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PediatricICD-10: R10.83Affects approximately 10-25% of infants worldwide

Colic

Colic is a condition in otherwise healthy, well-fed infants characterized by frequent, prolonged, and intense crying or fussiness that is difficult to soothe. It is traditionally defined by the 'rule of threes': crying for more than 3 hours a day, more than 3 days a week, for at least 3 weeks. Colic affects up to 25% of infants, typically begins around 2-3 weeks of age, and usually resolves on its own by 3-4 months of age.

Symptoms

Intense crying episodes that often occur in the late afternoon or evening
Crying that seems to occur for no apparent reason despite the baby being fed, clean, and comfortable
Clenched fists, arched back, and drawn-up legs during crying episodes
Red or flushed face during prolonged crying
Episodes that may last several hours
Difficulty soothing or consoling the baby
Normal growth and development between crying episodes

Causes

  • The exact cause is unknown; colic is likely multifactorial
  • Immature digestive system leading to gas and discomfort
  • Imbalance of beneficial gut bacteria (gut microbiome dysbiosis)
  • Overstimulation of the developing nervous system
  • Cow's milk protein allergy or lactose intolerance in some infants

Risk Factors

  • No consistent risk factors have been identified; colic affects all types of infants equally
  • Maternal smoking during or after pregnancy (associated with higher incidence)
  • Firstborn children (some studies suggest slightly higher rates)
  • Both breastfed and formula-fed infants are equally affected

Diagnosis

  • Clinical diagnosis based on the pattern of crying and exclusion of other causes
  • Thorough physical examination to rule out underlying medical conditions
  • Assessment of feeding patterns, growth, and developmental milestones
  • Possible evaluation for cow's milk protein allergy or GERD if additional symptoms are present

Treatment

  • Soothing techniques such as swaddling, gentle rocking, shushing sounds, and pacifier use
  • The '5 S's' method (swaddle, side/stomach position, shush, swing, suck)
  • Probiotic supplementation (Lactobacillus reuteri) which may reduce crying time
  • Trial elimination of cow's milk protein from the breastfeeding mother's diet or switching to hydrolyzed formula
  • Simethicone drops for gas-related discomfort
  • Carrying the baby more frequently during non-crying periods

Prevention

  • No proven way to prevent colic entirely
  • Avoid maternal smoking during and after pregnancy
  • Ensure proper feeding technique and adequate burping
  • Consider probiotic supplementation for breastfed infants (with pediatrician guidance)

When to See a Doctor

  • You want to rule out other causes of your baby's excessive crying
  • The baby has fever, vomiting, bloody stool, or poor weight gain
  • Crying significantly worsens or changes in character
  • You or your partner feel overwhelmed and at risk of harming the baby

Frequently Asked Questions

Related Conditions

Acid Reflux (Heartburn)

Digestive

Anxiety Disorders

Mental Health

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.