Colic in infants
What is infant colic?
Colic is excessive crying in an otherwise healthy and well-fed baby. It can happen anytime, but usually develops in the first few weeks of life and tends to peak at around 6 to 8 weeks of age. Sometimes a parent may say their baby is “unsettled”. Colic is a very common condition in Australia, and affects up to one in 5 babies.
Crying is normal in babies – at around 6 to 8 weeks of age, a baby typically cries for 2 to 3 hours each day. When a baby has colic they may cry for more than 3 hours each day, on more than 3 days per week.
Babies with colic usually don’t have an underlying medical problem that is causing them to be unsettled. They are generally well and thriving. However, having a baby with colic can be a very exhausting, frustrating and worrying experience for parents.
What are the symptoms of infant colic?
Babies with colic cry and fret inconsolably for more than 3 hours at a time on at least 3 days each week, and this cycle tends to last for more than 3 weeks.
Babies with colic may:
- Cry at the same time each day, often in the late afternoon or evening
- Cry for several hours at a time
- Clench their fists and draw their legs up to their tummies or arch their backs
- Have a red or flushed face when they cry
- Cry intensely and look as though they are in distress; the cry is often high-pitched
- Cry for no apparent reason (e.g. they don’t need a nappy change, they are not tired or hungry)
- Not be able to be comforted or calmed easily.
Doctors don’t know what causes colic. It affects boys and girls equally, and it’s not clear why some babies get colic and others don’t.
There is no evidence that colic is caused by pain, a digestive problem or wind.
Experts have investigated a range of other factors such as allergies, lactose intolerance, changes to the bacteria in the digestive system, feeding styles and anxious parents, but no particular cause has been identified.
Some studies have found a link between colic and infant migraine, and further studies are looking into this association.
Babies are more likely to get colic if their mothers are smokers, or smoked during pregnancy.
How long does colic last?
It’s hard to tell how long colic will last for, but it usually improves by the time a baby is 3 to 4 months of age. Colic does not have any long-lasting effects; babies grow and develop normally.
Colic is not dangerous, although it can be frightening, frustrating and upsetting for parents.
There are no tests to diagnose colic. Colic can usually be diagnosed based on the pattern and amount of crying, and the fact that the baby is otherwise thriving – they are gaining weight normally and eating well. If parents are concerned about their baby’s crying, their doctor may examine the baby and check for problems with their digestive system or signs of other medical conditions.
When should I see a doctor about my baby’s crying?
Parents should visit the doctor if they are concerned about their baby’s crying or they are finding it hard to cope.
Parents should seek prompt medical attention if their baby:
- Won’t feed normally
- Has a continuous, weak or high-pitched cry
- Has a fever
- Has problems breathing or is breathing very quickly
- Is floppy when picked up
- Is unusually drowsy
- Has a seizure (a fit)
- Becomes very pale or turns blue, develops blotchy skin or has a purple-red rash on the body
- Is vomiting repeatedly or has green vomit (due to bile)
- Has a bulging fontanelle (the soft spot at the front of the head).
The above symptoms are NOT caused by colic. If your baby has any of these symptoms they may have a more serious medical condition, and you should seek prompt medical attention.
There are no treatments that have been proven to help colic, and it usually gets better on its own in a few months.
Many parents have tried things like over-the-counter gas relieving medicine, but these medicines haven’t been shown to improve colic. Other people have tried probiotics (things that help to maintain the balance of ‘good’ bacteria in the digestive system). While some studies have shown that certain probiotics may improve colic, others have shown no improvements. Experts currently don’t recommend probiotics for treating colic.
Experts have also looked at the effects of changing diets or restricting certain foods, but currently there no specific dietary recommendations for treating colic. Switching from breastfeeding to formula does not help colic. Using a special teat on feeding bottles has not been shown to help colic.
Coping with colic
Looking after a baby with colic can be very difficult for parents, particularly first-time parents. It's important to remember that colic:
- Is not the parents’ fault
- Doesn't mean a baby is unwell or in pain
- Is temporary: it will go away eventually.
It’s important that parents take care of themselves as well. Parents should try to take a break and ask someone else to take over for a little while, even just for an hour or 2.
Remember that caring for a baby with colic is not a one-person job. A doctor or child health nurse can provide support and will have some ideas that may help to soothe an unsettled baby.
It may be helpful to:
- Check with the doctor to make sure the baby is otherwise well
- Make sure the baby is not hungry or needs a nappy change
- Develop a regular daily pattern for feeding, sleeping and playing
- Develop a routine for settling the baby for naps and sleep
- Avoid excessive stimulation before sleep
- Avoid excessive quiet – most babies find a low level of background noise soothing, e.g. gentle music
- Darken the bedroom for daytime naps
- Try soothing techniques such as baby massage, gentle rocking or gentle patting
- Respond to the baby before they become too worked up
- Avoid startling the baby, e.g. with quick movements
- Handle the baby gently and speak quietly to them
- Carry the baby in a front pack or sling when they are unsettled
- If using formula, check that it is being made up correctly
- Ask for and accept offers of help
- Talk to a health professional if you need support or are feeling that you can’t cope.
2. The Royal Childrenâ€™s Hospital, Melbourne. Clinical Practice Guidelines: Unsettled or crying babies (colic) (Updated September 2012). Available at http://www.rch.org.au/clinicalguide/guideline_index/Crying_Baby_Infant_Distress/. Accessed May 2016.
3. Gelfand AA. Infant colic. Semin Pediatr Neurol 2016: 23:79-82. Available at http://www.ncbi.nlm.nih.gov/pubmed/?term=Gelfand+AA.+Infant+colic.+Semin+Pediatr+Neurol+2016%3A+23%3A79-82.