Colic in babies: what it is and what helps

What is colic in babies?

The NHS says colic is when a baby cries a lot and there is no obvious cause. It describes colic as a common problem. A baby may be said to have colic if they cry for more than 3 hours a day, on 3 days a week, for at least a week, but are otherwise healthy. Colic usually begins a few weeks after birth. NHS pages describe crying that gets more frequent over the first weeks and tends to peak at about 6 to 8 weeks. After about 8 weeks, babies start to cry less each week. Crying is not always colic, because babies may also cry from hunger, a wet or dirty nappy, tiredness or illness.

What are the signs of colic?

A baby with colic may clench their fists, go red in the face or draw their legs up. Arching the back is also listed as a sign. The NHS says crying often begins at about the same time each day, often in the afternoon or evening. The crying often winds down when the baby is exhausted, or after they have passed wind or a poo. Sources describe a baby with colic as otherwise healthy. Other signs that sources say need a check by a doctor include a weak or high-pitched cry, a floppy baby, poor feeding, green vomit, blood in the stool, a fever or a bulging soft spot on the head.

What causes colic?

NHS guidance says the cause of colic is unclear. Food sensitivities such as cow's milk allergy are sometimes suspected. Other NHS pages suggest indigestion, trapped wind or a temporary gut sensitivity to breast and formula milk. One source says the cause is unknown but likely linked to intestinal discomfort such as bowel cramping. Colic may also be at the extreme end of normal crying in babies. It can affect babies whether they are breastfed or formula fed. These are possible explanations rather than proven causes.

What may help a baby with colic?

NHS pages point to soothing methods such as winding, rocking and bathing. Burping during and after feeds is standard advice. The NHS suggests holding a baby upright during feeds so they swallow less air. For bottle feeding, the NHS says to sit the baby as upright as possible, which helps stop them swallowing too much air. It also says to hold the bottle just slightly tipped, so that milk fills the teat, there are no air pockets and the milk flows steadily. One NHS page suggests an anti-colic bottle may help. It adds that some parents use a fast-flow teat, which may help a baby swallow less air. A Midlands NHS trust gives a slower guide for how quickly milk should drip from the teat, so advice on teat flow differs between NHS sources.

What is not proven to help?

NHS formulary guidance says there is not enough good-quality evidence that simeticone drops (such as Infacol) or lactase drops (such as Colief) help colic, so they are not recommended. A Frimley NHS pathway lists simeticone, probiotic supplements and herbal supplements among the products it does not recommend. Most of these sources instead point to soothing methods such as winding, rocking and bathing.

When does colic get better, and when should parents seek advice?

The NHS says colic should get better by around 3 or 4 months of age. Another source says it usually stops by four to six months at the latest. The NHS advises calling NHS 111 or seeing a GP if a parent is worried. Poor weight gain, or colic-type symptoms that are still present after about 4 months, are also reasons for a baby to be checked. The NHS says to go to A&E or call 999 if a baby has a weak or high-pitched cry. NHS 111 Wales adds that a cry that does not sound like the baby's normal cry also means A&E or 999. For concerns outside normal hours, one NHS source says NHS 111 can give advice.

Where can parents get support?

Local NHS programmes say infant crying is normal and comforting methods can help. Several NHS sources say that if a parent feels overwhelmed, it is fine to put the baby in a safe place and walk away for a few minutes to calm down. A Berkshire NHS page says a crying baby will not be harmed by being left alone in a safe place for a few minutes. These sources also say never to shake a baby, because shaking moves the head violently and can cause brain damage. Shaking will not stop the crying and can cause severe injury or even death. If a parent feels they might harm their baby because of the constant crying, one source says to get help immediately. Cry-sis is a charity for parents of unsettled babies, and NHS Best Start and a Kent NHS page list its free helpline as 0800 448 0737, open 9am to 10pm every day. Older NHS pages list a different number, so cry-sis.org.uk can be checked. A GP, health visitor or midwife can also be asked for help.