screening for colic

Overview

Colic is a pattern of excessive, unexplained crying in a healthy baby. It is not a disease or a sign of bad parenting. Babies with colic cry for more than three hours a day, more than three days a week, usually for more than three weeks, without a clear medical reason. The crying often happens at the same time each day, typically in the late afternoon or evening. Colic usually starts around two to three weeks of age and goes away on its own by four to six months.

Yes. It is one of the most common reasons parents bring a young baby to a doctor. About 1 in 5 babies gets colic in their first few months.

Colic affects healthy babies, both boys and girls, usually starting around 2 to 3 weeks of age and peaking at about 6 weeks. Premature babies may start colic a little later. It affects all cultures and families.

Symptoms

Common symptoms

• Crying that lasts more than 3 hours a day, more than 3 days a week
• Crying episodes that happen around the same time each day, especially in the evening
• A flushed, red face and clenched fists during crying
• Pulling knees up to the belly, arching back, or passing gas
• The baby is hard to comfort, but may settle briefly for feeding
• Although crying is severe, the baby gains weight normally and has normal poos and wees

Symptoms in children

• Infantile colic affects babies and young infants, not older children. If an older child has persistent belly pain with crying, that is not colic and needs medical evaluation.

Symptoms in older adults

• Colic is a condition of infancy. Older adults do not get infantile colic. If an older person has severe abdominal pain, that is a different situation and requires prompt medical assessment.

Causes

Main causes

• The exact cause is unknown, but several things may play a part.
• A still-developing digestive system, leading to gas or trapped wind
• An immature nervous system that is overwhelmed by light, sound, and activity
• Sensitivities to cow's milk protein or other foods passed through breastmilk, or to formula
• A baby's natural temperament, as some babies are more sensitive than others

Risk factors

• This is the first few months of life (starting around 2 to 3 weeks)
• Having a parent who smokes during or after pregnancy (some evidence suggests higher risk)
• There is no clear evidence that a parent's diet or feeding method causes colic, but changing them should only be done with medical advice

When to see a doctor

See a doctor urgently if:

• Any of the emergency symptoms listed above
• Your baby's crying is increasing in frequency or severity and you are worried
• Your baby appears withdrawn or not interested in feeding or bonding

Book a routine appointment if:

• You are concerned about how much your baby cries, even if they seem otherwise well
• You have tried soothing techniques and nothing seems to work
• You want a professional to check your baby's weight and development
• Before trying any drops, supplements, or reflux medicines, talk to your doctor or pharmacist

Diagnosis

A doctor or health visitor will ask you about your baby's crying pattern, feeding, nappies, and general behaviour. They will examine your baby from head to toe and check weight and growth. The main aim is to rule out other causes of excessive crying such as infection, reflux, or feeding problems. There is no laboratory test for colic.

Tests that may be done

• There is no test that confirms colic.
• Your doctor may ask you to keep a crying and feeding diary for a few days.
• Urine or blood tests may be done if the doctor suspects infection or another medical condition.
• Sometimes a stool sample is tested if there is concern about a milk sensitivity or blood in the stool.

What to expect at your appointment

The appointment will not be rushed to a diagnosis. Your doctor may reassure you that colic is a phase, or they may arrange simple tests to exclude other problems. Ask your doctor to show you safe ways to soothe your baby and give you written information to take home.

Treatment

Treatment for colic focuses on soothing your baby, supporting yourself, and trying safe strategies to reduce crying. There is no single cure. The goal is to help everyone in the family survive this intense phase. Your doctor should guide you before any medication or supplement is tried.

Self-care at home

• Use gentle motion, such as walking with your baby in a sling or a pram ride
• Offer a dummy (pacifier) if your baby seems to want to suck
• Swaddle your baby snugly (with hips and knees a little bent) or provide skin-to-skin contact
• Try a warm (not hot) bath or placing a warm towel on your baby's tummy
• Play continuous white noise or gentle shushing sounds
• Feed slowly, pause often, and burp your baby after every feed
• If you breastfeed, your doctor may suggest trying to remove cow's milk from your diet for 1 to 2 weeks – but only with support
• Take turns with a partner or trusted adult so you can get breaks

Medical treatments

Do not give any drops, teas, or herbal remedies to your baby without asking a doctor or pharmacist first. Some over-the-counter anti-colic drops are available in some countries, but evidence for most is weak. A doctor might consider a short trial of a reflux medicine or a hypoallergenic formula if they suspect food sensitivity. These should only be used under medical supervision, using the exact dose prescribed for your baby's age and weight.

When is surgery considered?

Surgery is not used for infantile colic. If your baby has an underlying condition such as a blockage or a hernia, that would be treated separately by a specialist.

Living with this condition

Colic can feel unending, but it will pass. In many cases, the crying peaks at 6 weeks and improves by 3 to 4 months. To cope, create a calm, predictable environment, respond to your baby quickly, and let go of guilt. It is okay to put a crying baby safely in their cot and walk away for a few minutes to collect yourself if you feel overwhelmed.

Lifestyle tips

• Keep a predictable daily rhythm for feeds and sleeps, even while trying to calm a crying baby
• Have a plan to get help: ask a partner, a friend, or a family member to take over for an hour
• Protect your own sleep and meals as much as possible
• Do not smoke near your baby; if you smoke, speak to your doctor about ways to quit
• Get outside briefly with your baby if you can; fresh air may help both of you

Diet and exercise

For breastfeeding mothers, some babies are sensitive to cow's milk or other foods, but do not change your diet without medical advice. For formula-fed babies, a doctor may recommend a special hypoallergenic formula for a trial period. There is no convincing evidence that refusing to feed often helps colic, so feed on demand. For parents, gentle exercise such as walking is a good way to relieve stress, and a balanced diet will help you keep energy for the long nights.

Mental health and emotional wellbeing

Caring for a baby with colic is exhausting and can trigger anxiety, depression, or even intense frustration. You are not a bad parent if you have mixed feelings. If you feel like you might harm yourself or your baby, please ask for help urgently. Speak to your doctor, a mental health professional, or a crisis line.

Prevention

Colic cannot always be prevented, and it is not caused by a lack of care. That said, responding promptly to your baby's cues, keeping a calm environment, and avoiding over-stimulation may reduce the likelihood of long crying episodes. Do not shake a baby, ever. If you feel yourself losing control, put the baby down in a safe place and step away for a few minutes.

Vaccines

Ensure your baby receives all routine childhood immunisations on schedule. This will protect them from infections that could cause crying and serious illness. Talk to your doctor about vaccination timing.

Screening programmes

There is no specific screening test for colic. Instead, your baby's routine health checks are a form of screening: a professional will ask about feeding, growth, and crying patterns. This helps identify babies who need extra support and rules out more serious causes. Trust your instincts; if you feel something is wrong, ask for a review.

Complications

If left untreated

• Colic itself is harmless and goes away on its own.
• Untreated excessive crying can lead to serious stress for parents, increasing the risk of misuse of frustration or shaken baby syndrome.
• Rarely, an underlying condition such as reflux, a milk allergy, or an infection could be missed if the crying is simply dismissed as colic without a proper assessment.

Long-term outlook

The outlook for babies with colic is excellent. Most are completely well and calm by 4 to 6 months of age. They go on to develop, grow, and thrive normally. Even though this period can feel endless right now, it is temporary. Seeking help and using safe, supportive strategies will help you and your baby get through it.

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