Common age range | 2 weels-3 months; Onset may be early to late but most commonly within first 2 weeks | 3 weeks to 3 months but may occur outside of these ranges, infant needs ability to hold antalgic posture | 1-6 months (seen less frequently 7-12 months) |
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Crying patterns | Loud, disturbing, relentless unsoothable crying often late afternoon/evening | Crying may be high-pitched at any time of day. Often triggered by positioning child out of position of comfort | Many episodes and long bouts of crying, peaking during the day; high intensity, priercing cries common |
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Physical presentation/behaviour | Tense abdomen, flexed posture, kicking, flailing legs and boxing arms. Unconsolable whether picked up or not. | Antalgic posture held for sake of comfort; asymetric movemetns/unilateral spinal hypertonicity; tactile defensive; musculoskeletal sensitivity. | "Pained faces" (facial grimaces) accompany crying; body unrest, arching postures, general irritability and difficult to soothe; difficult to distinguish from colic crying/movements, but not limited to end of day and longer hours |
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Other signs/symptoms | Appears in pain, changes from happy to crying in an instant, wants frequent cuddling but may not respond | Restless sleep; may not wish to rest supine (some will only sleep in car seat); affective disorder common. | Male predominance (60:40); feeding problems common, sleep disorders common (difficulty falling asleep and staying asleep) |