Written for Stock My Medicine and clinically reviewed by Hajra Dhanchora, MPharm (GPhC 2216990).
Colic is the word for a healthy, well-fed baby who cries for hours, usually in the evening, for no reason anyone can find. It affects up to one in five babies, it is not caused by anything you're doing, and it stops. Those three facts don't make 6pm easier, but they're worth holding onto. Here's what colic is and isn't, what helps, and the things that get called colic but are something else.
What is colic in babies?
The working definition is the rule of three: crying for more than three hours a day, on more than three days a week, for at least a week, in a baby who is otherwise healthy, feeding well and gaining weight. The crying is intense and hard to console, often at the same time each day, most often late afternoon and evening. Nobody knows the cause. Wind, an immature gut, an immature nervous system that struggles to settle after a stimulating day, and sensitivity to something in milk have all been suggested, and colic probably has more than one cause.
When does colic start and when does it end?
It usually begins at two to three weeks, peaks around six weeks, and most babies are through it by three to four months. Premature babies follow the same timeline from their due date rather than their birth date. A baby who is still crying inconsolably at five months, or whose crying started suddenly after months of calm, doesn't have colic and should be seen.
Signs of colic
Crying that starts suddenly and builds to a scream; a red face; clenched fists; knees drawn up to the tummy or a back arched away from you; a tense, bloated tummy; lots of wind; and a baby who won't be soothed by the things that usually work. Between bouts the baby feeds, sleeps and gains weight normally. That last part is the reassuring bit and the diagnostic bit: colic doesn't make a baby unwell.
What helps a colicky baby
None of these is a cure, and all of them help some babies some of the time. Work through them and keep the ones that work for yours.
- Feeding position and winding. Hold the baby upright during feeds, check the latch or the bottle teat so less air goes in, and wind halfway through and after every feed, upright over your shoulder or sitting on your lap with your hand supporting the chin.
- Movement. Walking with the baby held against your chest, gentle rocking, a sling, a pram walk, or a drive. Rhythm and motion settle the nervous system.
- Warmth and touch. A warm bath, then a gentle clockwise tummy massage; skin-to-skin; a firm, calm hold.
- Noise and light. White noise, a hairdryer in the next room, the hum of a washing machine, and dimmed lights all reduce the stimulation a tired baby can't process.
- Keep feeding as normal. Don't switch formula, thin feeds or cut out foods on a hunch. If you're breastfeeding, cutting dairy from your own diet is worth discussing with a health visitor before trying, because it's only relevant to a minority.
Colic and breastfeeding: does what you eat matter?
For most breastfed babies, no. Colic is just as common in breastfed and formula-fed babies, and cutting foods out of your own diet on a hunch tends to make a tiring time harder without changing the crying. The exception is cow's milk protein allergy, which affects a small minority and comes with other signs: eczema, mucus or blood in the nappy, loose green stools, reflux or poor weight gain. If those fit, talk to your health visitor or GP before removing dairy, because it needs to be done properly and with calcium replaced. What does help breastfed babies with colic is attachment: a deep latch means less swallowed air, so ten minutes with a breastfeeding support worker can be worth more than any drops.
Does Infacol work?
Honestly: the evidence is thin. Infacol is simeticone, which breaks up small gas bubbles in the stomach into bigger ones that are easier to burp up. It's safe from birth, given as a dropperful before each feed, and it can't do harm, which is why so many parents use it; the trials, though, don't show it reduces crying overall, and the NHS says as much. The same goes for gripe water and lactase drops. A fair approach is a week's trial of Infacol alongside better winding: if the baby is clearly less windy and calmer, keep going; if nothing has changed, stop and save your money. Herbal remedies, cranial osteopathy and spinal manipulation have no evidence and the last two carry risk in babies, so leave those alone.
When it might not be colic
A few conditions get called colic and need different handling. Reflux: crying during or straight after feeds, arching, lots of vomiting, poor weight gain. Cow's milk protein allergy: colicky crying plus eczema, mucus or blood in the nappy, loose stools, or vomiting; it can affect breastfed babies via the mother's diet. Constipation: hard, pellet-like stools with straining. Teething doesn't start until around six months, so it isn't the cause of colic in a six-week-old, whatever the grandparents say. And an infection or a hernia: a bulge in the groin, a fever, or a baby who is floppy or pale. If any of those fit, see a GP or health visitor.
When to call 111 or see a GP
Call NHS 111 or see a GP if you're worried about the crying, if the baby is over four months and still colicky, if they're not gaining weight, have a fever, are vomiting green or bringing up blood, have blood in their poo, or if the crying sounds different: weak, high-pitched or unlike their usual cry. Go to A&E or call 999 for a baby who is floppy, blue, has a fit, is breathing fast or with grunting, or has a rash that doesn't fade under a glass. For a temperature, our Calpol dose by age guide has the numbers, but a fever in a baby under three months needs 111, not Calpol.
How to cope
Colic is as hard on parents as on babies, and it's the crying, not anything you've done, that's the problem. Share the evenings, take turns, and if you're alone and at the end of your patience, put the baby down safely in the cot, shut the door and take ten minutes; a crying baby in a safe cot is fine, a shaken baby is not. Cry-sis runs a helpline for parents of crying babies on 0800 448 0737. Your health visitor has heard it all before and wants to hear from you. See our baby and child range for the practical bits.
Frequently asked questions
How much crying is normal?
Babies cry more in the first three months than at any other time, peaking at six weeks at around two hours a day on average, sometimes more. Colic is the top end of that curve, not a separate illness.
Why is colic worse in the evening?
Nobody is sure. The best guess is a nervous system that has taken in a whole day of stimulation and can't switch off, which is why dimming lights, white noise and rhythm help most at that hour.
Can I give a colicky baby anything for pain?
Not paracetamol for colic; it isn't a pain condition and infant paracetamol is only for fever or clear pain from two months. Simeticone drops are the only routine option, and their effect is modest.
Does colic mean my baby will be a difficult child?
No. Colicky babies grow into the same range of children as everyone else, and colic has no lasting effect.