Colic

Colic is the term for frequent, prolonged, intense crying or fussiness in an otherwise healthy baby. It affects up to 1 in 5 babies in the first few months of life and, while distressing for parents, is not a disease — it always resolves on its own.

How is colic defined?

The "Rule of 3s" describes a baby with colic:

• Crying for more than 3 hours a day
• For more than 3 days a week
• For more than 3 weeks
• In an otherwise healthy baby

Colic typically peaks around 6-8 weeks of age and resolves by 3-4 months.

What causes it?

The exact cause is unknown. Possible contributors:

• Immature digestive system
• Gas and abdominal discomfort
• Overstimulation — too much noise, light, or handling
• Baby's developing nervous system
• Gut bacteria differences
• In a small number of babies — cow's milk protein allergy (if the mother consumes dairy and is breastfeeding, or if the baby is on cow's-milk-based formula)

Typical features

• Intense crying, often at the same time of day (commonly evenings)
• Clenched fists, legs pulled up or arched back
• Red face
• Hard to comfort
• Often worse at the end of the day, even if the baby was content during the day

What can help

Different babies respond to different approaches. Try several:

• Hold and comfort — skin-to-skin contact, gentle rocking, carrying in a sling
• Swaddling — snug wrapping can calm some babies
• Gentle motion — rocking chair, pram walk, car ride
• White noise — a fan, rhythmic hum, or white-noise app
• Warm bath
• Massage — slow, gentle abdominal massage in a clockwise direction
• Burp the baby during and after feeds to release trapped air
• Feeding position — feed in a more upright position for reflux/gas; pause for burps
• Check latch if breastfeeding, or bottle flow if formula-feeding
• Trial of dairy-free diet for the mother (if breastfeeding) or hypoallergenic formula — only if you suspect cow's milk protein allergy and ideally under a doctor's guidance

What doesn't reliably help

Common "gripe water" preparations and many over-the-counter colic drops haven't been shown to help reliably. Some contain alcohol or sugar — avoid. Herbal mixtures (e.g. kala namak, asafoetida preparations) are widely used traditionally but there's no strong evidence they help, and some may be unsafe for infants — check with a paediatrician.

When to see a doctor

Colic is a diagnosis of exclusion — the doctor makes sure nothing else is going on. See a doctor if:

• Fever
• Poor feeding or poor weight gain
• Vomiting (more than normal small spit-ups)
• Blood or mucus in stools
• Baby is lethargic or unusually floppy
• You feel unable to cope

Looking after yourselves matters. Colic is exhausting. Take turns, accept help, and put the baby down safely in the cot if you feel overwhelmed — stepping away for a few minutes to compose yourself is always better than frustration. Never shake a baby. If you're feeling very low, speak to your doctor — postnatal depression is common and treatable.