Fussiness with irritable behavior is common among children. It may last from a few hours up to a few days. It may be due to some type of change that your child is adjusting to. This may include changes in the child's surroundings (new location or air temperature) or feeding habits (changes in type of food given or feeding schedule). It may be a physical change (new body sensations) as the child develops.
Most often the fussy behavior goes away as the child adjusts to the new situation. Sometimes, though, fussy behavior is an early sign of a physical illness. Quite often such an illness is minor, such as teething, or a cold or other viral illness. Sometimes the cause can be serious enough to need further exam and treatment.
Although the exam today did not show any signs of a serious illness, it may take another 12 to 24 hours for the usual signs of an illness to appear. Continue watching for the warning signs listed below.
Home care
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Feeding. Your child’s appetite may be poor. For most children, it's okay to go without solid food for the next 24 hours, as long as the child drinks lots of fluid.
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Fluids. Continue giving the usual fluids (such as milk and formula). Give extra fluids if your child does not want to eat solid foods. To prevent dehydration, you may be told to replace lost body fluids with oral rehydration solution. You can get this at pharmacies and most grocery stores without a prescription. Ask your child's doctor about what is safe to give to your child.
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Activity. Encourage rest, quiet play, and frequent naps during the next 24 hours.
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Sleep. A change in usual sleep patterns, with sleeplessness or waking up often, is not unusual. You may need to spend extra time to comfort your child during this time.
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Medicine. Follow the doctor’s directions on the use of over-the-counter pain medicines, such as acetaminophen or ibuprofen, for fever, fussiness, or discomfort. Also note:
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If your child has chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with the doctor before using any of these medicines.
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Don't give ibuprofen to a child age 6 months or younger.
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Don't give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.
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Follow-up care
Follow up with your child’s doctor as advised. Continued use of pain medicines, such as acetaminophen or ibuprofen, may hide symptoms of a more serious illness. If your child continues to be fussy, and the cause of the symptoms isn't clear, contact the doctor.
When to get medical advice
Unless your child's doctor advises otherwise, contact the doctor right away if your child:
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Has a fever (see Fever and children, below).
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Is fussy or cries and cannot be soothed.
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Doesn't feed well or doesn't gain weight.
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Repeatedly vomits or has diarrhea, or pulls at an ear.
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Has blood in the stools or vomit (black or red color).
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Shows an unexpected change in their crying pattern.
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Becomes drowsy or confused.
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Shows signs of belly (abdominal) pain, such as drawing the legs up to the chest while crying.
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Cries without stopping for more than 2 hours.
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Has breathing that becomes faster.
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Has a change in urine, such as less, more, darker, cloudy, foul-smelling, or painful.
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Has any other worrisome symptoms.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.
Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.
When to contact a doctor about your child’s fever
For a baby under 3 months old:
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First, ask your child’s doctor how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the doctor
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the doctor
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the doctor
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