What is colic?

Colic is usually defined as crying that lasts more than 3 hours per day for more than 3 days out of the week in an otherwise healthy infant under 3 months of age. It can be very stressful and frustrating to parents. Colic usually begins suddenly, with loud and mostly continuous crying.

What causes colic?

Healthcare providers are not certain what causes colic. There are several theories about why colic may or may not occur, including the following:

• Temperament and adjusting to the world. Newborns must also make adjustments to the world they are living in. Not all babies have the same temperament. Some adjust to lights, loud noises, and all the other stimulation around them with no trouble, while others are not able to adapt as easily. Just like adults, some babies are easy-going, and some are impatient. Crying may be one way for a baby to vent feelings as he or she is getting adjusted to the world.
• An inability to self-soothe. Some babies seem overly sensitive to stimulation and are unable to calm themselves. As a baby matures, he or she is better able to regulate his or her immature nervous system. As this happens, colic disappears.
• Gas. Gas may contribute to colic. Gas is produced by bacteria in the intestines and can also be swallowed into the intestines (aerophagia). Symptoms of gas include fussiness, enlarged abdomen, and passage of excessive gas through burping or flatulence.
• Milk allergy. Milk allergies may cause abdominal pain, but usually also cause diarrhea. A baby who can't tolerate cow's milk and responds to a change in formula may have a milk allergy. However, there is no evidence that changing to a non-milk formula has any effect on colic.

What are the symptoms of colic?

A child who is otherwise well, who cries or is fussy several hours a day, especially from 6 p.m. to midnight, with no apparent reason, may have colic. Also, babies with colic may burp frequently or pass a significant amount of gas, but this is thought to be due to swallowing air while crying, and is not a cause of colic. The face may be flushed. The abdomen may be tense with legs drawn toward it. The hands may be clenched.

The symptoms of colic may look like other conditions or medical problems. Always consult your child's healthcare provider for a diagnosis.

Who is at risk for colic?

All families are at risk of having a baby with colic. All babies are at equal risk of developing colic, no matter their sex, race, or socioeconomic class.

Why is colic a concern?

Colic may become a concern due to the following reasons:

• Frustrating and stressful to parents
• Parents and infant lose sleep
• Infant may be overfed in an attempt to stop the crying

Babies with colic usually grow and gain weight appropriately, despite being fussy or irritable, being gassy, and losing sleep.

How is colic diagnosed or evaluated?

A healthcare provider will examine your baby and obtain a medical history. Questions might be asked about how long and how often your child cries, if you have noticed anything that seems to trigger the crying, and what comfort measures are effective, if any. Blood tests and X-rays or other imaging tests may be done to determine if there are other problems present.

When should we contact our primary care provider?

Before assuming your child has colic, you should look for other signs of illness. These may include, but are not limited to, the following:

• Not sucking or drinking a bottle well
• Drinking less milk than usual
• Gastrointestinal (GI) issues like vomiting or diarrhea
• Becoming more irritable when held or touched
• Strange sounding cry
• Change in breathing rate or effort
• Being more sleepy or sluggish than usual

Call your child's healthcare provider if you note any of these symptoms, or if your baby is crying excessively. Your child's healthcare provider will examine your child to make sure other problems are not present that might be causing colic-like symptoms.