title: Excessive crying in infants.
abstract: OBJECTIVE
  Review the literature on excessive crying in young infants, also known as infantile colic, and its effects on family dynamics, its pathophysiology, and new treatment interventions.
  
  
  METHODS
  The literature review was carried out in the Medline, PsycINFO, LILACS, SciELO, and Cochrane Library databases, using the terms "excessive crying," and "infantile colic," as well technical books and technical reports on child development, selecting the most relevant articles on the subject, with emphasis on recent literature published in the last five years.
  
  
  RESULTS
  Excessive crying is a common symptom in the first 3 months of life and leads to approximately 20% of pediatric consultations. Different prevalence rates of excessive crying have been reported, ranging from 14% to approximately 30% in infants up to 3 months of age. There is evidence linking excessive crying early in life with adaptive problems in the preschool period, as well as with early weaning, maternal anxiety and depression, attention deficit hyperactivity disorder, and other behavioral problems. Several pathophysiological mechanisms can explain these symptoms, such as circadian rhythm alterations, central nervous system immaturity, and alterations in the intestinal microbiota. Several treatment alternatives have been described, including behavioral measures, manipulation techniques, use of medication, and acupuncture, with controversial results and effectiveness.
  
  
  CONCLUSIONS
  Excessive crying in the early months is a prevalent symptom; the pediatrician's attention is necessary to understand and adequately manage the problem and offer support to exhausted parents. The prescription of drugs of questionable action and with potential side effects is not a recommended treatment, except in extreme situations. The effectiveness of dietary treatments and use of probiotics still require confirmation. There is incomplete evidence regarding alternative treatments such as manipulation techniques, acupuncture, and use of the herbal supplements and behavioral interventions.
authors.affiliation: Child Development Outpatient Clinic, Hospital da Criança Santo Antônio (HCSA), Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil. Electronic address: ricardo.halpern@gmail.com.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Halpern
authors.affiliation: Child Development Outpatient Clinic, Hospital da Criança Santo Antônio (HCSA), Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Renato
authors.initials: R
authors.lastname: Coelho
mesh_terms: D000367:Age Factors; D003085:Colic / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D003448:Crying / Q000502:physiology*; D005190:Family; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000502:physiology; D007231:Infant, Newborn
keywords: Choro excessivo; Circadian rhythm; Cólicas do lactente; Excessive crying; Infant; Infantile colic; Lactente; Ritmo circadiano