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pediatric-newborn

Colic in Babies: Understanding the Crying and Finding Ways Through It

Colic means intense unexplained crying in an otherwise healthy infant. It usually peaks at 6 weeks and resolves by 3–4 months. Strategies exist to help soothe and cope.

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Dr. Lena Park — Pediatric NP

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What colic actually means

Colic is not a disease or a diagnosis in the traditional sense — it is a description of a behavioral pattern. The classic working definition (sometimes called the "rule of threes") is crying for more than three hours a day, more than three days a week, for more than three weeks in an infant under three months.

In practice, most providers use colic as a label for excessive, inconsolable crying in an otherwise healthy, well-nourished baby where no physical cause can be found. Colic affects approximately one in five babies, typically beginning around the second to fourth week of life and peaking at six weeks 1. The cry in colic is often high-pitched, the baby may draw up their legs or arch their back, and the crying tends to cluster in the late afternoon and evening. Between episodes the baby typically returns to normal — feeding, sleeping, and appearing comfortable.

What may be behind it

Researchers and pediatricians have proposed many theories, and the honest answer is that no single cause has been confirmed. Possibilities that have been studied include:

  • Immature nervous system: some infants may have a harder time filtering out sensory input and become overwhelmed — a concept the AAP describes as "unusually sensitive to stimulation" 1.
  • Gut immaturity: the digestive system is still developing, and gas or gut motility may be uncomfortable.
  • Dietary sensitivity: in breastfed infants, sensitivity to foods in the parent's diet (dairy, caffeine, onions) is sometimes a contributor.
  • Feeding issues: overfeeding, underfeeding, or swallowing air can contribute to discomfort.

None of these explains every case, and for many babies the cause remains unclear.

Soothing strategies that some families find helpful

No single approach works for every baby, but these are commonly tried 1:

  • Motion: gentle rhythmic movement — a swing, a car ride, being carried and walked — can be calming for many infants.
  • White noise or shushing: steady, gentle noise reminiscent of the womb environment may help.
  • Swaddling: a snug, secure wrap can reduce startle reflexes and help some babies settle.
  • Sucking: a pacifier or nursing (if feeding-appropriate) can be soothing.
  • Positioning during feeding: keeping the baby more upright during and after feeds and burping gently may reduce gas discomfort.
  • Skin-to-skin contact: holding the baby against the caregiver's bare chest is calming for many.

Probiotics (specifically *Lactobacillus reuteri*) have been studied in colicky infants, with some earlier trials showing benefit in breastfed babies; however, a rigorously designed double-blind trial found no overall benefit compared with placebo 2. A pediatric provider can discuss whether a probiotic trial is worth trying in a specific situation.

Diet changes and when they may be relevant

For breastfeeding caregivers, eliminating dairy from the diet is sometimes tried for two to three weeks to see whether it makes a difference — cow's milk protein intolerance can cause fussiness and digestive discomfort in some infants. The AAP notes soy sensitivity as a related possibility 1. This is worth discussing with a provider before making significant dietary changes.

For formula-fed babies, some families try a hydrolyzed or partially hydrolyzed formula. A provider can help assess whether a trial switch is appropriate.

Changes should be given adequate time (at least two weeks) to show effect.

Taking care of the caregiver

Colic is genuinely hard. Listening to an inconsolable infant for hours — especially through exhaustion and uncertainty — takes a real toll on caregivers. A few important things to hold onto:

  • Colic is not caused by bad parenting. It is not a reflection of the caregiver's attunement or ability.
  • It does end. For the vast majority of babies, colic resolves by three to four months of age 1.
  • It is safe to put a baby down in a safe sleep space (on their back, in a crib or bassinet, with no soft bedding) and take a brief break if the caregiver feels overwhelmed. Walking away for a few minutes is safer than staying and reaching a breaking point.
  • Never shake a baby. Shaking can cause serious brain injury even when done in frustration for a brief moment.
  • Reaching out for support — to a partner, family member, friend, or provider — is not weakness.

Common questions

How do I know if it's colic or something else?

A provider should evaluate a crying baby to rule out causes like an ear infection, a hair tourniquet (a strand of hair wrapped around a finger or toe), constipation, reflux, or a hernia. Colic is a diagnosis after other causes have been considered.

Does colic mean something is wrong with my baby?

Colic, by definition, occurs in babies who are otherwise healthy. It does not indicate a serious underlying problem, though that does not make it easier to live through.

When does colic go away?

Most babies with colic see significant improvement by three months and resolution by four months. It tends to peak around six weeks of age.

Can I try gripe water or gas drops?

Over-the-counter gas drops (simethicone) are widely used and considered safe, though evidence for their effectiveness in colic is limited. Gripe water formulations vary; check ingredients and discuss with a provider before using, especially herbal versions.

Talk to a clinician

Dr. Lena Park — Pediatric NP

kids & families. Gale can match you with a licensed clinician for a visit.

Find care →

When to get care right away

  • —Baby has a fever (any fever in an infant under 2–3 months; 100.4°F / 38°C or higher in a baby under 3 months is an urgent concern)
  • —Crying is accompanied by vomiting, especially forceful or bile-green vomit
  • —Baby seems to be in significant pain and there is a swollen or hard belly
  • —Baby is not feeding, has no wet diapers, or seems dehydrated
  • —You notice a finger, toe, or other body part that looks swollen or has hair wrapped tightly around it
  • —Crying pattern has changed suddenly or is accompanied by other new symptoms
  • —You feel you may lose control — it is safe and appropriate to call for help

If you believe the baby may be seriously ill, is hard to rouse, is having trouble breathing, or you are in crisis, call 911 or go to the nearest emergency department. If you are feeling overwhelmed to the point of concern for yourself or your baby, call or text a trusted person, your provider, or a crisis line.

This article provides general health information for parents and caregivers and is not a diagnosis or treatment plan for any individual child. A pediatric provider should evaluate any baby with prolonged or concerning crying.

References

  1. 1.American Academy of Pediatrics (HealthyChildren.org) (2023). Colic Relief Tips for Parents. HealthyChildren.org. link ✓Prevalence of colic in about one in five babies, typical age of onset and resolution (peaks 6 weeks, resolves by 3–4 months), soothing strategies, and dietary sensitivity considerations
  2. 2.Sung V, Hiscock H, Tang MLK, et al. (2014). Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ. doi:10.1136/bmj.g2107 ✓Rigorous double-blind trial (n=167) finding L. reuteri DSM 17938 did not benefit a community sample of breastfed and formula-fed infants with colic compared with placebo

2 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.