The Ten Medical Red Alerts Your Doctor Will Consider - Woodmam

1. Infection: From Ear Infections to Appendicitis

You might think the best way to tell if your baby has an infection is to take her temperature, but many sick newborns don’t get fevers. So even if your crying baby doesn’t have fever, you should consider that her fussiness may be a sign of infection if she acts lethargic or irritable for more than a few hours. Call your doctor immediately. He may check her for:

Ear Infection—These babies may just get fussy and upset; they rarely pull on their ears.

Urine Infection—These babies can have smelly urine, but usually don’t.

Brain Infection (meningitis)—These infants have bulging soft spots, vomiting, lethargy, and irritability that rapidly worsens over just a day or two.

Appendicitis—Extremely rare in infants, it may cause a hard stomach, poor appetite, and constant irritability. Intestinal Infection—A baby with “stomach flu” vomits, has diarrhea, and usually has been in contact with a sick relative.

2. Intestinal Pain: From Intestinal Blockages to Stomach Acid Reflux

Some stomach problems cause pain and may explain crying in ten to fifteen percent of colicky infants (in descending order of seriousness):

Intestinal Blockage—This is an extremely rare medical emergency that may occur right after birth or weeks later. Babies suffer from waves of severe painful spasms plus vomiting and/or the cessation of pooping. With intestinal blockages, the vomit often has a distinct yellow or green tint. (During the first days of life, a breast-fed baby’s vomit may also be yellow, because that is the color of colostrum. However, if your baby has yellow vomit, never assume it’s from your milk. Immediately consult your doctor to make sure it isn’t the sign of a more serious condition.)

Stomach Acid Reflux—This cause of burning pain occurs in approximately one to three percent of fussy babies.

Food Sensitivity—Five to ten percent of fussy babies get better with a change in diet and so presumably have this condition. Besides crying, it may cause vomiting, diarrhea, rash, or mucousy blood in the stools.

(For a complete discussion of reflux and food sensitivities see Chapters 4 and 14.)

A “Pain in the Rear”: Can an Overly Tight Anus Block a Baby’s Intestines?

In 100 A.D. the physician Soranus opined that a tight anus could block a baby’s intestines, leading to spasms. He recommended stretching the anus to relieve a baby’s crying. Over the next two thousand years, medical practitioners followed his advice and routinely stuck fingers up the behinds of crying babies. Today, however, we know this problem is extremely rare and probably never causes colic.

Crying before, during, and after feeding

Immediately before a feeding: hunger, thirst, challenging temperament

During a feeding: the gastro-colic reflex, the milk flow is too slow or too fast, the milk has a strange taste, stomach acid reflux

Immediately after a feeding: continued hunger, the gastro-colic reflex, needing to burp, needing to poop, wanting to suck more, food allergy, stomach acid reflux

3. Breathing Trouble: From Blocked Nostrils to Oversize Tongues

The most common cause of breathing trouble is a condition where a baby’s tiny nostrils are blocked. Babies don’t know how to breathe through their mouths, except when they’re crying. That’s why babies who are born with tight nostrils, or who have noses swollen shut from allergies or colds, get so frantic.

If you want to check for blockage, place the tip of your little finger snugly over one of your baby’s nostrils, closing it off for a few seconds. She should easily be able to breathe through the open nostril. Then repeat this test on the other side.

If your baby can’t breathe or gets agitated when you do this test, call your physician. If it seems the nostril is blocked from mucus, ask the best ways to clear it. And do your best to rid your home of dust, molds, sprays, perfumes, cigarette smoke, and anything else that might make her nose congested.

Very rarely, an infant will have trouble breathing if her tongue is too big for her mouth so it falls back into the throat and chokes her when she lies on her back. This problem is obvious from the moment of birth because her tongue will always stick out of her mouth.

4. Increased Brain Pressure

When pressure builds up inside a baby’s head, it also causes:

Irritability and crying from a headache

Vomiting

An unusual high-pitched cry

A bulging fontanelle (soft spot) even when the baby is seated

Swollen veins on the forehead

A head that’s growing too rapidly (your doctor should measure your baby’s head size at every well-baby checkup)

Sunset sign (a big-eyed stare with a crescent of the white of the eye displayed over the colored iris, making the eye look like a setting sun)

If your baby fits the symptoms described above, contact your doctor immediately.

5. Skin Pain: A Thread or Hair Twisted Around a Finger, Toe, or Penis

In years past, the sudden onset of sharp screaming in an otherwise calm baby made parents search for an open safety pin inside the diaper. Today, however, thanks to pin-less diapers, that no longer happens. Now a parent who hears that type of abrupt, shrill cry should look for a fine hair or thread wrapped tightly around their baby’s finger, toe, or penis. This problem requires immediate medical attention. (Doctors often treat this problem by applying a dab of hair-removal cream to dissolve the hair.)

6. Mouth Pain: From Thrush to Teething

Thrush, a yeast infection in the mouth, is easy to recognize because it causes a milky white residue on the lips and inside of the mouth that cannot be wiped away. Thrush may also cause a bumpy red rash in a baby’s diaper area and/or itchy, red nipples in a breast-feeding mom.

Thrush rarely causes fussiness, but on occasion it can cause crying from an irritated mouth. Fortunately it is easy to treat, and recovery is rapid.

Many parents ask if teething causes their baby’s crying. This is extremely unlikely, because teething two-month-olds are as rare as hen’s teeth. However, if you think your baby is having teething pain, give her some acetaminophen drops and see if it gives any relief (ask your doctor for the correct dosage). This medicine won’t help colic, but it may reduce mild teething pain.

7. Kidney Pain: Blockage of the Urinary System

A blockage of the kidney is a very rare cause of persistent crying that occurs any time, day or night. Unlike classic colic, which begins improving after two months, crying from kidney pain gets worse and worse.

8. Eye Pain: From Glaucoma to a Corneal Abrasion

Eye pain, also very rare, may come from glaucoma (high pressure inside the eyeball), an accidental scratch of the cornea, or even from a tiny, irritating object stuck underneath a baby’s eyelid (such as an eyelash). Your doctor should consider these problems if your crying baby has red, tearful eyes and severe pain that lasts through the day and night.

9. Overdose: From Excessive Sodium to Vitamin A

Persistent, severe crying can result from giving babies excessive amounts of sodium (salt). This may occur when a parent mixes formula with too little water. It has also rarely been described after the first week of life if a breast-feeding woman is making so little milk that her breast milk becomes very salty. These babies are easily diagnosed because they are losing weight, not drinking any other liquids, and are both irritable and lethargic all day long.

Excess Vitamin A is an extremely rare cause of infant crying. It only occurs in babies who are given high doses of supplemental vitamins or fish oil.

10. Others: From Migraines to Heart Failure

Some extraordinarily rare conditions that have been reported as the cause of unstoppable crying in young infants include: a bone fracture, sugar intolerance in babies fed fruit or fruit juice, migraine headache, hyperthyroidism, and heart failure. These babies don’t merely cry for three hours a day—they act poorly all day long.

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