Irritability is a state of being overly sensitive to stimulation. Children who are irritable may, for example, cry easily.
A child who is irritable may be responding to something that causes pain, fright, or discomfort. Some children are more sensitive to stimuli than others and may become more easily irritated. In some cases, a serious medical condition can cause irritability.
Symptoms depend on the cause of the irritability. The healthcare professional may ask: if there is a known causehow the child is actingwhen it beganhow long it has been going onwhether it is constant or comes and goeswhat the child's usual response to problems or pain isif anything makes the child better or worseif it occurs only at certain times of the dayif there are any other symptoms, such as fever, stomach upset, pulling on the ear, pain, injury, depression, sadness, or poor developmentif there is any history of any other illnesses, conditions, allergies, or surgerieswhat medications the child takes, if any
Other questions may be asked about the child's eating, drinking, and sleeping habits, and activity level.
The cause is of irritability is harder to figure out in very young children who cannot talk. Being overtired or hungry, teething, having soiled diapers, and the need for attention may all cause mild irritability.
Medical conditions can also cause irritability. These include (roughly, from most common to least common): infections of any part of the body, such as upper respiratory infections or acute otitis media reaction to medications or vaccines, such as the pertussis vaccine or antibioticscolic, with excessive crying in an otherwise normal babydisorders causing emotional or mental impairment, such as depression, anxiety, and abnormal grief child abuse any other new or chronic illnessautism, a developmental disorder affecting the brain and personalitypoisoning from toxic substances, such as lead poisoning hormone imbalances, such as diabetes and hyperthyroidism head injury, meningitis, intracerebral hemorrhage, and increased intracranial pressure, or pressure inside the skulltumors or cancer, such as a brain tumor fetal alcohol syndrome, a collection of birth defects due to the mother drinking alcohol during the pregnancy defects present at birth, such as congenital heart disease any serious illness, such as liver disease, chronic obstructive pulmonary disease, kidney disease, or heart disease vitamin or mineral deficiencies, such as iron or folate deficiencyinborn errors of metabolism, such as aminoaciduria
Avoiding people with infections may reduce the risk of irritability due to these causes. Many cases cannot be prevented.
Sometimes, the cause of the irritability is obvious to the healthcare professional from the history and physical exam. In other cases, he or she may order tests such as: a complete blood count (CBC) to detect infection or blood cancerx-ray tests, such as a chest x-ray, to help diagnose some infections and cancersthyroid function tests to check for abnormalities with the body's metabolismpsychological testing to check for mental or psychological impairments
The effects depend on the cause. For instance, if an infection is causing the child's irritability, antibiotics may cure the infection and there are usually no long-term effects. A child with cancer may need lifelong treatment.
Irritability itself is not contagious. If an infection is the cause, the infection may be contagious.
Infections causing irritability are often treated with antibiotics. A child who has colic may be treated with comfort measures, such as rocking. Treatment for autoimmune disorders may include medications to reduce inflammation and suppress the immune system. If a medication causing the irritability, it may be stopped.
A child with cancer may need surgery, chemotherapy, or radiation therapy. Some conditions, such as heart defects present at birth, may be treated with open heart surgery. Medications are often used for mood problems, such as depression.
Side effects depend on the treatments used for the underlying cause of the irritability. For example, antibiotics can cause stomach upset and allergic reactions. Surgery can be complicated by infection, bleeding, or reactions to anesthesia. Chemotherapy can cause many side effects.
In many cases, treatment "cures" the child's irritability. In other cases, the cause cannot be cured and needs further treatment.
A child with a mild illness or infection can often be monitored at home by the caregiver. Any new or worsening symptoms should be reported to the healthcare professional. A child with HIV or leukemia may need to be monitored with repeated blood tests. Some medications require monitoring with blood tests to make sure the level in the person's body is correct.
Your Child's Health, Schmitt, 1991
Current Pediatric Diagnosis and Treatment, Hathaway et al., 1993
Illustrated Guide to Diagnostic Tests, Springhouse, 1998
