Irritability is an excessive response to stimuli.

The term "irritability" is used specifically in regard to infants and young children who, when ill, demonstrate increased fussiness, whining, and fretfulness despite attempts at comforting and soothing.

Irritability is seen at the beginning of many infectious diseases, some metabolic diseases, head trauma, malignancies, and other types of disease. It can be a very early sign of serious problems.

Although irritability is not a symptom of any specific illness, it should arouse suspicion in the parent that something might be wrong with the child, even though there may not yet be other symptoms.

Parents are usually very aware of their child's normal behavior and may pick up early changes that would be unremarkable to the examining health care provider. This may aid in the early diagnosis of illness.

• Meningitis or other serious infection
• Otitis media
• Head trauma
• Alcohol or drug withdrawal state
• Nutritional deficiencies
• Intestinal obstruction
• Milk intolerance
• Intracranial bleeding or abscess
• Headache (migraine or other)
• Colic in infants
• Congenital infections
• Diabetes or other metabolic disease
• Fracture, sprain, or other bone, joint or tissue injury
• Encephalitis
• Hydrocephalus
• Hypoglycemia
• Iron deficiency anemia
• Lead poisoning
• Neoplastic disease (cancer)
• Pinworm
• Viral infection
• Sleep disorders
• Tay-Sachs or other genetic disease
• Drug reaction

Attempt to soothe the child with usual measures -- rocking, cuddling, or whatever the child normally finds soothing. If the child cannot be consoled, consult your health care provider. Observe the child for other symptoms such as fever, abdominal pain, vomiting, rash, or any other unusual finding.

If your child is irritable or inconsolable with or without other symptoms, consult your health care provider.

The medical history will be obtained and a physical examination performed. Tests may include a complete blood count, electrolyte analysis, and blood culture.

Medical history questions documenting irritability in detail may include:

• How irritable is the child?
• Does the irritability persist?
• How does the child normally eat (how often, how much)?
• How is the child eating now?
• How often does the child normally have bowel movements?
• Does the child have problems with diarrhea or constipation?
• What other symptoms are also present?
• Is there any fever, confusion, or pain?

After seeing your health care provider:

You may want to add a diagnosis related to irritability to your personal medical record.