation. For babies under six months, DO NOT use water from the mains tap in the kitchen – you will need to boil and then cool the tap water because it is not sterile straight from the tap. Water for babies over six months of age doesn’t need to be boiled.
If your baby is in significant pain despite doing this, arrange for them to be reviewed by your GP, who may decide to start them on treatment.
Where to seek help
- If it is non-urgent, speak to your local pharmacist or health visitor.
- Alternatively, you can contact your GP practice and a qualified member of the clinical team will check whether your child needs to be seen urgently. Out of hours GP details are available here.
- You should only call 999 or go your nearest Emergency Department in critical or life-threatening situations.
- See our section: How does the Children’s Emergency Department Work?
Community pharmacists in Northern Ireland
How to take your baby’s temperature