Tired signs or something more sinister?

[Braes]

My 5 month old constantly scratches his eyes and head.  I have treated him for itchiness with mild steroid cream prescribed by a doctor.  I dont believe that itchiness is the cause.  The behaviour increases in frequency as he gets tired and is accompanied by head thrashing.  I cannot leave him unsupervised with his hands free at any time as he will end up with a bleeding face.  He is usually ok for about 10-15 mins straight after a sleep and then he starts.  It seems to come in waves that increase in frequency the more tired he gets.  If it is a tired sign then he is tired a lot!  He sleeps about 18 hours out of 24.  When put to bed he simply goes to sleep by himself and never cries or grizzles.  His development is normal (grabbing and holding things, laughing, talking, following sound with his eyes etc) He is fully breast fed.  Is this a behavour that has replaced crying?  Is a lack of crying a symptom of something else?  Even as a newborn he did not cry.  When extremely distressed (hurt etc) he will cry but it is unusual.  This is my second child (the first did not do this and cried normally) and Im a bit confused.

[Kevin Kennedy, Ph.D.]

Overall, it sounds like your son is developing well. The lack of frequent crying is not necessarily a worrisome sign. Crying indicates discomfort, stress, etc., and serves both a summoning purpose and also a tension reduction purpose. In other words, the crying is designed, if you will, to promote survival. Now, some infants respond to distress (e.g., being tired, uncomfortable) with excessive motor movement, such as you are witnessing. Be sure his fingernails are short, to reduce the scratching, and try covering his hands at the most susceptible times with little mittens which you can tie on. You won't need to do this for long. Also, be sure he has within his reach items he can grasp.