Colic Symptoms in Infants: When to Seek Medical Help

What Is Colic?

If you’re asking what is colic in newborns, clinicians commonly use the “Rule of Threes”: crying for ≥ 3 hours/day, on ≥ 3 days/week, for ≥ 3 consecutive weeks in an otherwise healthy, thriving infant – after a doctor rules out other causes [2]. Most colic in infants is selflimited, with crying gradually decreasing by 10–12 weeks [1,2].

Typical Presentation: colic symptoms in a newborn

What parents usually see—and what clinicians ask about [2,3]:

• Long, loud crying spells that are hard to stop, often in late afternoon or evening.

• No clear reason (not hunger or a dirty diaper) and regular comfort steps don’t work.

• Baby looks uncomfortable: knees pulled up, gassy or bloated tummy, tight fists, back arched. Sometimes brief relief after passing gas or stool.

• In between episodes, the baby eats well, gains weight, and calms down normally.

A reassuring trend: population data show crying time falls across the first 12 weeks; the earliest weeks are usually the toughest [1].

Not Everything That Cries Is “Colic”: Common LookAlikes to Consider

Your clinician rules these in/out before confirming colic. A quick map for parents:

• Gastrooesophageal reflux (GOR/GERD): Spitting up, arching back during feeds, feeding issues. True painful reflux is rarer and needs medical guidance.

• Cow’s milk allergy/intolerance: Signs include blood/mucus in poop, eczema, family allergy history — handled with diet or special formula as needed under medical advice.

• Infection: Fever, tiredness, strange poop or pee, trouble feeding — these need same-day medical review.

• Pyloric stenosis (weeks 3–6): Forceful vomiting after feeds, always hungry, not gaining weight, urgent doctor check needed.

• Intussusception (older babies): Severe pains, crying, pale skin, vomiting, red jelly-like stool, see doctor immediately.

• Hair/thread tourniquet: Sudden crying, swollen red finger/toe/genitals, check for hair or thread wrapped tightly.

• Corneal abrasion/foreign body: One eye closed, lots of tears, sensitivity to light,  needs a doctor’s check.

• Injury: Any bump, bruising, or trouble moving limbs, get immediate care.

RedFlag Symptoms: When to Seek Medical Help Today

Call your paediatrician the same day (or visit urgent care/A&E) if any of the following occur; these point away from straightforward colic in infants and require prompt assessment [2,4]:

• Fever ≥ 100.4 °F (38 °C) in an infant.

• Green (bilious) or projectile vomiting, or blood in stool.

• Poor feeding, refusal to feed, or faltering weight gain.

• Lethargy, unusually weak or continuous highpitched cry.

• Breathing difficulty, bluish colour to lips/skin, or apnoealike pauses.

• Distended/tender abdomen, severe rash with fever, or your strong parental concern.

Immediate, Safe Steps While You Arrange Care

These measures are safe to try and may shorten an episode:

• Lower stimulation — Dim lights, reduce noise, and respond to early calming cues to prevent escalation [3].

• Feeding & burping tweaks — Pace bottle feeds, check latch/position, burp midfeed and after to reduce swallowed air [2].

• Calming motion + contact — A useful rhythm shown in lab data: walk while holding for ~5 minutes, then sit and hold for 5–8 minutes before laying baby down; this reduced crying and reawakenings in a controlled study [6].

• Safesleep every time — Backtosleep on a flat, firm surface; no soft bedding or inclined products; stop swaddling at first signs of rolling; keep swaddles hiphealthy [7,8].

• Hydration & weight signals — Track wet nappies (at least ~6/day after the first week), weight checks at visits, and signs of dehydration (fewer wet diapers, dry mouth, sunken fontanelle); discuss any concerns with your clinician.

What Your Doctor Will Do (and Why That Helps)

• History & exam — Pattern/timing of crying; feeds (amounts, pace, latch); stools/urine; sleep surface/position; growth; family history (atopy/migraine); full headtotoe exam.

• Testing — Often not needed in well infants with classic colic. Tests are targeted only if history/exam suggests another diagnosis.

• Care plan — Coaching on cuebased care and soothing routines; feeding/latch review; considering a timelimited maternal diet or formula trial only when indicated; discussion of probiotic evidence (benefit clearest in exclusively breastfed infants, mixed results in others) [9,10].

• Followup — Safetynetting for red flags, growth checks, and parental support.

About gripe water for infants: What Parents Should Know

It’s common to explore newborn colic remedies, including gripe water—a traditional overthecounter herbal liquid marketed for colic/gas. Formulations differ; evidence of benefit is mixed; and product regulation varies by country. If you wish to try it, choose a reputable brand like Woodward’s, and follow the label exactly. Keep core soothing routines and safesleep practices non-negotiable. Gripe water is not a cure for colic; think of it as an optional adjunct for symptom relief under clinician guidance [2,11,12].

Preparing for the Appointment: What to Bring

• A crying diary (start/end times, what you tried, baby’s response).

• Feeding log (breast/formula amounts and timing), burps, spitups, wet nappies, stools (colour/consistency).

• Sleep details (where/position, swaddle use).

• List of medicines/supplements given (including any gripe water infant product).

• Your top questions (e.g., reflux? allergy? soothing methods?).

FAQs (quick, practical)

What are what are signs of colic vs normal fussing?
A predictable pattern of long, intense, hardtosoothe crying (often evenings) with normal growth and a reassuring exam between episodes suggests colic; your clinician confirms this after ruling out other causes [2,3].

Which newborn colic remedies are safe to start now?
Lower stimulation, paced feeds with midfeed burps, the walkthensit routine, gentle tummy/back rubs, and safesleep practices are firstline while you arrange care; anything beyond that should be clinicianguided [2,6,7].

Does colic in infants cause longterm problems?
Colic itself does not cause lasting harm; most babies improve by 3–4 months. The priority is ruling out illness, supporting feeding/growth, and protecting parent wellbeing [1,2].

References

1. Wolke D, Bilgin A, Samara M. Systematic review and metaanalysis: fussing and crying durations and prevalence of colic in infants. J Pediatr. 2017;185:5561.e4. doi:10.1016/j.jpeds.2017.02.020.
2. Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician. 2015;92(7):577582.
3. Mayo Clinic Staff. Colic — Symptoms & causes. [Internet]. Rochester (MN): Mayo Clinic; 2022 Apr 5 [cited 2025 Aug 28]. Available from: https://www.mayoclinic.org/diseases-conditions/colic/symptoms-causes/syc-20371074
4. National Institute for Health and Care Excellence (NICE). Colic — infantile. Clinical Knowledge Summaries. [Internet]. London: NICE; 2025 [cited 2025 Aug 28]. Available from: https://cks.nice.org.uk/topics/colic-infantile/
5. American Academy of Pediatrics. Crying & colic: parent guidance. HealthyChildren.org. [Internet]. Itasca (IL): AAP; c2024–2025 [cited 2025 Aug 28]. Available from: https://www.healthychildren.org/English/ages-stages/baby/crying-colic/Pages/default.aspx
6. Ohmura N, Okuma L, Truzzi A, Shinozuka K, Saito A, Yokota S, et al. A method to soothe and promote sleep in crying infants utilizing the transport response. Curr Biol. 2022;32(20):45214529. doi:10.1016/j.cub.2022.08.041.
7. Moon RY, Carlin RF, Hand I; Task Force on Sudden Infant Death Syndrome; Committee on Fetus and Newborn. Sleeprelated infant deaths: updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics. 2022;150(1):e2022057990. doi:10.1542/peds.2022-057990.
8. International Hip Dysplasia Institute. Hiphealthy swaddling. [Internet]. Orlando (FL): IHDI; c2025 [cited 2025 Aug 28]. Available from: https://hipdysplasia.org/infant-child/hip-healthy-swaddling/
9. Sung V, D’Amico F, Cabana MD, Chau K, Koren G, Savino F, et al. Lactobacillus reuteri to treat infant colic: an individual participant data metaanalysis. Pediatrics. 2018;141(1):e20171811. doi:10.1542/peds.2017-1811.
10. Sung V, Hiscock H, Tang MLK, Mensah FK, Nation ML, Satzke C, et al. Treating infant colic with the probiotic Lactobacillus reuteri: randomized controlled trial in community settings. BMJ. 2014;348:g2107. doi:10.1136/bmj.g2107.
11. Gordon M, Biagioli E, Sorrenti M, Lingua C, Moja L, Banks SS, et al. Dietary modifications for infantile colic. Cochrane Database Syst Rev. 2018;(10):CD011029. doi:10.1002/14651858.CD011029.pub2.
12. Biagioli E, Tarasco V, Lingua C, Moja L, Savino F. Painrelieving agents for infantile colic. Cochrane Database Syst Rev. 2016;(9):CD009999. doi:10.1002/14651858.CD009999.pub2.