colic urine test explained

Overview

Colic is when a healthy baby cries for more than 3 hours a day, more than 3 days a week, for at least 3 weeks. A urine test (also called a urinalysis) is a simple check of your baby's pee to look for signs of infection that could be causing the crying. This test helps doctors rule out a urinary tract infection (UTI) as a cause of colic-like symptoms.

Yes, colic affects about 1 in 5 babies. A urine test is not always needed for colic, but it is a common test when a healthcare provider suspects a UTI.

Colic most often affects healthy babies from about 2 weeks to 4 months old. A urine test for colic is usually done in infants under 6 months who have unexplained crying, fever, or other signs of infection.

Symptoms

Common symptoms

• Crying that starts at the same time every day, often in the late afternoon or evening
• Crying that lasts for hours and is hard to soothe
• Baby clenches fists, arches their back, or draws legs up
• Baby passes gas or has a red face when crying

Symptoms in children

• Older infants may have the same crying pattern, but colic is less common after 4 months.
• For children beyond infancy, unexplained crying might have other causes, and a urine test can help check for infection.

Symptoms in older adults

• Colic as a condition does not affect older adults. However, if an older adult has new bouts of severe abdominal pain, a urine test may be done to check for kidney stones or infection. This is not the same as infant colic.

Causes

Main causes

• The exact cause of colic is not known, but it may be related to a baby's developing digestive system, sensitivity to certain foods (if breastfeeding), or difficulty settling.
• A urinary tract infection (UTI) can cause similar symptoms – a urine test helps tell the difference.
• Less commonly, colic-like crying could be from a food allergy, reflux, or other medical issues, which a doctor can explore.

Risk factors

• Babies who are formula-fed may be at slightly higher risk for colic, though it is not well understood.
• Mothers who smoke during pregnancy or after birth may have a higher chance of having a baby with colic.
• A family history of colic or migraine headaches may increase risk.
• For UTIs in babies, being female, having a kidney abnormality, or using a catheter can raise risk.

When to see a doctor

See a doctor urgently if:

• Your baby has a fever, is vomiting, or has blood in their urine or stool.
• Your baby seems very sick, is not feeding at all, or has fewer than 4 wet nappies in 24 hours.
• You are worried your baby might have a UTI – especially if the crying is accompanied by smelly or cloudy urine.

Book a routine appointment if:

• Your baby cries a lot but is otherwise healthy and feeding well.
• You want advice on safe ways to soothe your baby.
• Your doctor suggests a urine test as part of a routine check for colic.

Diagnosis

A healthcare provider, usually a doctor or nurse, will talk with you about your baby's crying pattern, feeding, and diapers. They will do a physical exam. If they suspect a UTI, they will ask for a clean urine sample from your baby. The diagnosis of colic is made when no other cause is found, and the crying fits the pattern.

Tests that may be done

• Urine test (urinalysis) – checks for white blood cells, nitrites, or blood that suggest infection.
• Urine culture – sent to a lab to see what type of bacteria is growing, only if the first test suggests infection.
• Other tests (like blood tests or an ultrasound) are rarely needed unless symptoms point to a more serious condition.

What to expect at your appointment

To collect urine from a baby, the nurse or doctor may give you a special bag or pad to place inside the diaper. They might also use a small soft tube (catheter) to get a clean sample – this only takes a minute. The urine is tested right away in the clinic, and results often come back in a few minutes. If an infection is found, your doctor will prescribe antibiotics safe for babies. If the test is negative, colic is likely the reason for the crying.

Treatment

Treatment depends on the cause. If a UTI is found, antibiotics will be prescribed. If no infection is found and colic is diagnosed, the focus is on soothing your baby and supporting the family. There is no cure for colic, but it usually goes away on its own. Always consult your healthcare provider before giving any remedy.

Self-care at home

• Hold your baby upright and gently rock them, use a baby swing, or go for a walk in the pram.
• Try burping your baby more often during feeds.
• If you are breastfeeding, consider cutting out caffeine, and dairy or soy for a week (ask your doctor first).
• Use white noise (like a fan or hairdryer on low) or gentle music.
• Keep a calm environment – dim lights and avoid too many visitors.
• Take breaks when you feel overwhelmed – lay your baby safely in their cot and step away for 5 minutes.

Medical treatments

Your doctor may suggest over-the-counter gas drops or probiotics, but there is limited evidence they work. Do not give any medication to a baby without a doctor's advice. If a UTI is diagnosed, your doctor will prescribe antibiotics such as amoxicillin or cephalexin (these are examples, not recommendations). Always follow the exact dose and duration given by your healthcare provider.

When is surgery considered?

Surgery is not needed for colic or for a simple UTI. In rare cases if a baby has a structural problem in the urinary tract, surgery may be considered, but that is not related to the urine test for colic.

Living with this condition

Living with a colicky baby can be exhausting and frustrating. Remember that the crying is not your fault. Take care of yourself, ask your partner, family or friends for help, and rest when you can. The urine test is a one-time event; once the result is clear, you can focus on comforting your baby through this phase.

Lifestyle tips

• Try to keep a daily routine – feeding, sleeping, and awake times can help predict the crying periods.
• Share the care with someone else so you can take breaks.
• Use a baby carrier to keep your hands free.
• Talk to your health visitor or doctor about local support groups. Many parents find it helpful to know they are not alone.

Diet and exercise

If you are breastfeeding, you might try eliminating common allergens like dairy, soy, eggs, or caffeine for a week (under medical guidance). There is no special diet for the baby. Gentle movement like swaying or walking may help soothe the baby. For yourself, light exercise (like a short walk) can help reduce stress.

Mental health and emotional wellbeing

Caring for a colicky baby can be very stressful. It is normal to feel frustrated, guilty, or even angry. If you feel the crying is too much, put the baby in a safe place and walk away for a few minutes. If you have thoughts of harming yourself or the baby, call your local emergency number or mental health crisis line immediately. You are not alone – many parents feel this way, and help is available.

Prevention

There is no known way to prevent colic. A urine test cannot prevent colic, but it can help find a treatable UTI early. To reduce the chance of a UTI in babies, keep the diaper area clean, change nappies frequently, and wipe front to back for girls. Do not give your baby any 'preventive' medications without a doctor's advice.

Vaccines

All routine childhood vaccines are safe and important. Vaccines do not prevent colic, but they prevent serious infections that could make your baby fussy. If your baby is due for a vaccine, inform your doctor about the crying.

Screening programmes

Routine urine tests are not recommended for all babies with colic. Your healthcare provider will decide if a test is needed based on symptoms like fever, vomiting, or signs of infection.

Complications

If left untreated

• If a UTI is left untreated, it can spread to the kidneys and cause a serious kidney infection (pyelonephritis), which may require hospital treatment.
• Untreated kidney infections in infants can lead to long-term kidney damage or scarring.
• Colic itself, if not recognized, can lead to parental exhaustion and stress, which may affect bonding with the baby.

Long-term outlook

The outlook for colic is excellent. Most babies stop having colic episodes by 4 to 6 months of age. Even without treatment, colic does not cause any lasting health problems. If a UTI is found and treated promptly with antibiotics, the baby usually recovers fully. With proper support, parents also recover from the stress of the colic period. Your healthcare team is there to help you and your baby through this phase.

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