Identifying Colic and How To Cope

Expert Sources: Pricilla Dunstan; Robert W. Sears, MD, FAAP

For many parents, hearing the sounds of their baby’s cry will have them jumping up instinctively to tend to their little one’s needs. However, for the exhausted caregivers of a colicky baby, the seemingly endless crying often elicits a different response—stress.

Up to one in four babies will experience colic, according to Johns Hopkins Medicine, and though it’s relatively short-lived, the experience can feel like never-ending torture for parents and their little ones. Given how hard it is on families, new and expecting parents are often desperate to discover ways to avoid this fate—but is prevention possible? Unfortunately not, since there’s still a lot to be learned about colic, but here’s everything we do know about the condition and how to manage it.

What Is Colic and What Are the Symptoms?

All babies cry, so what makes colic different? The timing, frequency, and duration of a baby’s cries are what help caregivers and health care providers differentiate colic from general fussiness or a symptom of another condition.

“There is no real official definition [for colic],” explains Robert W. Sears, MD, FAAP, a pediatrician practicing in Dana Point, California. “The way I see it, healthy babies are supposed to be happy … They should not cry nonstop for hours and hours.”

Colic affects between 10-40% of babies and typically begins when an infant is around 3 weeks old, peaks when they are around 6 weeks old, and can last up until 6 months old. To diagnose the condition, most pediatricians and physicians use the rule of threes:

• Inconsolable crying for more than three hours a day
• More than three days per week
• For longer than three weeks

Caregivers may find their colicky infant crying as if they are in pain, pulling up their legs, squirming, grunting, or passing gas excessively.

If your baby is crying for long periods but they don’t quite meet all of the diagnosis criteria for colic, it’s still reason enough to call the pediatrician. “Parents have an intuition that something is wrong, [that] their baby is hurting,” says Dr. Sears.

What Is the Main Cause of Colic?

This is the million-dollar question—and unfortunately, doctors still haven’t found an answer. According to the American Academy of Pediatrics (AAP), there is no “definite explanation” for why colic happens. One theory is that colicky babies are “unusually sensitive” to stimulation and are unable to self-soothe or regulate their nervous systems when they are overstimulated.

Another common theory is that colic is somehow linked to the digestive system. The AAP says colic in breastfeeding babies may be the result of a sensitivity to a food in their lactating parent’s diet. Sensitivity to milk protein in baby formula is another possible cause of colic.

To determine if a substance is aggravating your little one’s system, your child’s pediatrician may advise that you remove it from the scene—whether eliminating it from a breastfeeding parent’s diet or switching to soy-based formula—and see what happens. (This should always be done under the advice and supervision of a health care provider.) If you take these measures and there is no change, your doctor may suggest an over-the-counter treatment of lactase digestive enzymes that break down milk sugars in breast milk or formula.

“These two steps cover the most common causes of colicky symptoms,” says Dr. Sears. “If breastfed babies don’t show improvement within another week, I’ll have [the breastfeeding parent] remove other colicky foods from [their] diet, such as gluten, soy, nuts, eggs, and corn.”

Keep in mind, however, that digestive issues aren’t always the cause of colic. Babies without any food sensitivities can still show signs of the condition.

Colic vs. Acid Reflux

The theory that colic is the result of digestive problems is so popular that parents often wonder if their baby’s colic isn’t colic at all, but acid reflux. However, while acid reflux can certainly leave a baby feeling miserable enough to cry for extended periods, you can often tell the two conditions apart by looking closely at the symptoms your baby is exhibiting.

“Acid reflux involves stomach contents (milk and acid) coming up into the throat, causing painful burning, and spitting up,” says Dr. Sears. “Colic is irritation down lower in the digestive system—intestines and colon.”

An infant with reflux will spit up a lot, fuss more upon laying down, have trouble sleeping due to pain, and find relief from symptoms when held upright. Colicky babies, however, tend to have an easier time sleeping and periods of crying will continue regardless of the baby’s position.

Still, if your little one’s doctor doesn’t seem too concerned with distinguishing between colic and acid reflux, don’t panic. Oftentimes treatment options are the same whether an infant is diagnosed with colic or acid reflux (or both), “so it isn’t always necessary to distinguish between the two,” explains Dr. Sears.

How Do You Treat Colic?

As Dr. Sears explained, since colic can often be linked to digestive problems, many pediatricians will have breastfeeding parents eliminate certain foods from their own diet to see if the crying improves—if so, this usually occurs within two weeks, according to the AAP. For parents who formula feed, a pediatrician may advise them to switch brands or try a protein hydrolysate formula. According to the AAP, if formula sensitivity is the culprit, then colic symptoms should improve within a few days.

If the cause of your baby’s colic doesn’t seem to be linked to digestive problems, then, unfortunately, there aren’t any quick fixes. All you can do is take measures to relieve symptoms and keep your infant as comfortable as possible until they grow out of this phase. Some suggestions from the AAP include:

• Avoid overfeeding your baby, as it can cause discomfort.
• Wear your baby and go for a walk; the motion and skin-to-skin contact will help soothe them (even if they are still in discomfort).
• Rock your baby and create a soothing environment where they can hear calming sounds like the clothes dryer, a fan, a white noise machine, or even a vacuum running in the next room.
• Offer (or introduce) a pacifier—babies who don’t actively refuse it will often experience instant relief.
• Lay your little one across your knees, tummy-down, and gently rub their back (but if they fall asleep this way, move them to their crib and lay them on their back).
• Swaddle them so that they feel warm, snug, and secure.

Another way to help your baby feel more comfortable is to focus on how you’re holding them. One popular method is called the “colic carry,” where you lay your baby chest down on your arm, with their legs on either side of your elbow, while supporting their head with your hand. Once you have your little one safely positioned, use your other hand to provide any additional support needed and then walk around. The rhythmic walking combined with this position can help ease discomfort and soothe a colicky baby.

Pricilla Dunstan, author of Calm the Crying: The Secret Baby Language That Reveals the Hidden Meaning Behind an Infant’s Cry, offers even more ways to hold a baby with colic. She explains that when your baby is in a colic crying spell, “you will notice that the baby’s stomach is hard and body is rigid and difficult to hold … it’s best to concentrate on holds that will help to relieve gas and offer comfort to the stomach area.” She suggests parents:

• Try to keep baby upright as much as possible and burp them whenever they need it—not just after a feed—especially if the crying regularly starts in the evening or afternoon (which is often when colicky babies cry the most).
• Relieve gas buildup by using a high over-the-shoulder hold where baby’s tummy is held high up and pressed against your shoulder.
• Try a warm bath to soothe and relax your baby and add in some lower back baby massage to enhance the effect.

Coping Tips for Parents

Babies with colic aren’t the only ones who need comforting during these incredibly difficult crying spells—-their caregivers will also need a little extra love and grace, too. Caring for a colicky baby takes an incredible toll on a parent’s well-being, and if you’re currently in the thick of it, it’s important to protect your mental health as best as you can. (We know, this is easier said than done.)

Some things you can do to help manage and get through this challenging time include:

• If possible, pass the baby to a family member or friend when you’re feeling tense and anxious so that you can get out of the house for a while.
• If there is no one around who can take over for a bit, lay your baby on their back in the crib and leave the room for a few minutes. (Keep your video monitor nearby with the volume all the way down if leaving them alone makes you nervous.)
• Set up a relief schedule with your partner or family/friends to ensure you’ll get a break from the crying.
• Join a colic support group—online or in person—so that you have a community of people who truly understand what you’re going through and can offer you validation and grace.
• Reach out for professional help if you are experiencing symptoms of depression, anxiety, rage, or intrusive thoughts.

It may be impossible to imagine when you’re in the thick of those colicky weeks or months, but it’s true—colic won’t last forever (so hang in there!). In the meantime, talk to your baby’s pediatrician, call on your friends and family for help, try different techniques to keep your baby comfortable, and continuously remind yourself that better days are just around the corner. Rest assured: things will get better.

Original articles were published between 2012 and 2014 and have been updated by Ashley Ziegler.