colic with fever

Overview

Colic is when a healthy baby cries for more than 3 hours a day, more than 3 days a week, for more than 3 weeks, often in the evening. It is common and usually harmless. But if your baby has colic-like crying along with a fever, it is not typical colic. A fever can be a sign of an infection or other medical problem that needs attention.

Colic alone is very common, affecting about 1 in 5 babies. But colic with a fever is much less common and not something to brush off.

It mostly affects young babies, usually between 2 weeks and 4 months old. It can happen in any family, and boys and girls are affected equally. Fever with colic-like symptoms can also happen in toddlers, but the cause may be different.

Symptoms

Common symptoms

• Prolonged crying or fussiness that lasts for hours
• Crying often happens around the same time each day, often in the evening
• Clenched fists, arched back, tense tummy
• Face may look red or flushed from crying

Symptoms in children

• For babies with colic plus fever, they may also have a temperature above 38°C (100.4°F)
• They may be more irritable or difficult to comfort
• They may feed poorly or refuse feeds
• They may have a change in stool (poo) or vomit

Causes

Main causes

• The exact cause of colic is not fully understood. It may be related to an immature digestive system, gas, or overstimulation.
• Fever is usually caused by an infection, such as a viral or bacterial infection.
• In some cases, colic with fever can be a sign of a more serious condition, such as an intussusception (a part of the bowel 'telescopes' into itself), a urinary tract infection, or an ear infection.
• Rarely, a fever and belly pain can be linked to appendicitis, especially in older children.

Risk factors

• Being a first-born baby (this may reflect parents noticing symptoms more often, or a true difference).
• Tobacco exposure during pregnancy or after birth (smoking around a baby).
• A family history of colic or migraines.
• A baby who is formula-fed (though breastfed babies still get colic).
• For fever with colic: being under 3 months old is the biggest risk factor for serious infection.

When to see a doctor

See a doctor urgently if:

• If your baby is under 3 months and has a fever (38°C or higher).
• If your baby has a fever and is not feeding well, has fewer wet diapers, or is unusually quiet or drowsy.
• If the crying has been continuous for more than 3 hours and comfort has not helped.
• If your baby has blood in their stool, vomiting, or a swollen stomach.

Book a routine appointment if:

• If colic symptoms are frequent and you want reassurance and support.
• If crying is affecting your family's ability to cope.
• If your baby is gaining weight but still seems unhappy, and you need advice on feeding or soothing techniques.

Diagnosis

A doctor or nurse will take a detailed history and examine your baby. They will ask about how long the crying lasts, what the temperature is, how your baby feeds, and whether there are any other symptoms. The doctor will check for signs of dehydration, feel your baby's tummy, check the ears, throat, and fontanelle, and listen to the chest.

Tests that may be done

• A urine sample may be checked for a urinary tract infection.
• A blood test may help look for signs of infection.
• Stool (poo) tests may be done if there is blood or mucus.
• If the doctor suspects a bowel problem, they may order an ultrasound scan.

What to expect at your appointment

Most babies with colic and fever will not need any tests. A doctor will often reassure you that it is a viral infection, like a cold, or a mild tummy bug. If your baby is under 3 months, they may be referred to a specialist for further checks, which may involve blood, urine, and sometimes a spinal tap (lumbar puncture) to rule out serious infection.

Treatment

Treatment depends on the cause. If the doctor finds a bacterial infection, they may prescribe antibiotics (which are safe for babies). If a virus is the cause, treatment focuses on keeping your baby comfortable and hydrated. There is no cure for colic itself, but there are many soothing techniques to help.

Self-care at home

• Offer small, frequent feeds to keep your baby hydrated.
• Use skin-to-skin contact, gentle rocking, or a warm (not hot) bath.
• Swaddle your baby lightly (stop swaddling once they start rolling over).
• Try 'white noise' such as a vacuum cleaner or hairdryer at safe volume.
• Take a break: if you feel overwhelmed, put your baby down in a safe place and let someone else take over for a while.

Medical treatments

If a bacterial infection is suspected, a doctor may prescribe a course of antibiotics. Always follow the doctor's instructions. For colic itself, no medicine is proven to help. A doctor may suggest managing the feeding or the way you soothe your baby. In some cases, they might recommend a trial of a different formula, but you should always discuss this with a healthcare professional first.

When is surgery considered?

Surgery is only needed in specific conditions like intussusception (a bowel blockage) or appendicitis. The doctor will explain if surgery is necessary, but most cases of colic with fever do not require surgery.

Living with this condition

Caring for a baby with colic can be exhausting and stressful. Remember that colic is not caused by anything you did wrong. Your baby is not rejecting you. It will pass with time. Keep a diary of crying episodes, feeds, and temperatures to share with the doctor. Accept help from family and friends, and take short breaks when you can.

Lifestyle tips

• Try to keep a consistent feeding but allow for flexibility if your baby is unwell.
• Create a calm, low-stimulation environment at night.
• Make sure you and your partner or other caregivers are getting support.
• If you are breastfeeding, you do not need to give up unless advised.

Diet and exercise

If you are breastfeeding, you do not need a special diet. Some babies are sensitive to certain foods like cow's milk in your diet, but it is rare and the evidence is mixed. If you suspect a food link, talk to a doctor or lactation consultant. For formula-fed babies, there are special formulas, but they should only be used with medical advice. Exercise is important for parents' wellbeing—even a 20-minute walk with your baby can help.

Mental health and emotional wellbeing

Caring for a baby with colic can trigger anxiety, exhaustion, and even postpartum depression. It is very common for parents to feel overwhelmed. Talk to your healthcare provider if you are feeling sad, anxious, or disconnected. Remember to ask for help when you need it.

Prevention

Colic itself cannot always be prevented, but you can reduce the risk of triggers by feeding your baby in an upright position, burping regularly, and avoiding overstimulation. The most important prevention is making sure your baby is not around cigarette smoke, because tobacco exposure increases the risk of colic and other problems. For fever, good hygiene, like handwashing, can lower the chance of infections, but most viral infections cannot be fully prevented.

Vaccines

Vaccinations are a safe and effective way to protect your child from serious infections like rotavirus (a common cause of diarrhea and fever) and pneumococcal disease. Keep up to date with the recommended vaccination schedule.

Screening programmes

Most newborns have a hearing test and blood spot screening soon after birth. There is no routine screening for colic, but if your child has a fever, your doctor may recommend urine or blood tests based on their symptoms.

Complications

If left untreated

• Untreated bacterial infections, such as a urinary tract infection, can spread to the kidneys or bloodstream.
• A bowel obstruction like intussusception can cause damage to the intestine if not treated quickly.
• Dehydration can happen if your baby is not feeding enough because of discomfort or fever.
• Even without a medical problem, chronic crying can affect the parent-child bond and cause parental stress.

Long-term outlook

Most babies who have colic with a fever recover with time and appropriate care. If the cause is a viral infection, symptoms usually improve within a few days. If a bacterial infection is found, antibiotics work well. Even in rare cases where a bowel problem is found, early treatment has very good results. Your healthcare team will support you and your baby through it.

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