Clinical Reference Systems: Pediatric Advisor 10.0
Colic (The Crying Baby)
DESCRIPTION OF FUSSY CRYING (COLIC)
- Unexplained crying
- Intermittent crying one or two times per day
- Healthy child (no sickness or source of pain)
- Well-fed child (not hungry)
- Bouts of crying usually last 1 to 2 hours
- Child acts fine between bouts of crying
- Child is usually consolable when held
- Onset usually under 2 weeks of age (crying that begins
after 1 month of age is not colic)
- Usually stops by 3 months of age
Normally infants do some crying during the first months of
life. When babies cry without being hungry, overheated, or
in pain, we call it colic. About 10% of babies have colic.
While no one is certain about what causes colic, these
babies seem to want to be cuddled or to go to sleep. Colic
tends to occur in high-need babies with a sensitive
temperament. Colic is not the result of bad parenting, so
don't blame yourself. Colic is also not due to excessive
gas, so don't bother with extra burping or special nipples.
Cow's milk allergy may cause crying in a few babies, but it
is a possible cause of crying only if your baby also has
diarrhea or vomiting.
Colic is not caused by abdominal pain. The reason the belly
muscles feel hard is that a baby uses these muscles to cry.
Drawing up the legs is also a normal posture for a crying
baby, as is flexing the arms.
This fussy crying is harmless for your baby. Although the
crying can't be eliminated, the minutes of crying per day
can be dramatically reduced with treatment.
The hard crying spontaneously starts to improve at the age
of 2 months and is gone by 3 months. In the long run, these
children tend to remain more sensitive and alert to their
- Hold and soothe your baby whenever he cries without a
A soothing, gentle activity is the best approach to
helping a baby relax, settle down, and go to sleep. You
can't spoil a baby during the first 4 months. Consider
using the following to calm your baby:
- cuddling your child in a rocking chair
- rocking your child in a cradle
- placing your child in a frontpack or pouch, which
frees your hands for housework
- placing your child in a windup swing or vibrating
- going for a stroller (buggy) ride, outdoors or
- anything else you think may be helpful (for example,
a pacifier, massage, or warm bath).
If all else fails, you might want to buy a device named
Sleep Tight. This new device attaches under the crib
and simulates the motion and sound of a moving car.
This gadget has lessened colicky behavior in over
90% of babies. It costs about $70. For more
information call Sleep Tight at 1-800-662-6542.
- A last resort: Let your baby cry himself to sleep.
If none of these measures quiets your baby after
30 minutes of trying and he has been fed recently, your
baby is probably trying to go to sleep. He needs you to
minimize outside stimuli while he tries to find his own
way into sleep. Wrap him up and place him on his back
or side in his crib. (As of 1992, this is the sleep
position recommended by the American Academy of
Pediatrics for healthy infants.) He will probably be
somewhat restless until he falls asleep. Close the
door, go into a different room, turn up the radio and do
something you want to do. Even consider earplugs or
earphones. Save your strength for when your baby
definitely needs you. But if he cries for over 15
minutes, pick him up and try the soothing activities
- Prevent later sleep problems.
Although babies need to be held when they are crying,
they don't need to be held all the time. If you rock
your baby every time he goes to sleep, you will become
indispensable to your baby's sleep process. Your baby's
colic won't stop at 3 months of age. To prevent this
from occurring, when your baby is drowsy but not crying
place him in the crib and let him learn to comfort
himself and go to sleep by himself. Don't rock or nurse
him to sleep at these times. Colic can't be prevented,
but sleep problems can be prevented.
- Promote nighttime sleep (rather than daytime sleep).
Try to keep your child from sleeping excessively during
the daytime. If your baby has napped 3 hours, gently
awaken and play with or feed your baby, depending on his
needs. This will help to cut down the amount of time
your baby is awake at night.
- Try these feeding strategies:
Don't feed your baby every time he cries. Being hungry
is only one of the reasons babies cry. It takes more
than 2 hours for the stomach to empty, so wait at least
that long between feedings or you may cause cramps from
bloating. If you are breast-feeding, avoid taking or
drinking coffee, tea, colas, and other stimulants.
If your child also has diarrhea, vomiting, eczema,
wheezing, or a family history of milk allergy, he may be
allergic to cow's milk in your diet. If you are
breast-feeding, avoid drinking or eating any forms of
cow's milk for 1 week to see if your baby's condition
If you are feeding your baby formula, and he also has
symptoms of allergy, try a soy formula for 1 week. Soy
formulas are nutritionally complete and no more
expensive than regular formula. If your baby's
condition dramatically improves when he is on the soy
formula, call your baby's physician for additional
advice about keeping him on the formula. Also, if you
think your child is allergic, but soy formula doesn't
seem to help him feel better, call your baby's physician
about the elemental formulas.
- Get rest and help for yourself.
Avoid fatigue and exhaustion. Get at least one nap a
day, in case the night goes badly. Ask your husband, a
friend, or a relative for help with other children and
chores. Caring for a colicky baby is a two-person job.
Hire a baby sitter so you can get out of the house and
clear your mind. Talk to someone every day about your
mixed feelings. The screaming can drive anyone to
- Avoid these common mistakes.
If you are breast-feeding, don't stop. If your baby
needs extra calories, talk with a lactation nurse or
specialist about ways to increase your milk supply.
The available medicines are ineffective and many
(especially those containing phenobarbital) are
dangerous for children of this age. The medicines that
slow intestinal motion (the anticholinergics) can cause
fever or constipation. The ones that remove gas bubbles
are not helpful according to recent studies, but they
Don't place your baby face down on a waterbed, sheepskin
rug, bead-filled pillow, or other soft pillow. While
these surfaces can be soothing, they also run the risk
of suffocation and crib death. A young infant may not
be able to lift his or her head adequately to breathe.
Inserting a thermometer or suppository into the rectum
to "release gas" does nothing except irritate the anal
Stay with TLC (tender loving care) for best results.
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:
- Your baby cries constantly for more than 2 hours.
- Your baby is less than 1 month old AND acts sick.
- You are afraid you might hurt your baby.
- Your baby is acting very sick.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- You can't find a way to soothe your baby's crying.
- The crying continues after your baby reaches 4 months of
- Your baby is not gaining weight and may be hungry.
- You have other concerns or questions.