What is colic? The real reason babies cry (and how to help)

Watching your baby cry is always a heartbreaking sight.

To make matters worse, if your baby cries nonstop for hours and quite persistently too, without any obvious reason, the doubts and worries only snowball further in the minds of caregivers.

Why is your baby acting so fussy? Is this a serious medical condition? Should you be concerned? We’ll cover everything about it in today’s blog, dealing with each topic one at a time.

Yes, that does sound a lot! And while it might feel overwhelming, this crying phase is completely normal and can last until your baby is around 3 to 6 months old.

What is colic in babies?

If your baby cries continuously for a longer period (more than 3 hours a day, 3 days a week, for 1 week), without an obvious cause and there’s no way you can find to soothe your little one back to peace, chances are that your baby has colic. 

It’s mostly a benign (meaning, harmless) condition that occurs in otherwise healthy and well-fed infants, typically within the first few weeks they’re born. The crying episodes peak around 6 weeks and usually resolve by the time they are 3 to 6 months old.

How to differentiate between normal crying & crying due to colic?

There’s a traditional criterion, called Wessel’s Rule of Three, to identify a colicky baby. It includes the following signs:

• Excessive crying lasts for at least 3 hours a day, more than 3 days a week, and for over 3 weeks. However, the doctors have dropped the third requirement, as parents would not like to wait 3 weeks to contact a medical provider when their baby is suffering.
• Each episode begins suddenly; often during the late afternoon or evening hours (between 6 pm and midnight).
• The crying is intense, loud, and high-pitched. It may sound more urgent, as if the baby is in pain.

Signs of colic in infants

If your baby is crying a lot (also known as an infantile colic episode), you may find it difficult to console your crying and screaming baby.

You may also find  the following physical signs:

• Clenched fists
• Knees drawn to chest (suggesting abdominal discomfort)
• Tensed abdominal muscles
• Arching of the back
• Facial grimacing
• Furrowed brow
• Flushed face (i.e., reddening of the face)
• Tummy rumbling

Colic onset and duration

When does colic start in babies? 

Colic begins when the infant is around 2-3 weeks of age.

How long does colic last in babies?

Symptoms of colic in babies reach a climax around 6 weeks and eventually disappear by 3-6 months of age.

How late can colic start?

It is very uncommon for symptoms of colic to appear in an infant after 6-8 weeks of life. 

However, if the crying begins at a later stage, it is advisable to get your baby examined thoroughly for any underlying health issues.

What causes colic in babies?

It is important to note that after all these years, scientists and doctors have no definite answers to what causes long crying bouts in some babies. The following maybe some of the underlying causes of infant colic:

1. Imbalance in gut bacteria

Studies made on the gastrointestinal microbiome in infant colic suggest that infants with colic may have lower counts of beneficial bacteria like Lactobacillus and Bifidobacterium in their intestines. To add to it, they may also have higher counts of gas-producing bacteria like E.coli and Klebsiella. This imbalance in ‘good and bad bacteria’ leads to bloating and discomfort and imbalance in gut health.

2. Increased motilin levels in gut

A research on motilin and infantile colic indicates that infants with colic often exhibit higher levels of motilin, which is a hormone that induces muscle contractions. This elevation of motilin causes hyperactivity in the gut, causing discomfort.

3. Intolerance to cow’s milk protein

There might be a link between infant colic and cow’s milk protein intolerance. If your diet includes cow’s milk, you may contribute to colic in your breastfed baby. But you must note that the evidence on this theory is mixed and inconclusive. 

In the cases where breastfeeding mothers have eliminated cow’s milk protein from their diet, colic symptoms in their babies have improved to a certain extent. 

Plus, a few studies also show that when regular formulas are switched to hydrolyzed formulas (which are made with partially or extensively broken down milk proteins), the results have favored infants and helped manage their colic.

4. Immature nervous system 

Sometimes, this makes an infant more sensitive to external stimuli (or sensations), resulting in the baby getting overstimulated and crying for prolonged episodes. 

5. Parental stress and anxiety

While colicky infants can increase stress and anxiety levels in parents, its end-effects can circle back to them and intensify their colic symptoms.

6. Overfeeding or underfeeding

Improper feeding techniques or volumes may trigger colic in babies. It is recommended that you feed your baby with care and a steady diet plan at hand. If you are unsure or think there is a lag, consider taking professional help.

7. Insufficient burping

When your baby swallows air while nursing or bottle-feeding, it can become trapped in their stomach if not released while burping, causing discomfort, bloating, pressure, and pain. Your baby can also swallow air while crying causing painful gas bubbles to build up in the digestive tract if not released.

Colic symptoms in breastfed babies vs formula-fed babies

It is interesting to note that colic affects both breastfed and formula-fed babies, and the core symptoms, like intense, inconsolable crying for hours, are the same regardless of how a baby is fed. Also, under both feeding methods, the gut microbiome and inflammation patterns are similar in coicky infants. 

• There may be differences in timing and crying patterns. Some research suggests formula-fed babies may experience intense crying earlier (around 2 weeks), while breastfed babies often peak closer to 6 weeks, with breastfed babies sometimes crying more at that later peak.
  
• Breastfed babies may cry longer during peak colic weeks. One study found breast-fed infants cried nearly 40 minutes more per day at six weeks than formula-fed infants, and a larger proportion met colic criteria at that age.
  
• Feeding issues specific to each type can influence symptoms. Fast let-down or overactive milk flow can cause breastfed babies to swallow air and appear colicky, while formula-fed babies may be affected by intolerance to cow’s milk protein or other formula components.
  

How to relieve colic in babies?

Easy colic treatments help caregivers with short-term soothing solutions. They include:

1. Swaddling: Swaddling provides a sense of security in newborns. Wrap the baby snugly in a thin blanket. It’s important to swaddle correctly to prevent potential risks, such as hip dysplasia. Ensure the baby’s hips can move freely to avoid injury.
2. Gentle motions: Gentle motions can have a soothing effect. Hold your baby, rock your baby in a chair or using a baby swing. Or, taking the baby for a car ride. The rhythmic movements help compose the infant.
3. Pacifiers: They give immediate relief to some babies. Some breastfed infants may refuse it, but others find it soothing.
4. White noise: Playing soft sounds, such as recordings of heartbeats or gentle shushing. These sounds mimic the womb environment and, therefore, comfort the baby. Devices that produce white noise or soft music are also beneficial.
5. Tummy pressure: They help baby pass gas and reduce discomfort. Place the baby tummy-down across your knees. Start rubbing the back gently. Always monitor the baby during this practice. Return the baby safely to their back for sleep.
6. Abdominal massage: A massage helps alleviate gas and discomfort. Gently massage the baby’s abdomen in a clockwise direction. 
7. Warm baths: A warm water bath helps soothe your colicky infant by relaxing their tense muscles, reducing stress, and easing abdominal discomfort caused by gas.

Wearing your baby in a sling, nursing your baby, or singing to your baby can help soothe your baby, though it is not a guarantee. Furthermore, reducing ambient lighting, lowering music volume, avoiding strong-smelling odors or perfumes, and feeding your baby in a darkened room can help them to reduce crying, calm down, and sleep.

Old home remedies for colic in babies

Traditional remedies that have long been used to relieve colic in babies include:

1. Herbal preparations 

Fennel preparations in the form of teas or oil were historically used in different cultures to manage colic symptoms. A few studies observe that fennel preparations, in fact, can be effective. 

2. Gripe water 

It is A combination of water and herbs used for treating colic. However, there is not much scientific data to support it. 

Note: Certain mint teas containing pennyroyal oil are sometimes consumed to treat colic in infants. However, pennyroyal oil is a highly toxic agent that may cause extreme liver and neurological damage. Experts strongly discourage its use.

Could it be something more serious than colic?

Your baby could be crying because they have a true medical condition. Some medical conditions that can result in excessive crying include:

• Acid reflux: It occurs when the stomach contents drift back into the esophagus, causing the baby to spit up. 
• Hernia: A hernia happens when part of an organ pushes through a weak spot in teh muscle, often appearing as a bulge in your baby’s groin or belly causing pain and persistent crying. 
• Food allergy: If your baby’s immune system reacts to certain proteins, commonly cow’s milk protein, it can lead to symptoms like excessive crying. Your baby might also show signs of vomiting, diarrhea, rashes, or blood in stools. 

Intestinal obstruction: A serious condition where something blocks the baby’s intestines, causing severe abdominal pain, bloating, vomiting, and inconsolable crying. This condition needs urgent medical attention.

A gentle note for parents who are in the thick of it

We understand that caring for your baby, who cries for long stretches without an apparent cause, can feel overwhelming and exhausting. However, what matters most is keeping your baby safe and giving yourself permission to pause when things feel like too much.

If the crying feels like too much, place your baby in a safe space like their crib and step away for a few minutes to breathe, have a sip of water or tea, or calm your body. Letting your baby cry briefly while you reset is far safer than trying to cope while frustrated.

Lean on support whenever you can, whether it’s a partner, family member, or groups like La Leche League or MOPS. This phase will pass, and with support and self-care, you and your baby will get through it together.

FAQs

You may also like:

• How to relieve constipation in babies quickly (and gently)
• How to get rid of baby hiccups and prevent them?
• Why can’t babies have honey (even in baked goods)

Sources:

• Key clinical features of infantile colic. National Library of Medicine. 2018. Infantile colic. 
• Gut microbiome in infants. National Library of Medicine. 2022. The Gastrointestinal Microbiome in Infant Colic: A Scoping Review.
• Motilin levels in infants leading to colic. National Library of Medicine. 1990. Motilin and infantile colic. A prospective study. 
• Causes and treatment of infantile colic. National Library of Medicine. 2015. Infantile Colic: Recognition and Treatment.
• High toxicity of pennyroyal oil used in mint teas. National Library of Medicine. 1996. Multiple organ failure after ingestion of pennyroyal oil from herbal tea in two infants.