Colic is frequent, prolonged and intense crying or fussiness in a healthy infant. Colic can be particularly frustrating for parents because the baby's distress occurs for no apparent reason and no amount of consoling seems to bring any relief. These episodes often occur in the evening, when parents themselves are often tired.
Episodes of colic usually peak when an infant is about 6 weeks old and decline significantly after 3 to 4 months of age. While the excessive crying will resolve with time, managing colic adds significant stress to caring for your newborn child.
You can take steps that may lessen the severity and duration of colic episodes, alleviate your own stress, and bolster confidence in your parent-child connection.
Babies have been known to fuss and cry, especially during the first three months of life. The range for what's considered typical crying is difficult to pin down. In general, colic is defined as crying for three or more hours a day, three or more days a week, for three or more weeks.
Features of colic may include the following:
- Intense crying that may seem more like screaming or an expression of pain
- Crying for no apparent reason, unlike crying to express hunger or the need for a diaper change
- Extreme fussiness even after crying has diminished
- Predictable timing, with episodes often occurring in the evening
- Facial discoloring, such as skin flushing or blushing
- Body tension, such as pulled up or stiffened legs, stiffened arms, clenched fists, arched back, or tense abdomen
Sometimes there is relief in symptoms after the infant passes gas or has a bowel movement. Gas is likely the result of swallowed air during prolonged crying.
When to see a doctor
Excessive, inconsolable crying may be colic or an indication of an illness or condition that causes pain or discomfort. Schedule an appointment with your child's health care provider for a thorough exam if your infant experiences excessive crying or other signs or symptoms of colic.
The cause of colic is unknown. It may result from numerous contributing factors. While a number of causes have been explored, it's difficult for researchers to account for all the important features, such as why it usually begins late in the first month of life, how it varies among infants, why it happens at certain times of day and why it resolves on its own in time.
Possible contributing factors that have been explored include:
- Digestive system that isn't fully developed
- Imbalance of healthy bacteria in the digestive tract
- Food allergies or intolerances
- Overfeeding, underfeeding or infrequent burping
- Early form of childhood migraine
- Family stress or anxiety
Risk factors for colic are not well-understood. Research has not shown differences in risk when the following factors were considered:
- Sex of the child
- Preterm and full-term pregnancies
- Formula-fed and breast-fed babies
Infants born to mothers who smoked during pregnancy or after delivery have an increased risk of developing colic.
Colic does not cause short-term or long-term medical problems for a child.
Colic is stressful for parents. Research has shown an association between colic and the following problems with parent well-being:
- Increased risk of postpartum depression in mothers
- Early cessation of breast-feeding
- Feelings of guilt, exhaustion, helplessness or anger
Shaken baby syndrome
The stress of calming a crying baby has sometimes prompted parents to shake or otherwise harm their child. Shaking a baby can cause serious damage to the brain and death. The risk of these uncontrolled reactions is greater if parents don't have information about soothing a crying child, education about colic and the support needed for caring for an infant with colic.
Apr 05, 2022
- McInerny TK, et al., eds. Colic. In: American Academy of Pediatrics Textbook of Pediatric Care. 2nd ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2017. https://pediatriccare.solutions.aap.org. Accessed October 10, 2017.
- Shelov SP, et al. Crying and colic. In: Caring for Your Baby and Young Child: Birth to Age 5. 6th ed. New York, N.Y.: Bantam Books; 2014.
- Turner TL, et al. Infantile colic: Management and outcome. https://www.uptodate.com/content/search. Accessed Dec. 1, 2017.
- Turner TL, et al. Infantile colic: Clinical features and diagnosis. https://www.uptodate.com/content/search. Accessed Dec. 1, 2017.
- Pace CA. Infantile colic: What to know for the primary care setting. Clinical Pediatrics. 2017;56:616.
- Xu M, et al. The efficacy and safety of the probiotic bacterium Lactobacillus reuteri DSM 17938 for infantile colic: A meta-analysis of randomized controlled trials. PLOS One. 2015;10:e0141445. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0141445. Accessed Dec. 1, 2017.
- Savino F, et al. Crying time and RORgamma/FOXP3 expression in Lactobacillus reuteri DSM17938-treated infants with colic: A randomized trial. Journal of Pediatrics. 2018;192:171.
- Fatheree NY, et al. Lactobacillus reuteri for infants with colic: A double-blind, placebo-controlled, randomized clinical trial. Journal of Pediatrics. 2017;191:170.
- Schreck Bird A, et al. Probiotics for the treatment of infantile colic: A systematic review. Journal of Pharmacy Practice. 2017;30:366.