All infants cry as a form of communication, it is the only means for them to express their needs. Thus most cases wines an expression of hunger, discomfort (eg. As a wet diaper) or separation and it stops when the needs (eg. As feed through, drain, tender embrace) are met. The crying is normal and reduced in duration and frequency after about 3 months. However, should a child even after all needs have been satisfied, continue to further crying constantly be examined so that a cause can be found. Etiology cause of crying is organic at <5% of cases functional in 95% of cases Organic causes Organic causes must always be considered, even if they are rare. Cardiological, gastrointestinal, infectious and traumatic causes are to be excluded (see table: Some causes of wines). Of these findings, such as heart failure, intussusception, volvulus, volvulus, meningitis (see also Bacterial meningitis in children over three months and Neonatal Bacterial meningitis) and intracranial hemorrhage due to head injuries potentially life-threatening. Colic manifests itself in excessive crying that occurs in infants aged ? 4 months and has no apparent organic cause. Most at least 3 hours a day for> 3 days a week over a period of> 3 weeks it takes. Some causes of wines basic Suspicious findings Diagnostic procedure coarctation Heart Diminished or absent pulses of the femoral tachypnea cough sweating Poor nutrition systolic ejection murmur, systolic click radiograph of the chest ECG sonography heart failure tachypnea cough sweating Poor nutrition gallop rhythm (S3) Chest X-ray ECG Echocardiography supraventricular tachycardia tachypnea cough sweating Poor nutrition heartbeat> 180 beats / min (usually 220 to 280 beats / min in infants; 180-220 beats / min in older children) chest radiograph ECG gastrointestinal obstruction Analrisse or fissures history with decreased stool frequency and hard stools Abdominal distension Clinical evaluation gastroenteritis Abnormal bowel sounds soft, frequent stools Clinical evaluation Gastroesophageal Reflux history of spitting, warping or crying after nursing observation of swallowing study with esophageal pH or impedance probe intussusception Severe colicky abdominal pain turns jelly-like with quiet pain-free periods lethargy vomiting chairs radiograph of the abdomen air inlet cow’s milk protein intolerance (milk protein allergy), vomiting, diarrhea or constipation Poor diet failure to thrive test for occult blood in the stool volvulus bilious vomiting Druckdolenter, bloated stomach Bloody stools No bowel sounds radiograph of the abdomen barium enema Incarcerated hernia Druckdolente, red mass in the groin Clinical examination infection meningitis fever hopelessness, irritability lethargy Beaded anterior fontanelle in infants (see Neonatal Bacterial Meningitis) stiff neck (neck stiffness) in older children (see Bacterial meningitis in infants older than 3 months) lumbar puncture for CSF testing Otitis Media fever pulling on the ears or complaints of earaches erythematous, clouded, beaded eardrum Clinical evaluation respiratory infection (bronchiolitis, pneumonia) fever tachypnea Sometimes hypoxia Sometimes wheezing, rattling or decreased breath sounds urinary tract infection on auscultation chest radiograph (UTI) Fever Possible vomiting Urinalysis and urine culture Trauma corneal abrasion wines without other symptoms fluorescein test fracture (abuse) area of ??swelling and / or bruising favoring a limb x-ray of the skeleton to the review of current and old fractures hair collar Swollen tip of a toe, a finger or the penis with a question looped hair near the swelling Clinical evaluation Head trauma with intracranial bleeding Heartbroken, high-pitched crying Localized swelling in the skull with underlying deformity CT head Abusive Head Trauma (Shaken Baby Syndrome) Heartbroken, high-pitched crying lethargy seizure activity CT head examination of the retina skeletal survey Other cold medicines Recently conducted medical treatment a cold Clinical evaluation Testicular torsion Swollen, reddened, asymmetrical scrotum; lack cremasteric Doppler sonography or nuclear medical diagnosis of testicular vaccine reaction recently conducted vaccination Clinical Evaluation S3 = third heart sound evaluation History The history of the current disease includes the beginning of weeping, duration, and to comfort it, the reactions of the child to attempts. Further, the frequency or the specificity of the cry episodes are recorded. Parents should be asked for in connection therewith events or situations such. As recently carried out vaccinations, injuries or falls, interactions with a sibling, infection or medication. It should also be asked whether the crying is related with feedings or bowel movements. A review of organ systems focuses on the causative symptoms of diseases, including constipation, diarrhea, vomiting, Körperverkrümmung, explosive bowel movements, bloody stools (gastrointestinal disease), fever, cough, shortness of breath, nasal congestion and difficulty breathing (respiratory infection) as well as obvious pain when bathing or wrap (trauma). The history of history should earlier episodes of wines as well as detect certain conditions that could cause potentially such. As heart disease or Entwicklungsverzögerung.Körperliche investigation The investigation will begin with a review of vital signs as signs of fever and tachypnea. A first observation evaluated the infant or the child for signs of apathy or distress and observed how the parents deal with the child. The infant or child is pulled out and for signs of respiratory distress examined (eg. As superclaviculare and subcostal retractions, cyanosis). The total body surface area is searched for swelling, bruising and abrasions. The auscultatory examination looks for signs of infection of the respiratory tract (eg. As wheezing, rattling, decreased breath sounds) and cardiac disorders (eg. As tachycardia, palpitations, holosystolic heart murmur, systolic click). It is scanned if the abdomen is soft. The diaper is removed for examination of the genitals and anus to see (particularly swelling in the groin or in the scrotum), or anal fissures signs of torsion (in particular red ecchymatöser scrotum, pain during sampling), hair cuff on the penis, hernia. The extremities are examined for signs of fractures, in particular swelling, redness, tenderness, pain with passive mobility. Fingers and toes are checked for hair cuffs. The ears (especially red, plump eardrum) are examined for signs of trauma (especially blood in the ear canal or behind the eardrum) or infection. Corneas are stained with fluorescein and checked with blue light to rule Hornhautabschürfungen. The back of the eye is examined with an ophthalmoscope for signs of bleeding. If retinal hemorrhages are suspected, an investigation is advised by an ophthalmologist. The oropharynx is searched for signs of thrush or oral abrasions. The skull is gently for signs of fractures The following findings are abgetastet.Warnhinweise of particular importance: shortness of breath bruising and abrasions Extreme irritability fever and inconsolable fever in an infant who is ? 8 weeks old assessment of the findings, a high attention in the assessment of wines attached. Parental responsibility is an important indication. If parental concern is large, the doctor should take them seriously even if there are no clear findings because parents can respond to subtle but significant changes unconsciously. Conversely, a bonding problem or disability can at parents who show very little concern that underlie to identify the child’s needs and deal appropriately with them. This can especially be the case if an interaction between child and parent is missing. When the history of inconsistent and the clinical findings are accordingly should be given to possible abuse. It is helpful to differentiate the area exactly the cause for concern. So in case of fever, the most likely etiology is an infectious disease while breathlessness without fever to a kardialiologische etiology or pain indicating Previous abnormalities during a bowel movement or abdominal pain during the investigation against it are consistent with a gastrointestinal etiology. Specific findings point to specific causes (see Table: Some causes of wines). Also, the time frame may be important in diagnosis. Intermittently occurring crying that lasts for a number of days is less serious than a sudden, incessant screaming. The information whether the cry occurs at a given time, day or night, can also be important. Thus, a-appeared only recently crying his reference to separation anxiety or sleep-related difficulties during the night in an otherwise happy, healthy infant or child. The kind of crying can ebefalls be instructive. Parents can often differ on whether the child is crying from pain or fear. It is also important to determine the degree of urgency. An inconsolable infant or child is inconsolable besorniserregender as an infant or child who looks well and be well comforted kann.Tests The tests depending on the suspected cause deliberately performed (see Table: Some causes of wines). Particular attention is paid to potential life-threatening signs, unless the medical history and physical examination are sufficient for diagnosis. If there are few or no specific clinical findings and no tests are displayed, a follow-up examination and re-evaluation is recommended. Treatment The underlying physical cause should be treated. Support and encouragement are important for parents if the infant or child has no apparent disease. can spit be helpful in an infant in the first 4 months of life. An infant or to take on the arm a child, helps to reduce the duration of crying. It is also useful to parents who are exhausted and frustrated, to encourage remove their cry baby for a few minutes to a secure surface and take a break. to advise parents and give them permission to take a break, can help to prevent possible abuse. Contact points for cry babies and other means of support for parents who are overwhelmed, contribute to the protection of children. Conclusion Crying is part of normal development and occurs is within the first 3 months of life the most. Excessive crying organic origin must be distinguished from colic. Less than 5% of cases of wines is based on an organic cause. If no organic cause is identified, it is the parents may need the support.