Is my baby sick? Is something really wrong?

The first step in figuring out why your baby is fussy is assessing whether this is a new problem or one that has been going on for awhile. A baby that has been fussy for several weeks or months might have a formula intolerance, reflux, a medical condition known as anal stenosis, or because they have a difficult temperament.

It is more difficult when a baby that has usually been happy all of a sudden becomes fussy, crying, and inconsolable. Although these babies usually need to be seen and have an appointment at Town and Country Pediatrics, there are some things you can look for first.

* Is he off his usual routine, with a late night or a missed nap? This often happens after vacation or if you have visitors in your home or new caregivers.

* Does your baby have a fever? Has he had a runny nose or cough? If so, then he might have a simple ear infection.

* Does he have sores or blisters in his mouth or on his hands and feet? These sores and blisters could be a sign of a viral infection, like Hand Foot and Mouth disease.

* If he has some vomiting and diarrhea, then he might have a stomach virus or gastroenteritis especially if other people around him have been sick with similar symptoms. Persistent vomiting and a distended and tender abdomen might indicate a more severe infection or a blockage, so call us if your baby has any of these other symptoms, or if you notice decreased urination, signs of lethargy, or other signs of dehydration.

* Does he have a rash? Insect bites, eczema, or skin irritation can cause an itchy rash that might make a baby fussy as they can't usually get relief from scratching the rash. If he has a fever and a rash, he should be seen as soon as possible for an appointment.

* In an older, mobile infant, you might also look for signs that he may have fallen and injured himself. Is he moving all of his arms and legs normally? Are any areas of his arms or legs painful when touched or moved? Remember that some injuries in young children, like a toddler's fracture, might not be red or swollen.

* Does he arch his back, spit up after a feeding, seem like he is uncomfortable drawing his legs up and crying after a feeding as in signs of gastroesophageal reflux (GERD)?

The infant without other symptoms may be even more confusing for the parent. If this is the case, make sure to undress your infant and carefully examine your undressed baby.

The first thing to look at is your baby's fingers and toes (check your baby boy's penis too). Are any of them red or swollen? If so, then he may have a hair tourniquet, in which a hair or thread twists and wraps around the extremity and cuts off circulation. This is usually a medical emergency, so if your child's fingers or toes are red, tender and swollen, you should seek immediate medical attention.

An incarcerated hernia can be another cause of inconsolable crying. Check your baby's genital area. Is there an area that is swollen? If so, is it painful when touched? A swollen and painful bulge in your child's genital or groin area could be caused by a hernia that has become trapped. This is also a medical emergency and you should seek medical attention for your child as soon as possible. A hernia that is not painful is not usually a medical emergency, but you should still see us today for an appointment.

Another cause of crying in an otherwise healthy baby is a scratched eye or cornea. Is his eye red and watery? Does he have other scratches on his face? Although this will usually heal on its own in a few days, your doctor may prescribe antibiotic eye drops or an ointment to prevent the scratch from getting infected, so call us if you suspect this.

Food intolerances might also cause your child to become fussy. Have you introduced anything new into your baby's diet? If breastfeeding, have you changed your own diet recently?

So what do you do when your baby is fussy? If your baby is less than 2 months old, call the office for an appointment.

The first thing you should likely do is check your baby for a fever. A fever is a rectal temperature greater than or equal to 100.4 degrees Fahrenheit, If your child is less than 3 months old and has a fever, call the office immediately. Next, get him undressed and check his body for entangled hairs, red areas, or bumps. Do you notice any of the problems described above?

If he appears normal, doesn't have a fever, is eating well, and is consolable and you don't suspect any of the symptoms described above, you might just observe him or call the office to discuss these findings with a doctor or nurse. A pain reliever such as Tylenol may be given if he is above the age of two months. If that relieves the fussiness, a visit with us the next day is indicated.

If he does have a fever and is inconsolable, or you do suspect an injury, hernia, hair tourniquet or any of the other problems described above, then you should call Town and Country Pediatrics immediately or seek emergency care.

It can be overwhelming taking care of a crying baby, so get help if you are having trouble coping with your infant's crying. Remember that you should never shake your baby, which can cause shaken baby syndrome. Get help if you think you might harm your baby.

A research project in Chicago is attempting to understand why babies fuss and whether fussiness in infancy predicts other behaviors during development. The study, called the Fussy Baby Study, is looking at how changes in heart rate and breathing during play and/or feeding are related to crying, fussiness and social development. This study may provide you and your family with an opportunity to learn more about your baby's behavior and development.

The Fussy Baby Study is federally funded by a grant from the National Institute for Child Health and Human Development. The project represents the only study currently funded by the National Institutes of Health on fussy babies. The grant was awarded to Dr. Stephen W. Porges at the University of Illinois at Chicago. The grant research is in collaboration with Dr. Keri Heilman at the University of Illinois at Chicago, Drs. Linda Gilkerson and Zack Boukydis at the Erikson Institute, and Dr. Larry Gray at the University of Chicago.

The researchers are looking for infants between the ages of 6-10 weeks that do not cry excessively as well as those who do.

The Fussy Baby Study involves calling the Fussy Baby Study Coordinator before your baby is 10 weeks old, filling out a crying diary, filling out questionnaires, and bringing your baby to the Brain-Body Center at the University of Illinois at Chicago for up to 3 research sessions: at 6 months, 12 months, and 24 months old.

During each research session, your child will have his/her heart rate and breathing monitored during social play with you and a researcher. A small compensation will be provided to you for your time.

Additionally, your child will receive a developmental assessment during each research session. By request, the results of the developmental assessment will be mailed to you, at which point you may choose to share this assessment with your health care provider so it may be a part of his/her chart at Town and Country Pediatrics as well. Please be assured that no information or data provided by you or your child during the research will be directly shared with anyone outside of the research team.

If you would like to participate or have questions about the Fussy Baby Study, please call (312) 436-1499 or email fussybabystudy@yahoo.com