Colic: How to tell if your baby has it (and what to do next) 6 years ago

Colic: How to tell if your baby has it (and what to do next)

"For the first few weeks, she was a very sunny little baby, feeding and sleeping quite easily. We felt so lucky. But now she’s like a different child. She cries so much, most of all in the evening, and nothing I do seems to console her. She really seems to be in such pain, it can’t simply be colic...."

Every baby cries, but is it normal when your dream baby turns into a screamer overnight? For quite a large number of babies (up to one in four) it can be.

Colic is very real, very difficult to manage and it will push your own limits. Doctors are fascinated by colic, but I have huge sympathy for anyone who has to live with it every day. If it is any reassurance:

  • A child with colic is usually perfectly healthy.
  • No matter how bad it is, it should stop within four months.
  • Drugs and changes in formula have virtually no role to play.
  • While there’s no single remedy, you can help your baby.

You will need support with this one; someone to share the job and keep you sane for those few weeks; someone to remind you that your baby will bounce back soon, none the worse for wear. But make sure it is colic first.

Why Babies Cry (Normally)

If only babies could talk. But they communicate by crying and at first it is expressive – baby is bothered and it is one loud universal shout. By three months old, her central nervous system has matured a little and her crying starts to communicate. Now when baby is bothered, she is calling you.

Do babies always cry because something is wrong? Yes; they are not simply manipulating you – that’s the toddler’s job! But what is wrong may be as basic as tiredness or wanting a cuddle. Normal babies have their own crying style – some cry more (and louder) than others and are slower to soothe.

Most babies follow the same crying pattern, whatever culture they live in or its attitude to rearing children. There is usually a crying ‘peak’ around four to six weeks old and then it all eases off around eight to 12 weeks – a little earlier if baby is bottle-fed. That’s normal.


Colic Crying

What is not so normal is colic or ‘excessive’ crying. Your colic baby will cry more intensely and at a higher pitch than ‘normal’ crying and will sound as if she is in pain. She may also cry for longer – up to an hour at a time – and will resist most of your efforts to soothe her, including feeding. Her tiny fists may clench, legs may stiffen and she may grimace. She may also throw up milk or be windy.

If it is bad, she may arch her back.

This crying tyrant will typically show up at around two weeks-old and sweeten again at about four months. The bouts of colic will usually start and end for no obvious reason. Unfortunately for you, it is often in the evening when you are already worn out.

If you are used to an ordered life, the mayhem she causes can be especially hard to take. But do remember: she’s crying because she’s bothered and she has absolutely no idea what may be wrong.

Is It Colic?

Colic is never a quick diagnosis. The Wessel Rule of Threes is the system traditionally used by doctors: if your baby cries for more than three hours a day for more than three days a week for three weeks, she has colic. But what parent with a screaming baby will wait that long? I suspect colic if:

  • Your baby has cried intensely for three hours a day for three days of the past week
  • If there is no other cause.
  • I see typical ‘colic crying’ symptoms.

Or Something Else?

The vast majority of babies who cry excessively have colic. But when your baby is screaming hard and has a temperature or other symptoms, we want to rule out a serious bacterial infection – such as meningitis, septicaemia or a urinary tract infection.

There are other medical problems that can mimic colic but they are actually quite rare.


Problem How likely?
Cow’s milk protein allergy Less than 5 per cent of colicky infants
Effects of drugs the mother is taking A growing problem
Reflux from the oesophagus Rare
Lactose intolerance Rare

If you are breastfeeding and taking drugs, there may be a link. Some mother’s medications (especially drugs for anxiety and depression) can cause symptoms in a baby that are very like colic. Clues that point to something other than colic are a very high-pitched cry with an arched back, a colic that does not happen mainly in the evening, crying that starts at around three months of age or crying that increases dramatically when you change from breast to formula feeding.

This is an extract from When Your Child is Sick by Professor Alf Nicholson, Professor of Paediatrics at Temple Street Children's University Hospital and Grainne Malley.

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