Colic 101: Everything You Need to Know
You know babies are supposed to cry, but sometimes does it seem like your baby’s cries go on a little longer than “normal”? Even after you’ve checked her diaper and made sure she’s been fed and burped, no amount of holding, rocking or jiggling seems to console her—or stop her cries. Watching her sob and writhe in pain, you probably feel helpless and at the end of your rope. Well, you’re not alone.
Like other parents, you’re probably wondering whether baby is suffering from what many of us dread—colic. Even though those cries might make you think otherwise, baby colic generally isn’t a sign of something serious, and it definitely doesn’t mean you’re doing anything wrong. Luckily, colic eventually goes away by itself (it does, we promise). “The good news is that colic won’t last forever,” says pediatrician Deena N. Blanchard, MD, MPH. Here, we’ll walk you through what colic is, what causes colic, the colic symptoms to look for and colic remedies that might help ease baby’s discomfort.
As you probably know by now, colic is, well, a lot of crying! All newborns are fussy and cry, especially during the first three months of life. But some babies go beyond the normal amounts; colic affects about 20 to 25 percent of infants. In general, colic is typically defined by the “rule of three,” Blanchard says. The colic “rule of three” is when an otherwise healthy baby under 3 months of age cries for more than three hours a day, more than three days a week, for more than three weeks in a row for no apparent reason.
Believe it or not, there’s still no definitive answer for what causes colic, and there’s no test to officially confirm baby has it. “One of the worst sounds a parent can hear is their child crying,” Blanchard says. “Worse yet is when your infant is crying and you can’t figure out why, even after he’s been fed, burped and changed.” To get to the bottom of things, it helps to know all the possible reasons baby might be showing signs of colic, so you can use the process of elimination.
Potential causes of colic:
• Milk allergy. Baby may have a cow’s milk protein intolerance. About 2.5 percent of kids under age 3 are allergic to milk, according to the Food Allergy Research & Education. But most with this allergy will outgrow it during their first year. “Children with this condition have an intolerance to either whey or casein or both, which are proteins found in cow’s milk,” Blanchard says. “They’ll often cry with feedings and you’ll typically find blood in their stool.”
• Your diet. If you’re breastfeeding, there’s a chance colic may be a reaction to your diet. Consider making adjustments to what you eat and drink if you’re breastfeeding and see if that results in less crying. One at a time, you might want to try eliminating caffeine, soy, fish, nuts, egg, dairy, wheat or other possibly irritating foods from your diet and see if baby’s colic symptoms get better. Talk with your pediatrician before you go ahead and switch what you eat. Just be forewarned that this tactic may be unsuccessful. “If your baby is simply just fussy or not sleeping, there is no proof that taking foods out of your diet will make baby better in the long run,” says pediatric gastroenterologist Barbara Verga, MD.
• Overfeeding. Some babies may cry if their bellies are too full. Signs of overfeeding include baby turning away or closing his mouth before your normal nursing time is done or his bottle is completed. He may also be spitting up excessively. Baby needs a few hours between feeds for his stomach to empty, Verga notes. Since many parents don’t know what else to do to stop the crying, they often keep feeding a colicky baby. But Verga says to try not to overfeed as you’re only going to make baby feel worse.
• Gas. The painful bloating from gas can be to blame for all those colicky cries. Trouble is, it’s hard to tell if the gas is what’s causing colic or if the colic leads to gas when baby swallows too much air while crying for so long.
• Cigarette smoke. Babies of moms who smoke during pregnancy or after delivery, or who live in homes with smokers, tend to be more colicky, Verga says.
• Baby can’t self-soothe. It may just be a neurodevelopmental phase, Verga explains. “Some babies have an immature neurological system that’s not fully developed and they just can’t calm themselves down,” she says.
And then there’s gastroesophageal reflux (GERD) to consider. Blair Hammond, assistant professor of pediatrics at Mount Sinai Hospital in NYC, notes that GERD can indeed bring about crying in a child—the kind you might mistake for colic. But they’re two separate things. “Colic is much more likely to occur in the evening hours,” Hammond explains. “You might pick her up and carry her, or give her a pacifier, and she’s soothed for a little bit, but as soon as you put her down, she starts crying again.” However, with GERD, she says, “You’ll often see those babies pulling off the breast or the bottle, arching the back, and the fussiness is much more correlated to when the baby is actually feeding.”
Just as you’re settling into life with a new little human in the family and dealing with all these emotions is the time when signs of colic can start appearing, which makes it tough on new parents. “Often, babies with colic will start becoming fussy around 3 weeks of age,” Hammond says.
How long does colic last?
In the moment, it may seem like the crying will never stop, but hang in there, because it does. “Colic typically gets better somewhere between nine to 16 weeks,” says Hammond, but it can last as long as six months, according to the American Academy of Pediatrics.
As for when colic peaks, that’s right around 6 to 8 weeks of life, Hammond says. She notes, “You’ll see that during this period, babies with colic are often scrunching their abdomen, they’ll get red and they’ll be gassy.”
Crying, fussy babies are to be expected the first few months of life. But if baby is thriving and otherwise healthy—which means baby tolerates feeds, isn’t losing weight, isn’t vomiting, doesn’t have diarrhea and has no fever—and he falls into the “rule of three” mentioned above, he may have colic. You should also check if he exhibits one these colic symptoms:
• Posture changes. Colicky babies tend to show signs of tensed stomach muscles, clenched fists and curled up legs.
• Intense, inconsolable crying. Baby doesn’t need anything and appears to be crying for no apparent reason. This colicky crying is more intense with a distressed, higher-pitched tone that’s louder than his typical cry, Blanchard says. He may also look bright red and be impossible to comfort and soothe. Colicky cries are likely to happen around the same time every day, typically in the early evening, which some parents refer to as “the witching hour,” Blanchard says. Baby may pass gas or have a bowel movement when it’s finally all over.
No one remedy will make colic symptoms go away for good, or even work every time. “Some treatments may not work for your child at all, while some may seem like a lifesaver,” Blanchard says. It’s really about experimenting with different tactics and seeing what works. You can try some or all of these colic remedies to help baby calm down, reduce the intensity of her crying and regain a bit of your sanity. But as always, talk with your pediatrician before starting any colic remedies.
• Anti-gas medications. Over-the-counter gas-relief medications, sometimes known as colic drops (like Infants’ Mylicon), could ease baby’s colic symptoms. These medications are generally safe, unless baby takes thyroid replacement medications. Ask your doctor which brand she recommends before you give to baby.
• Probiotics. Some colicky babies may have an imbalance of the “good bacteria” in their digestive tract. Since probiotics help keep that natural balance, some pediatricians, including Hammond, prescribe them for babies who have colic, as long as baby doesn’t have a milk protein intolerance or problem with her immune system. While some doctors have debated their effectiveness, Dyan Hes, a board-certified pediatrician and founder of Gramercy Pediatrics in NYC, says probiotics can also help reduce gas, which is one of the things doctors suspect factors into colic. “Probiotics certainly don’t do any harm, so we’re fine with them,” she says.
You can also experiment with some of these home remedies for colic:
• Offer a pacifier. Baby loves to suck, so help soothe and calm him with a pacifier, even if you normally wouldn’t. Or offer him other ways to suck, such as his own thumb or hand. You can also try breastfeeding (just remember not to overfeed!).
• Give a tummy rub or gentle “colic” massage. Use the power of your touch to soothe a colicky baby. For a tummy rub, lay baby belly-down across your knees. Then gently rub her back to help release gas. For a soothing massage, slowly stroke her legs, back, arms, chest and face.
• Hold baby upright while feeding. Being in a vertical position may help reduce how much air baby swallows, Blanchard says. Burp him frequently, which also helps reduce gas and may offer some colic relief.
• Swap in formula for colicky babies. If you’re formula-feeding, try one called hydrolysate infant formula, which can sometimes make a difference, especially if baby has a milk intolerance or allergy to cow’s milk. “They can help. They don’t always reduce the crying time, but we try,” Hes says. “Because there’s no specific cure, we try formulas with hydrolyzed proteins or whey protein. For some parents, it’s miraculous.” Just a heads up, though—this special formula is usually more expensive than traditional formula. Still, if you suspect baby has colic, always speak with your pediatrician before switching to a formula for colicky babies, since you want to make sure the change makes sense for baby and that you aren’t just switching to something that’s going to make baby feel the same or worse.
• Stick to a bedtime.“One thing I tell parents is that babies can become colicky when they’re tired,” Hammond says. “So in that first month of life, try to make sure baby doesn’t stay up too late. Parents will try to get the baby back to sleep every two hours or so, and as a result, they’re not staying awake for long stretches.”
• Hold baby close. The easiest of home remedies for colic? Cuddle up. Skin-to-skin contact is a great way to soothe a colicky baby. But even if you’re clothed, snuggling baby against your body can go a long way to helping him calm down. If your arms need a break or you’re on the go, put him in a baby sling or carrier (as long as he’s the correct weight for the gear you have). Just make sure you don’t keep baby in the sling or carrier all day, Verga advises, since it’s important for infants to change positions throughout the day.
• Get baby moving. Babies are familiar with motion from being in the womb, so movement can offer some colic relief. “Babies who tend to cry a lot often respond to motion,” Blanchard says. Put her in a baby swing or vibrating bassinet or seat, rock her in your arms, or hold her and sway side to side as you sing or stroke her back gently, Blanchard suggests. You can also put her in the stroller and walk around the neighborhood or take her on a car ride.
• Play music or white/background noise. Another soothing way to remind a colicky baby of being in your belly? Steady noises that are loud (within reason). Buy a white noise machine or download a white noise app. “Just make sure to place it across the room so you don’t affect your baby’s hearing,” Blanchard says. You can also play some static on the radio, run a fan, vacuum, clothes dryer or hair dryer, or comfort baby with a toy or in a swing or seat that plays calming sounds like ocean waves or a rainstorm.
Warm bath. When you’re stressed out, you might grab a glass of wine and head for the bath. Try the same for a colicky baby (minus the wine, of course!); a warm bath is one of the home remedies that may help him relax and chill out.
• Gripe water. Although there’s not a lot of evidence that says gripe water works, some moms swear by it as a natural colic remedy. Since it isn’t harmful to baby in small doses, it can’t hurt to try if you’ve been thinking about using it. Need a brand recommendation? Try Colic Calm, a safe and gentle FDA-listed medication, which contains nine natural ingredients and is free of sugar, simethicone, sodium bicarbonate (baking soda), herbal oils and extracts, wheat, gluten, soy, dairy and animal products. (Colic Calm is also a form of “colic drops.” It comes with a drop dispenser so you can easily drop it into baby’s mouth and around the gums.) Just speak to your doctor before using gripe water or any other alternative colic remedies and carefully read the instructions so you give baby the right dose.
• Chamomile tea. Another one of the home remedies for colic is something you might enjoy yourself. “Sometimes, you can give baby an ounce of chamomile tea,” Hes says. “Chamomile is a natural relaxant of the tummy, so you can try it and see if it helps.” But only if the baby needs it. “If a baby is healthy, don’t give him chamomile tea.” And only do one ounce, once a day. “Babies really aren’t supposed to have water, so you only want to give it to a baby who needs it and a very small amount at a time.”
What not to use as a remedy for colic
Though it’s popped up on parenting boards, Hes advises against using essential oils to soothe a colicky baby. “Absolutely do not use essential oils!” she says, because they could have adverse effects. “Babies should not be inhaling those scents.”
And then there are so-called baby bottles marketed as “anti-colic.” Says Hes, “Yes, there are bottles where you swallow less gas, but there’s no such thing as a true ‘anti-colic bottle.’” So as much as you want to help your colicky baby, beware of advertising claims.
Unfortunately, there’s no way to prevent colic. "You can have four kids who are totally not colicky, and then your fifth kid is extremely colicky,” Hes says. And that’s what makes colic so frustrating. That said, patience and knowing that colic too shall pass can make all the difference for parents riding out this short but trying moment.
Updated September 2017