THE CRYING INFANT - 09/09/11

Doi : 10.1016/S0733-8627(05)70038-9

Douglas R. Trocinski, MD ^a,^b, Paul D. Pearigen ^b,^c, FACEP

^a Children's Hospital and Health Center (DRT)

^b the Department of Emergency Medicine (DRT, PDP), Naval Medical Center San Diego, San Diego, California

^c the Uniformed Services University of the Health Sciences (PDP), Bethesda, Maryland

Résumé

The crying of an infant evokes emotions ranging from the need to respond, comfort, and protect; to annoyance, aversion, or even rage.^{18 Brazelton T.B. Crying in infancy Pediatrics 1962 ; 29 : 579

Cliquez ici pour aller à la section Références, 21 Carey W.B. Infantile colic: A pediatric practitioner-researcher's point of view Infant Mental Health Journal 1990 ; 11 : 334

Cliquez ici pour aller à la section Références, 29 Geertsma M.A., Hyams J.S. Colic—a pain syndrome of infancy? Pediatr Clin North Am 1989 ; 36 : 905

Cliquez ici pour aller à la section Références, 57 Murray A.D. Aversiveness is in the mind of the beholder: Perception of infant crying by adults Infant Crying—Theoretical and Research Perspectives New York: Plenum Press (1985).
217-237

Cliquez ici pour aller à la section Références, 63 Schmitt B.D. Colic: Excessive crying in newborns Clin Perinatol 1985 ; 12 : 441

Cliquez ici pour aller à la section Références} The incidence of “excessive” crying ranges from 8% to 30% in the United States and was reported by Poole as the chief complaint for approximately 1 in every 400 visits to an urban pediatric emergency department (ED).^{20 Canivet C., Hagander B., Jakobsson I. , et al. Infantile colic—less common than previously estimated? Acta Paediatr 1996 ; 85 : 454

Cliquez ici pour aller à la section Références, 34 Hewson P., Oberklaid F., Menahem S. Infant colic, distress and crying Clin Pediatr 1987 ; 26 : 69

Cliquez ici pour aller à la section Références, 46 Lester B.M., Boukydis C.F.Z., Garcia-Coll C.T. , et al. Colic for developmentalists Infant Mental Health Journal 1990 ; 11 : 321

Cliquez ici pour aller à la section Références, 60 Poole S.R. The infant with acute, unexplained, excessive crying Pediatrics 1991 ; 88 : 450

Cliquez ici pour aller à la section Références} The child presenting to the ED with persistent crying generally represents the endpoint of a caregiver's frustration and fear for the health of their very young and vulnerable child.^{13 Barr R.G., Rotman A., Yaremko J. , et al. The crying of infants with colic: A controlled empirical description Pediatrics 1992 ; 90 : 14

Cliquez ici pour aller à la section Références, 18 Brazelton T.B. Crying in infancy Pediatrics 1962 ; 29 : 579

Cliquez ici pour aller à la section Références, 19 Brazelton T.B. Crying and colic Infant Mental Health Journal 1990 ; 11 : 349

Cliquez ici pour aller à la section Références, 64 Schmitt B.D. The prevention of sleep problems and colic Pediatr Clin North Am 1986 ; 33 : 763

Cliquez ici pour aller à la section Références} The parent often thinks that they have failed to meet the needs of his or her child and will seek medical care when the advice and counseling of friends and relatives is no longer effective or desired.^{18 Brazelton T.B. Crying in infancy Pediatrics 1962 ; 29 : 579

Cliquez ici pour aller à la section Références, 19 Brazelton T.B. Crying and colic Infant Mental Health Journal 1990 ; 11 : 349

Cliquez ici pour aller à la section Références, 21 Carey W.B. Infantile colic: A pediatric practitioner-researcher's point of view Infant Mental Health Journal 1990 ; 11 : 334

Cliquez ici pour aller à la section Références, 33 Heine R.G., Jaquiery A., Lubitz L. , et al. Irritability Arch Dis Child 1995 ; 73 : 121 [cross-ref]

Cliquez ici pour aller à la section Références, 43 Lehtonen L., Rautava P.T. Infantile colic: Natural history and treatment Curr Probl Pediatr 1996 ; 26 : 79

Cliquez ici pour aller à la section Références, 64 Schmitt B.D. The prevention of sleep problems and colic Pediatr Clin North Am 1986 ; 33 : 763

Cliquez ici pour aller à la section Références} Parents present looking not only for definitive diagnosis and reassurance that their baby is well but also for relief of both the child and themselves.^{18 Brazelton T.B. Crying in infancy Pediatrics 1962 ; 29 : 579

Cliquez ici pour aller à la section Références, 29 Geertsma M.A., Hyams J.S. Colic—a pain syndrome of infancy? Pediatr Clin North Am 1989 ; 36 : 905

Cliquez ici pour aller à la section Références, 43 Lehtonen L., Rautava P.T. Infantile colic: Natural history and treatment Curr Probl Pediatr 1996 ; 26 : 79

Cliquez ici pour aller à la section Références} The crying infant also represents a challenge to the emergency physician to evaluate a disruptive, noncommunicative patient in obvious distress while effectively managing the anxious, fearful, and frustrated caregiver. Unfortunately, for the emergency physician seeking useful information when faced with the infant who has been “crying all night and just won't stop,” the literature addressing the question of infant crying generally focuses on specific cry characteristics or the investigation of infants with persistent, paroxysmal, and recurrent crying. In an attempt to provide a practical framework for this vexing problem, this review presents an approach to the crying infant with a brief discussion of current and previous cry research, followed by a differential diagnosis and recommendations for evaluation and management of this chief complaint.

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Plan

CRY RESEARCH

EVALUATION OF THE CRYING INFANT

History

Physical Examination

Laboratory Tests and Ancillary Evaluation

DIFFERENTIAL DIAGNOSIS OF THE CRYING INFANT

DISPOSITION

COLIC

CONCLUSION

Address reprint requests to Douglas R. Trocinski, MD, Division of Emergency Medicine, Children's Hospital and Health Center, San Diego, 3030 Children's Way, Mail Code 5075, San Diego, CA 92123