Colic

Overview

Colic refers to repeated episodes of intense, hard-to-soothe crying in a baby who is otherwise healthy, feeding well, and growing normally. The crying is often described as occurring for long stretches, several days a week, frequently in the late afternoon or evening, and the baby may seem inconsolable, clench their fists, arch their back, or pull up their legs.

Colic is common and, although exhausting and distressing for parents, it is not a sign that anything is seriously wrong and it does not cause long-term harm. It usually begins in the first few weeks of life, peaks around six weeks, and improves on its own by about three to four months of age. The cause is not fully understood, and the term describes a pattern of crying rather than a single disease.

It can reassure exhausted parents to remember that colic is a phase that babies grow out of, usually by three to four months, and that it does not reflect poor parenting. Keeping a rough note of when the crying happens, feeding times, and any other symptoms can help a clinician confirm that the pattern is indeed colic.

Common Causes

The exact cause of colic is unknown, but several factors are thought to contribute:

• An immature digestive system: A developing gut may lead to gas, cramping, or discomfort.
• Sensitivity and overstimulation: Some babies are easily overwhelmed by sights, sounds, and activity, especially by the end of the day.
• Feeding-related factors: Swallowing air during feeds, or, less commonly, sensitivity to something in the diet.
• Developing nervous system: A still-maturing ability to self-soothe and regulate.
• Gut bacteria balance: Differences in the developing gut microbiome may play a role.

Importantly, colic is a diagnosis made after other causes of crying, such as illness, hunger, or discomfort, have been ruled out.

Associated Symptoms

Typical features of colic include:

• Intense, high-pitched crying that is hard to soothe
• Crying that often comes at a predictable time, frequently in the evening
• A flushed face, clenched fists, and tense, drawn-up legs
• Apparent passing of gas during or after crying
• A baby who otherwise feeds, grows, and develops normally

Colic should not include fever, vomiting, diarrhea, poor feeding, weight loss, or a baby who seems unwell between crying spells. These features point away from colic and toward a medical problem that needs evaluation.

It is reassuring that, between crying spells, a baby with colic usually feeds, settles, and behaves normally. A baby who seems persistently unwell, unusually sleepy, or difficult to rouse between episodes, or whose cry sounds different from usual, is showing signs that point away from simple colic and toward a problem that should be assessed.

Diagnosis & Evaluation

There is no specific test for colic; it is recognized by the pattern of crying in a healthy baby and by ruling out other causes. A clinician may:

• Ask about the timing, duration, and nature of the crying and feeding habits
• Examine the baby to check growth and look for signs of illness or discomfort
• Review feeding technique and consider whether reflux or a feeding intolerance could be contributing
• Order tests only if the history or examination suggests an underlying medical condition

A normal exam and growth, with no warning signs, supports the diagnosis of colic.

Treatment & Management

There is no cure that ends colic immediately, but soothing strategies and support can help both baby and caregivers:

• Soothing techniques: Gentle rocking, holding, swaddling, a warm bath, white noise, or a walk or car ride.
• Feeding adjustments: Frequent burping, an upright feeding position, and a slower pace to reduce swallowed air.
• Reducing overstimulation: A calm, dimly lit environment in the evening.
• Caregiver support: Taking breaks, sharing care, and asking for help to manage exhaustion and stress.
• Medical review: A clinician can assess for reflux or feeding intolerance and advise on whether any change is worth trying.

Never shake a baby. If you feel overwhelmed, it is safe to place the baby down on their back in a safe spot and step away for a few minutes to calm yourself.

When to See a Doctor

Have a baby evaluated, rather than assuming colic, if any of these occur:

• Fever, vomiting, diarrhea, or blood in the stool
• Poor feeding, fewer wet diapers, or weight loss
• A weak, high-pitched, or unusual cry, or a baby who seems floppy or unwell between cries
• Crying that follows a fall or injury
• A change in the usual pattern that concerns you

Seek urgent care for a baby who is hard to wake, has difficulty breathing, or shows any signs of serious illness. Always trust your instincts and contact a clinician with concerns.

Related Topics

Frequently Asked Questions

References

1. American Academy of Pediatrics (HealthyChildren.org). Colic.
2. Mayo Clinic. Colic — Symptoms and causes.
3. MedlinePlus, U.S. National Library of Medicine. Colic and crying.
4. National Health Service (NHS). Colic.