The crying infant – diagnosis and management strategies



All babies cry. What is normal and what is abnormal? Is the crying excessive or is that mother’s perception. What causes the crying – hunger, over handling, “wind”, “colic”, “silent reflux”, allergy? Or is it a phase in the infant’s development? What makes the problem worse and how does one settle the baby and help the mother? Are there answers to these questions? What does clinical practice and experience tell us? Is that helped by what has been published and/or by the newer concepts currently being advanced? This Grand Round will address these issues before inviting the audience for their comments and insights.


Professor Samuel Menahem is a consultant paediatrician with a subspecialty of cardiology. He has held senior staff appointments at The Royal Children’s Hospital and Monash Medical Centre. His early paediatric experiences exposed him to difficult areas not previously addressed in his training. One was in understanding and managing the crying baby. That spurred him to look into the psychological aspects of child care and take further training as a psychotherapist to better communicate with the child and his/her family – with the aim of becoming a psychologically orientated paediatrician and cardiologist. That resulted in studies and publications to understand and hopefully alleviate the stresses experienced by affected individuals and their family who require early intervention for complex congenital heart abnormalities. Prof Menahem acknowledges the insights gained by working closely with mental health professionals who collaborated on many of the studies.

Professor Harriet Hiscock is a consultant paediatrician and NHMRC Practitioner fellow. She is Director of the Royal Children’s Hospital Health Services Research Unit, Group Leader of Health Services at the Murdoch Children’s Research Institute, and Director of the Australian Paediatric Research Network. Her research focuses on common child health conditions, in particular (i) developing and trialling community approaches to improve access to care; (ii) reducing low value care (i.e. unnecessary imaging, pathology testing and medication); and (iii) optimising care for common mental health conditions such as ADHD and anxiety. Prof Hiscock set up and has been consulting in the Centre for Community Child Health’s Unsettled Babies Clinic for over 10 years.

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