Colic in babies: what it is, symptoms, how long it lasts and what helps

The NHS says colic is when a baby cries a lot but there is no obvious cause. All babies cry, and colic is a pattern of crying that is more than usual in an otherwise healthy baby.

NICE Clinical Knowledge Summaries (CKS) defines infant colic clinically as recurrent and prolonged periods of crying, fussing or irritability reported by caregivers that occur without obvious cause and cannot be prevented or resolved by caregivers, in an infant under 5 months old with no evidence of faltering growth, fever or illness. It is a self-limiting condition.

CKS says it occurs equally in breastfed and bottle-fed infants, and that it is more common in the first six weeks of life.

The NHS says your baby may have colic if they cry more than 3 hours a day, 3 days a week for at least 1 week but are otherwise healthy. They may cry more often in the afternoon and evening.

It may also be colic if, while they are crying, they are hard to soothe or settle, they clench their fists, they go red in the face, they bring their knees up to their tummy or arch their back, or their tummy rumbles or they are very windy.

The NHS says colic can start when a baby is a few weeks old and usually stops by the time they are 3 to 4 months old. It says it should get better by around 3 or 4 months of age. CKS describes it as self-limiting and notes that symptoms persisting beyond 5 months should be assessed by a specialist if severe or worsening.

The NHS says to see a GP or call NHS 111 if your baby still has symptoms of colic after 4 months of age, so that other causes can be checked.

The NHS says your baby does not usually need to see a doctor if they have colic. Remedies such as anti-colic drops, herbal or probiotic supplements are available but are not recommended, and there is no evidence they help colic. It suggests speaking to your health visitor for advice and support.

CKS says management involves reassurance that crying in otherwise well infants is common, and strategies that may help such as holding the baby, gentle motion, white noise and optimal winding techniques. It also encourages continuing breastfeeding wherever possible.

• Hold or cuddle your baby when they are crying a lot.

• Sit or hold your baby upright during feeding to stop them swallowing air.

• Wind your baby after feeds.

• Gently rock your baby over your shoulder, in their Moses basket or crib, or push them in their pram.

• Bath your baby in a warm bath.

• Have some gentle white noise, like the radio or TV, in the background to distract them.

• Keep feeding your baby as usual. The NHS says you do not need to change your diet if you are breastfeeding.

• Do not try putting gentle pressure on the baby's spine (spinal manipulation) or skull (cranial osteopathy); the NHS says there is little evidence it works and it may hurt your baby.

The NHS says it is not known exactly what causes some babies to get colic. It may be because babies find it harder to digest food when they are young, or because they have problems with food allergies, such as a cows' milk allergy.

CKS says it may reflect a neurodevelopmental stage causing an exacerbation of normal infant crying due to abnormal gut movement and gas production, reduced gut microbiome diversity, central nervous system deregulation and psychosocial factors.

The NHS says looking after a colicky baby can be upsetting, but it is usually nothing to worry about and will pass with time. It suggests asking for support from other parents, family or friends, or from your health visitor, NHS 111 or a GP.

CKS says complications of colic include parent or carer stress and sleep deprivation, fatigue, loss of confidence in parenting skills, anxiety or depression, and premature stopping of breastfeeding. It encourages parents to look after their own wellbeing by resting when able, accessing support and taking time out if needed.

The ICON programme says infant crying is normal, comforting methods can help, it is OK to walk away if you are putting your baby down safely and need a break, and you should never, ever shake a baby. It advises speaking to someone, such as family, friends, your midwife, GP or health visitor, if you need support.

The NHS says to call NHS 111 or see a GP if you are worried about your baby's crying, your baby has colic and nothing seems to be working, you are finding it hard to cope, your baby is not growing or putting on weight as expected, or your baby still has symptoms of colic after 4 months of age. A GP will check for possible causes.

The NHS says to go to A&E or call 999 if your baby has a weak or high-pitched cry, or their cry does not sound like their normal cry. It adds that you know better than anyone else what your child is usually like and should trust your instincts if you think something is seriously wrong, particularly if they have other worrying symptoms.

On the NHS the usual first contact is your health visitor, with a GP or NHS 111 if you are worried or if there are red flags. CKS says specialist paediatric referral or advice should be sought if parents cannot cope despite reassurance, there is suspected faltering growth, symptoms are severe, worsening or persist beyond 5 months, or there is a suspected underlying cause.

Some parents choose to see a private paediatrician or lactation specialist for reassurance. In general terms the same advice applies: rule out red flags and illness, check feeding and growth, and support the parents. Be cautious about treatments with no evidence of benefit, which the NHS says includes anti-colic drops and supplements.