Colic (Paediatric Guidelines)

What is Colic?

Colic is a condition where there are repeated bouts of crying in a baby who is otherwise healthy. This is defined by doctors as: a baby who cries for more than 3 hours a day, for more than 3 days a week, for at least 3 weeks. Colic is common and distressing. It usually goes away by 3 to 4 months of age.

Link to Printable Information for the Management of Colic document Parent Advice Sheet

A typical baby with colic

A healthy newborn baby may have periods of crying, for no apparent reason as if in pain. The usual methods of comforting do not work very well. Your baby may not want to feed, and may pull up their knees, sometimes the baby's tummy appears to rumble.

The cry may sound different and more piercing than normal. Your baby may appear to be settling when suddenly another bout of crying occurs. This may go on and off for several hours until he or she settles and falls asleep.

In some babies, a period of restlessness in the evening is all that you may notice. In some babies with severe colic, the crying may go on for many hours throughout the day and/or night.

Bouts of colic gradually become less frequent, and have gone in most babies by the age of 3 to 4 months.

Babies with colic are fine between bouts, they feed and grow well and do not show any other signs of illness.

Facts about colic

The term colic is used as it is thought the baby has pain in the abdomen
It occurs in both formula and breast fed babies
It is common, affecting up to 3 out of 10 babies
Smoking or taking nicotine replacement during pregnancy increases the risk
The cause of colic is poorly understood, some theories are – it may be related to a change in the level of hormones that control the movement of gut muscles; the baby may have an abnormal balance of bacteria in their gut, which gradually corrects itself over a few weeks; some (but only a small number) of babies with colic have an intolerance to cow's milk.

Helping colicky babies & their parents

There is no treatment that cures colic. Every parent has their own way of coping and may find different things helpful.
Try not to despair, remember that there is nothing that you have done to cause the colic.
One or more of the following may help:

Exclude common causes of excessive crying eg. hunger, thirst, wet/dirty nappy, too hot/cold.
Reduce anxiety: even newborn babies may sense anxiety which can make things worse. Try to create a relaxed atmosphere, if possible have a rest & a meal before the colic starts (usually in the evening). The more rested & relaxed you are, the better you will be able to cope.
Holding your baby through the crying episode may help to soothe. However, sometimes a colicky baby may not be comforted or soothed. At such times it is acceptable to leave a baby to cry for short periods if you are satisfied they are not hungry, too cold/hot, wet, or unwell.
Time out – friends/family may be willing to help or take turns with your partner to look after your baby.
Talk over your experiences with other parents, share coping strategies.
Remember - never shake a baby. If you need a break from the crying, or if you feel at the end of your tether, gently place the baby in their cot and leave the room for around 5 to 10 minutes. You could then do something which will help you - perhaps have a cup of tea, a snack or phone a friend.
Relax your body by dropping your shoulders, clenching & unclenching your fists & stretching your back, arms & legs.
If simple things don't work, you could try a medicine called simeticone (eg, Infacol®), or some people find gripe water helpful, however, there is no scientific evidence to support its use.

The following tips are often given, based on individual experiences so they may or may not help

White noise (non-specific background noise such as vacuum cleaners, washing machines, hairdryer).
Gentle motion (pushing pram or ride in the car).
Bathing in warm bath.
Baby massage.
Many alternative therapies are promoted and advertised for colic but there is no firm evidence that any of these are beneficial. Note: not all alternative therapies are without risk, some herbal products, such as star anise, have caused serious reactions in some babies, and are not recommended.

Your feelings

Sometimes parents become angry, tearful, or resentful towards a baby with colic. These are normal and common emotions. The crying can seem distressing, intolerable and very frustrating. For more information and support contact cry-sis helpline

Seek advice from a healthcare professional if the baby is:

Vomiting
Has diarrhoea or constipation
Is not gaining sufficient weight
Has a high temperature
Is not feeding properly
Appears unwell or sick in anyway
If you are not sure why your baby is crying always consult your health visitor or GP to rule out any other cause for your baby’s distress.

Last reviewed: 14/04/2021

Next review date: 30/04/2024

Author(s): Paediatric Department .

Version: 1

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Infant Feeding Advisor.

Document Id: TAM328