Topic Overview

What is colic?

All babies cry, but sometimes a baby will cry for hours at a time, no matter what you do. This extreme type of crying in a baby between 3 weeks and 3 months of age is called colic. Although it is upsetting for parents and caregivers, colic is normal for some babies.

Doctors usually diagnose colic when a healthy baby cries more than expected: more than 3 hours a day more than 3 days a week for at least 3 weeks in a row. Colic is usually worst when babies are around 6 to 8 weeks of age and goes away on its own between 8 and 14 weeks of age.

It is common to feel scared, upset, or frustrated when you cannot get your baby to stop crying. But remember that colic is normal—and temporary. Your baby will grow out of it.

What causes colic?

Doctors are not sure what causes colic, but it may be the result of a baby's sensitive temperament and an immature nervous system. These things may make a baby cry easily and have trouble stopping. As babies grow and develop, they are better able to control their crying.

Colic is not related to health conditions, such as digestion problems. But having gas in the belly can make crying worse.

Colic is not caused by pain or illness. If you think your baby is crying because he or she is hurt or sick, call your doctor.

Colic is not your fault or your baby's fault. It doesn't mean that you are a bad parent or that anything is wrong with your baby.

What are the symptoms?

Most babies will cry less when they are held, fed, and given attention. These things may not work for babies who have colic. When they are crying, they may clench their fists and stiffen their stomach and legs. Some babies arch their back, while others pull up their legs to their stomach.

Vomiting, diarrhea, fever, or blood or mucus in the stool is not a symptom of colic. If your baby has any of these symptoms, he or she needs to be checked by a doctor.

How is colic diagnosed?

If you are worried about your baby's crying, see your doctor or talk about it at your baby's next routine checkup. To make sure that crying is colic, your doctor may do a physical examination and ask you about your baby's past health, what comforting techniques you have tried, and whether you have noticed any other symptoms. You may also be asked about how the crying affects you and to show how you feed and burp your baby. Your doctor may suggest that you keep track of when and how often your baby cries.

If your baby has any symptoms that worry you, such as vomiting or a fever, your doctor may do lab tests or X-rays to find out what is causing them.

What can you do about colic?

It may help to see if there is a pattern to your baby's crying. Many babies cry most in the late afternoon and evening hours. If you notice that your baby cries at certain times of day, you can try holding your baby more before those times. But during expected fussy times, limit visitors, keep noise and lights low, and touch your baby only if needed.

After crying starts, try rocking your baby in a quiet room, or take him or her out for a walk in a front-pack carrier or stroller. Some babies are soothed by riding in a car or listening to a droning sound, like a fan or a clothes dryer.

Do what you can to comfort your baby, but accept that sometimes nothing works. If you feel stressed or worn out, ask a friend or family member to give you a break. Take good care of yourself, and remember that colic will go away soon.

What to Expect

Similarities and differences between normal crying and colic

Because infants cry more in their first 3 months than at any other time in their lives, it is often difficult to tell the difference between colic and expected crying behaviour. Both types of crying gradually increase, peaking at about 6 to 8 weeks of age. Most crying episodes occur in the late afternoon and evening hours, although the timing may vary. The length and intensity of crying episodes also may change from one day to the next.

The difference between colic and normal crying behaviour is related to the frequency, duration, and intensity of crying. Babies with colic typically cry for more than 3 hours a day more than 3 days a week for at least 3 weeks in a row. A colicky baby cries very loudly, sometimes piercingly, and often continuously. During a colic episode, babies may clench their fists and stiffen their stomach and legs. Some babies arch their backs, and others pull up their legs to their stomachs.

Most babies with typical crying behaviour are soothed and will cry less when they are held, fed, and given attention. But babies with colic are not easily soothed after they start crying. And their episodes typically last longer than expected.

Colic is usually worst when babies are around 6 to 8 weeks of age and goes away on its own between 8 and 14 weeks of age.

Other problems that can cause crying

By definition, colic is not caused by pain or discomfort. Most likely, your baby's crying is normal. But health problems or injuries can cause a baby to cry or make a colicky baby's crying worse.

Learn ways to tell the difference between normal colic and signs of a medical problem. For example, a baby may cry more when he or she has a digestion problem such as milk protein intolerance or milk sugar intolerance. Some mothers also say they notice their baby's crying gets worse after they have had certain foods or drinks and then breastfeed. Some foods may affect breast milk, such as garlic, broccoli, fresh fruits, and caffeine. They may contribute to intestinal gas or other digestive problems in the baby.

Home Treatment

After your baby has started to cry, use comforting and soothing techniques to try to shorten the episode or decrease its intensity. Certain preventive measures may also help. Colic gradually goes away on its own, regardless of what you do.

Prevention

Keep a diary to chart your baby's daily activities, including when he or she cries. The record may help you to notice patterns in your baby's crying and increase your ability to predict when colic episodes are likely to occur. You may be able to help prevent or decrease crying episodes during those times:

• Anticipate your baby's needs. Pay attention to your baby's natural habits and set a rough schedule for meals, nap, and play. That way, you can predict behaviour and respond appropriately. You may also want to try holding and comforting your baby before his or her usual crying time. Use a front carrier or sling so you can do other things while you keep your baby close to you.
• Create a calm environment. During expected fussy times, touch your baby only if needed, and try to limit visitors, bright lights, loud noises, and chaotic situations. Overstimulation can trigger a crying episode or make one worse.
• Reduce stress. Babies are very sensitive to the moods of their caregivers and may cry more during times of family stress or tension. Take good care of yourselves to help keep your baby's environment calm and safe. Remember that this challenging time won't last, and know that you have personal limitations.
• Ask for help when you need it. It may help shorten a crying episode by having another caregiver try to soothe your baby during times when you feel overwhelmed and discouraged. Your baby may respond better to someone who is "fresh" and relaxed. Plan ahead by scheduling help before you need it. Have a list of people to call in case you need help unexpectedly.

Colic is not caused by health problems. But when your baby doesn't feel good, crying episodes may get worse. You can help minimize colicky behaviour by taking preventive measures to reduce your baby's risk of illness.

• If you are breastfeeding, be aware of your diet. The foods you eat may affect your breast milk and cause abdominal (belly) pain in your baby, which may extend a crying episode.
• Feed your baby appropriately. Very young babies may be hungry 1 to 2 hours after a feeding. Offer food on demand. But to avoid overfeeding, be sure to watch for when your baby is full.
• Help prevent abdominal gas in your baby. Gas can cause pain, leading to extended crying.
• Practice good hygiene to avoid illness. A sick baby usually has more frequent and intense crying episodes. To help prevent illness as much as possible, use good hygiene, such as washing hands frequently, including your baby's. Ask visitors to do the same. Avoid being around large crowds during a baby's first weeks, especially around people who smoke. Breathing in second-hand smoke can increase a baby's risk for respiratory problems, ear infections, and asthma.

Comfort

After a colic episode begins, comforting measures may help.

• Respond to the crying quickly and appropriately. Quickly assess whether a cry likely indicates "I'm hungry" or "I need to be changed," and so on, and act accordingly. Doing so may prevent your baby from getting so upset that he or she cannot be consoled. For more information on figuring out what your crying baby needs, see the topic Crying, Age 3 and Younger.
• Burp your baby, especially if you suspect abdominal gas started the crying episode.
• Reduce the activity around your baby. Overstimulation from noise, lights, and too much attention can trigger a crying episode. Move your baby to a quiet and calm environment.
• Try infant massage. Some parents use infant massage to try and relieve colic.
• Soothe your baby by helping him or her to be more comfortable. Don't worry that you may be spoiling your baby by giving frequent and loving attention.

If you find that you are losing patience or are afraid that you may hurt your baby, act immediately.

• Place your baby in a crib to cry while you go into another room and calm yourself.
• Ask someone to take over for you. If nobody else is home, call a friend who can help you calm down. If you are afraid you cannot control yourself and cannot get other help, call 911.

Call your doctor if you frequently feel overwhelmed or are unable to get adequate support.

Other measures

Do not use unproven or dangerous treatments for colic. Get advice from your doctor before using alternative therapies, which may have unknown effects.

Also, be careful about acting impulsively or using desperate measures to treat colic. For example, do not:

• Let your baby stay in the crib and cry until he or she is exhausted.
• Stop breastfeeding your baby. This will not cure colic.
• Give your baby aspirin or aspirin products, because of the risk for Reye syndrome.
• Give your baby alcohol (even a pacifier dipped in brandy or other alcoholic beverages).
• Shake or spank your baby for crying. Serious or even fatal brain injuries may result (shaken baby syndrome).
• Give your baby medicine unless it is recommended or prescribed by your doctor.

Some doctors prescribe probiotics, which are bacteria that help maintain the natural balance of organisms (microflora) in the intestines. Studies are being done to find out how helpful probiotics are for babies who have colic.

Self-care

It is important to take care of yourself and remember that colic is not caused by poor parenting. Colic is temporary, and it will not affect a baby's general health or future development.

If nothing seems to console your baby, keep trying comforting techniques, but realize that sometimes nothing works. If you are not successful and you become exhausted by these efforts, ask for someone else to take over for you.

When to Call a Doctor

Call
911
or other emergency services immediately if:

• You are afraid that you are about to harm your baby and you cannot find someone to help you.
• Your baby has been shaken, has a change in his or her level of consciousness, or has signs of severe difficulty breathing.

Call your doctor immediately if your baby:

• Cries in a peculiar manner or for a very unusual length of time.
• Has not been diagnosed with colic but cries excessively and also has symptoms such as vomiting, diarrhea, fever, or blood or mucus in the stool.

Call your doctor and schedule an appointment if:

• Your baby is not gaining weight.
• Your baby has no symptoms other than crying, but you want to check for health problems that may be related.
• Your baby seems to be acting odd, and you can't identify exactly what concerns you.
• You have tried comfort measures repeatedly and have not been able to console your baby.

Also, think about your own health and well-being. Call your doctor if you:

• Frequently feel anxious or think you may be depressed.
• Feel that you are not able to nurture or emotionally connect with your baby.

Who to see

Your family doctor, general practitioner, or your child's pediatrician can examine your baby and diagnose colic or other conditions that may be related to excessive crying. They can also help you handle the common frustrations of having a colicky baby.

Routine Checkups

You can ask your doctor about your concerns regarding your baby's crying during regularly scheduled routine checkups. But don't hesitate to call and discuss your concerns at any time. This is especially true if comfort measures keep failing or if you notice other symptoms along with the excessive crying.

At the checkup, your doctor will want to find out whether your baby has colic or whether crying is possibly related to an illness, an injury, or a medical condition. To find out, your doctor:

• Will take a medical history.
• Will perform a physical examination of your baby.
• Will ask if your baby has other symptoms besides crying.
• May ask you to keep a diary of your baby's activities.
• May ask you to show how you feed and burp the baby.
• May ask how your baby's crying affects you.

If the baby cries excessively and has other worrisome symptoms (such as vomiting, diarrhea, blood or mucus in the stool, or fever), lab tests or X-rays may be done to help the doctor find out whether a condition other than colic is present.