Colic

What is colic?

Colic is when a healthy baby cries for a very long time for no obvious reason. It is most common during the first 6 weeks of life. It usually goes away on its own by age 3 to 4 months. Up to 1 in 4 newborn babies may have it. 

Colic is defined as when a baby’s crying:

• Lasts for more than 3 hours a day

• Happens more than 3 days a week

• Occurs for more than 3 weeks

Colic often begins suddenly, with loud and mostly nonstop crying. This constant, extreme crying can be very stressful and difficult for parents.

Babies with colic are often fussy, gassy, and don't sleep well. But in most cases, they grow and gain weight normally.

Colic will go away on its own. This often happens by age 3 months, and in most cases, by age 6 months.

What causes colic?

Experts don’t know for sure what causes colic. There are a few theories about why it happens. Colic may occur when babies:

• Are sensitive and have trouble adjusting to the world. After birth, newborns must get used to lights, loud noises, and other new things around them. But babies have different personalities (temperaments). Some babies can handle these things well. Other babies don’t adapt as easily. Crying may be one way for a baby to show their feelings while getting used to the world.

• Are unable to calm themselves. Some babies seem very sensitive to stimulation. They can’t calm themselves (self-soothe). Their nervous system is still developing (is immature). As babies get a little older, they are better able to control their nervous system. As this happens, colic goes away.

Other theories about what causes colic are less likely. These include:

• Being sensitive to gas. Some people think that gas may be to blame for colic. But there isn’t much proof to support this. In fact, treating gas has no effect on colic. Health experts also don’t think that colicky babies make more gas than other infants. Sometimes a colicky baby may seem to pass more gas than other babies do. But that is likely because they swallow more air while crying for longer periods of time.

• Having a milk allergy or intolerance. Having a milk allergy, or an intolerance to cow's milk protein, may cause belly pain. But often these also cause loose stool (diarrhea). A baby may have a milk allergy if they can't handle cow's milk and react to a change in formula. But there is no proof that changing to a nonmilk formula has any effect on colic.

Which children are at risk for colic?

All families are at risk for having a baby with colic. Any baby can become colicky.

What are the symptoms of colic?

A healthy baby may have colic if they cry or are fussy for several hours a day, for no obvious reason. Colicky babies often cry from 6 p.m. to midnight.

Colicky crying is louder, more high-pitched, and more urgent sounding than regular crying. Colicky babies can be very hard to calm down.

Babies who have colic may show symptoms such as:

• Burping often or passing a lot of gas. This is likely because of swallowing air while crying. It doesn’t cause colic.

• Having a bright red (flushed) face

• Having a tight belly

• Curling up their legs toward their belly when crying

• Clenching their fists when crying

The symptoms of colic can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.

How is colic diagnosed?

The healthcare provider will ask about your child’s symptoms and health history. The provider will give your child a physical exam. You may be asked questions such as:

• How long and how often does your baby cry?

• Have you found anything that seems to trigger the crying?

• What comfort methods help to calm your baby, if any?

Blood tests and X-rays or other imaging tests may be done. These can help find out if your baby has other health problems.

How is colic treated?

There are many tips for helping to soothe and deal with a colicky baby. Know that this is a common problem for new babies. Talk with your child's healthcare provider to find out more about colic and what you can do.

If your baby is bottle-fed, it may help to use a curved bottle. This lets you hold your baby in an upright position.

To reduce the amount of air your baby swallows during feeding, burp your baby often. Using a bottle with a collapsible bag or liner may also help.

Learning how to understand your baby's cry can help in dealing with colic. It takes some time for parents and babies to get used to each other. Also remember that it’s normal for babies to cry for a certain amount of time every day.

What works for one baby may not work for another. Other suggestions to try include:

• Make sure your baby isn’t hungry. But don’t force-feed your baby if they aren't interested in the bottle or breast.

• Change your baby's position. Sit your baby up if lying down. Let your baby face forward if you are carrying or holding your baby facing your chest. Babies like to see different views of the world.

• Give your baby interesting things to look at: different shapes, colors, textures, and sizes.

• Talk to your baby. Sing softly to your baby.

• Rock your baby.

• Walk your baby.

• Give your baby a warm bath.

• Place your baby in an infant swing on a slow setting.

• Let your baby lie on their belly on your lap, and softly rub your baby’s back.

• Go for a ride in the car. The motion of the car often soothes babies.

• Try using something in your child's room that makes a soothing sound, such as a fan, a white-noise machine, or a heartbeat CD. The sound of a vacuum or washing machine may also calm a fussy baby.

• Hold and cuddle your baby. Babies can’t be spoiled by too much attention. But they can have problems later in life if they are ignored and their needs are not met as infants.

• Try using a pacifier.

• Keep any stimulation to a minimum.

If your baby is bottle-fed and these methods don’t work, your child’s healthcare provider may recommend a 1-week trial of a non-milk-based formula.

If you breastfeed your baby, the provider may suggest that you not eat foods that are likely to cause an allergic reaction. This means that you should not have milk, eggs, nuts, or wheat for a period of time.

Dealing with a colicky baby is stressful. It may help to let someone care for your baby from time to time. Ask an adult family member, friend, or a responsible babysitter. Asking for help does not mean you're having trouble being a good parent. It means you are taking the best possible care of your baby. It’s important to take a break. Taking care of yourself and reducing your stress level may help your baby as well.

What are possible complications of colic?

Colic may become a concern because:

• It is frustrating and stressful for parents

• Both parents and baby lose sleep

• A colicky infant may be overfed in an effort to stop the crying, which might make the colic worse

Living with a colicky baby

Having a colicky baby can be very stressful for parents. It can make you feel tired, guilty, and even depressed. Your baby's healthcare provider can suggest some things to do that may help to calm your baby. It’s important to know that colic is a common condition in young babies. It will go away on its own, often by age 3 months. In most cases, it is gone by age 6 months.

If possible, have someone else watch your baby when you become stressed. If no one else is available, make sure your baby is safe and go into another room. Distract yourself from your baby's cries. Crying will not hurt your baby. Some communities have free or low-cost care called respite nurseries. You can leave your baby there for short periods of time.

When should I call my child's healthcare provider?

Before assuming your child has colic, look for other signs of illness. These may include:

• Not sucking or drinking a bottle well

• Drinking less milk than usual

• Vomiting

• Having loose stool (diarrhea)

• Becoming more irritable when held or touched

• Having a strange-sounding cry

• Having a change in breathing rate or using extra effort to breathe

• Being more sleepy or sluggish than normal

• Fever of 100.4°F (38°C) or higher, or as directed by your child's healthcare provider

Call your child's healthcare provider if you see any of these symptoms. Also call if your baby is crying too much. Your child's provider will give your baby an exam. This is to make sure that there are no other health problems causing your baby’s symptoms.

Key points about colic

• Colic is when a healthy baby cries for a very long time for no obvious reason.

• It affects some babies during the first 3 to 4 months of life.

• Colic usually begins suddenly, with loud and mostly nonstop crying.

• Before assuming your child has colic, look for other signs of illness. Call your provider if symptoms exist.

• Colicky babies can be very difficult to calm down.

• Changing how your baby is fed and using different calming methods can help to soothe a colicky baby.

• Colic goes away on its own, sometimes by age 3 months. In most cases, it is gone by age 6 months.

• Colic can put great stress on parents. It's important for parents to seek help when they feel overwhelmed.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.