Serious disorders not to be missed
Other systemic infection
Is the patient trying to tell me something?
?hunger ?soiled napkin ?tiredness ?family dysfunction ?inattention
Obtain detailed account from parents of the crying pattern and duration, as well as the circumstances of discomfort incl. feeding, time relationship to feeds and associations, particularly vomiting or possetting, presumed abdominal discomfort, constipation, bowel actions and fever. Establish if breastfeeding or providing other milk and food. Ask about recent immunisation.
General features: appearance of the child, growth parameters and vital signs
Abdominal examination esp. inspection, palpation and auscultation
Examine skin looking for evidence of eczema and napkin rash
Examine the ears, fontanelles
Also assess the child’s temperament and coping abilities
The normal pattern is for crying to start increasing around 2 weeks of age, to peak around 2 months and then settle down 3–4 months of age.