Medical Council of Canada

Medical expert

Crying or Fussing Child - 71-1

Rationale

While it is common for children to cry/fuss, it is important to distinguish between benign and organic causes of crying/fussing in an infant or child.

Causal Conditions

(list not exhaustive)
  1. Functional (e.g., hunger, irritability)
  2. Colic
  3. Trauma
  4. Illness

Key Objectives

Given a crying or fussing infant or child, the candidate will diagnose the cause, severity, and complications of the underlying problem, and will initiate an appropriate management plan. In particular, the candidate will differentiate pediatric emergencies from conditions not requiring emergency treatment.

Enabling Objectives

Given an infant/child who is crying and fussing, the candidate will

  1. list and interpret critical clinical findings, including
    1. eliciting a history of patient's previous behavior, sleep pattern, oral intake, associated symptoms (e.g., fever, pain);
    2. performing a full physical examination in order to determine whether the child is sick or not;
  2. list and interpret critical investigations, including investigations for any suspected underlying disease or trauma;
  3. construct an effective initial management plan, including
    1. counselling caregivers if the fussy or crying child does not have an organic disease;
    2. determining if the child requires follow-up for additional investigation and management;
    3. determining if the patient needs a referral, either immediate or elective.
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