Colic in babies
Colic is not an illness and not a diagnosis; it is a description. A healthy baby in its first months cries for hours on end and is almost impossible to console.
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Medicines commonly prescribed for Colic in babies
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: CHEWABLE TABLET, 120 mgActive substance: siliconesManufacturer: Laboratorios Normon S.A.Prescription not requiredDosage form: CAPSULE, 240 mgActive substance: siliconesManufacturer: Uriach Consumer Healthcare S.L.Prescription not requiredDosage form: CAPSULE, 257.5 mg simethiconeActive substance: siliconesManufacturer: Arkopharma Laboratorios S.A.U.Prescription not required
Colic is not an illness and not a diagnosis; it is a description. A healthy baby in its first months cries for hours on end and is almost impossible to console. It passes on its own, usually by three or four months, and leaves nothing behind. The hard part falls not on the baby but on the parents, out of helplessness and out of the thought that they must be doing something wrong. So this text has two central parts: how to tell ordinary crying from crying with something serious behind it, and how to get through it without harming the baby or yourself.
What it looks like
Colic is the word used when a baby cries for more than three hours a day, on more than three days a week, and keeps it up for at least a week, while in every other respect being well, feeding properly and gaining weight. It usually starts in the first weeks of life, peaks at around six weeks and fades markedly after the third month.
The episode is recognisable:
- the crying begins abruptly, often at the same time of day, most often towards the evening;
- it is loud, strained and high-pitched, and the usual remedies — the breast, rocking, a dummy — do not work;
- the baby clenches its fists, goes red, pulls its legs up to its tummy or, conversely, arches its back;
- the abdomen feels tense, there are rumbling noises and wind often passes;
- it lasts anything from minutes to hours and stops as suddenly as it began.
Between episodes this is an ordinary, contented baby. That detail matters: a baby who is also flat and unwell in between does not fit the definition of colic.
Where it comes from
The honest answer is that nobody knows for certain. The usual candidates are an immature gut and immature gut movements, trapped wind, sensitivity to a day's worth of stimulation piling up by evening, differences in gut bacteria, and the way a baby sucks and swallows air. Most likely the same crying has different causes in different babies.
What is known for certain is what colic does not mean. It does not mean the mother's milk is "bad" or "thin", that you cannot handle your baby, that you have spoiled it by holding it too much, or that it is hungry. Breastfed babies cry and bottle-fed babies cry; first children cry and fourth children cry. And in almost all of them it ends by itself, within the same window.
Rule out the simple things first
Before settling on colic, it is worth running quickly through the things that can be fixed in a minute:
- hunger, especially during a growth spurt, when the baby asks to feed noticeably more often;
- a wet or dirty nappy, a chafing elastic, a fold in the clothing, a scratchy label;
- too hot or too cold: judge by the back of the neck, not by hands and feet, which are normally cool;
- overtiredness — sometimes a baby cries precisely because sleep was due some time ago;
- a plain need to be held, which explains nothing further and is perfectly normal;
- a hair or thread wound tightly around a toe or finger — a rare but real cause of inconsolable crying, found only if the baby is undressed completely and each digit is checked;
- an eyelash or speck in the eye that has scratched the cornea: the eye then waters and the baby screws it shut against the light.
Some things resemble colic without being it: painful posseting with arching in reflux, constipation, and a reaction to cow's milk protein. Consider that last one if mucus or streaks of blood appear in the nappy, or if there is a stubborn rash, vomiting or poor weight gain. Do not cut dairy out of your own diet or switch formula on a hunch — that decision is made with a doctor.
What helps and what does not
There is no medicine for colic, but an episode can be softened and sometimes shortened:
- pick the baby up and carry it: a baby of a few months cannot be "spoiled" by being held, but it can be settled by contact;
- feed in a more upright position and hold the baby upright afterwards so that air can come up;
- rock it on your shoulder, push it in the pram, get outside — movement and cool air work better than any drops;
- a warm bath, a warm hand on the tummy, a gentle clockwise massage;
- steady background noise and dimmed light: by evening a baby usually needs fewer impressions, not more;
- carry on feeding as usual; a breastfeeding mother does not need a restrictive diet unless a doctor advises one.
Now for what is not worth your energy or your money. Colic drops, gripe water and herbal mixtures are on sale everywhere, but there is no convincing evidence that they help, and some plant preparations are not even safe in infants. Probiotics have been studied more than the rest, and the benefit, where there is one, is small and mainly concerns breastfed babies — talk to a doctor before buying anything.
One approach is better not tried at all: manipulation of a baby's spine or skull has no proven benefit and is capable of causing harm.
When it is no longer colic
These are the signs that take the crying out of the home. Go to emergency care or call an ambulance (112 across Europe) straight away if:
- the cry is weak and moaning, or on the contrary shrill and nothing like the usual one;
- a baby under three months has a fever: on its own that already calls for urgent assessment;
- there is green vomit, forceful projectile vomiting, or repeated vomiting with refusal to feed;
- there is blood in the nappy, stool like redcurrant jelly, and bouts of crying alternate with pallor and floppiness in between — that is how a twisted or telescoped piece of bowel can announce itself, and it needs help within hours;
- the abdomen is swollen and hard, or a firm, painful lump has appeared in the groin or scrotum and will not go back in;
- the baby is floppy, will not wake properly, and the skin looks pale, grey or mottled;
- a rash that does not fade when pressed with the side of a glass;
- fast breathing, grunting, the spaces between the ribs drawing in, or blue lips;
- the crying started after a fall or a knock, or if the baby has been shaken.
Not the same minute, but do have the baby seen if feeding falls off, there are fewer wet nappies, weight gain stalls, if crying like this appears for the first time after three or four months or carries on past five, and also if you simply feel that something is wrong. A parent's sense of it is a poor reason to panic but a good reason for an examination.
Getting through it yourselves
Hours of crying are exhausting, and it is normal to feel angry, to cry and to want to walk away. What is dangerous is something else: trying to carry it alone to the very last.
If you feel you have reached your limit, put the baby on its back in the cot where it is safe, close the door and step out for a few minutes. A baby crying in a cot is safe; a baby in the arms of someone who is no longer in control is not. Never shake a baby. A few seconds of shaking can damage the brain irreversibly, and it almost always happens not to cruel people but to worn-out ones.
Take turns with the other parent, ask family to cover you for even an hour of sleep, say out loud how hard you are finding it. If the anxiety and low mood do not lift even once the baby has settled, tell a doctor: postnatal depression is treatable, and asking for help here is part of looking after the child. And keep hold of the main thing: colic ends, and it ends on a predictable schedule.
Online consultation
A remote appointment does exactly the thing that is hardest to travel for with a small baby: going calmly through whether the crying fits colic or whether something in it is worrying. The doctor will ask about the shape of the day, feeds, nappies and weight, will look at the baby and at how it behaves during a quiet hour, will suggest what to try this evening and will explain which signs to watch for. It is also the place to raise a suspicion of reflux or of a reaction to cow's milk protein and to decide whether an in-person examination is needed. The signs in the list above are not handled on a screen — with those, go straight to emergency care.
This material is for information only and does not replace medical advice.
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