Infant Colic 101: What you Need to Know

It seems like, nowadays, “colic” is becoming a household term for crying babies who seem to be harder to console than average. 

By definition, however, infantile colic refers to the Rule of 3’s:  Crying more than 3 hours a day for 3 days a week for longer than 3 weeks of life. 

Babies who have colic start showing colicky behaviors as early as 2 weeks of life, peaking at 6 weeks of life, but colic can last as long as 4 months in otherwise healthy babies. 

Signs your baby may have colic

 In addition to the Rule of 3’s, colic can also be described as:

• Difficulty consoling the infant 
• Poor sleeper
• Excessive crying and the appearance of being in pain
• Crying that is sudden and lasts longer than 15 mins
• Difficulty with feeds-with the baby taking small amounts or feeds associated with spitting up and crying

Though it is described as excessive crying in healthy babies, colic can certainly cause stress and fatigue in even the most resilient loving parents. It is worth discussing this with your pediatrician who would consider a list of differential diagnosis of colic, meaning possible causes that may cause excessive crying in an infant. 

Other causes of excessive crying in infants: 

• Milk intolerance/Gas pain
• Reflux
• Cardiac abnormalities (like arrhythmias)
• Constipation
• Infections (ear infections, meningitis, viral infections, UTI’s, sepsis, etc)
• Corneal abrasion or foreign body
• Injury that may be causing pain to the infant
• Incarcerated hernia
• Hair tourniquet (around fingers, toes, penis)

Because babies, unlike toddlers, have very limited ways to communicate how they are feeling, we take these crying cues as an important clue to what might be going on internally. We evaluate colicky babies at your office visit to determine what may be causing the pain or triggering drying. The history and a complete physical exam help verify baby’s growth and rule out conditions that may contribute to these crying episodes.  

Remember colic is common in babies (up to 25%) of all newborns in the first month. If your baby has colic, rest assured that it is self-limited and will get better with time. Ask for help from your relatives, friends, and community, even if it just involves time to step away for some shut-eye time for the parents.

If symptoms persist longer than 3-4 months, make sure to circle back and follow up with your pediatrician for further evaluation.