Infant colic

Colic in babies

Key points about infant colic

  • Colic is ongoing crying without an obvious cause in otherwise healthy babies.
  • Colic won’t harm your baby or cause any long-term health issues. 
  • It can be very stressful to manage but usually passes by 16 weeks of age.
  • This page has some tips that might help.
  • NOTE: If your baby is not gaining weight or you are worried they are unwell, contact your doctor or lead maternity carer.
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Some babies begin crying more and may be hard to settle at around 2 weeks of age. Most babies grow out of it by 16 weeks. This may be referred to as ‘colic’ or, more recently, PURPLE crying.

The letters in PURPLE stand for the common parts of non-stop crying in babies, these are:

P – peak pattern (crying peaks around 2 months of age, then decreases)
U – unpredictable (crying can come and go for no reason)
– resistant to soothing (baby may keep crying no matter what you do to try to soothe them)
– pain-like look on baby's face
L – long bouts of crying (crying can go on for hours)
– evening crying (baby cries more in the afternoon and evening).

Babies who are ‘colicky’ or experience PURPLE crying will cry inconsolably for several hours at a time, without an obvious reason. They may clench their fists and draw their legs up to their tummies.

The crying episodes often occur in the late afternoon or early evening. Sometimes it ends with the passing of a bowel motion or gas, or the baby may simply cry until they fall asleep.

Video: What is colic and what should I do?

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(NHS, UK)

The cause of this unsettled period is not known but it is not considered to be harmful. Some theories are that the baby's gut hasn't fully developed, the mother’s milk composition has changed or that the gut bacteria is out of balance, but these theories have not been proven.

Sometimes other conditions such as refluxlactose intolerance or cows' milk allergy may be the cause. If it is colic or PURPLE crying, your baby is otherwise healthy. They will be happy between crying episodes and feeding and gaining weight as normal.

Babies of mothers who smoke or take nicotine replacement therapy during pregnancy are more likely to cry more. 

Some tips to help an unsettled baby: 

  • Hold your baby upright during feeds and burp them afterwards.
  • If your baby is breastfed and seems worse after you have eaten certain foods, or if there is a family history of food allergies, consider avoiding these foods for a couple of weeks to see if this helps. 
  • If your baby is bottle-fed, consider changing the type of bottle or formula you use. 
  • Discuss alternative formula options with your doctor or Plunket nurse. Read more about infant formula.
  • Hold your baby during crying episodes. Play soothing music or white noise and keep the lights dimmed. 
  • Babies like movement. Try gentle swaying or pushing them in a pram. Use a front pack or sling that allows you to carry your baby while you get on with some activities.
  • A warm bath or a gentle stomach rub might comfort your baby.

Read more about how to care for a crying baby.

Apps reviewed by Healthify

You may find it useful to look at some Baby care apps.

Looking after a baby with colic can be exhausting and stressful. Colic often seems to be worst when parents are tired themselves, so it is just as important to look after yourself as your baby. Your baby's crying is not your fault.

  • Be prepared – if your baby is likely to require your undivided attention for several hours in the evening, plan to keep those hours free.
  • Be creative – the rest of the family can eat dinner and have baths early for a few months if needed.
  • Eat a nourishing snack before an anticipated crying episode.
  • Drink plenty of water.
  • Ask for and accept offers of help – caring for an inconsolable baby is not a one-person job.
  • Keep in contact with your doctor, practice nurse or Plunket nurse (PlunketLine 0800 933 922) and follow their recommendations. You can also phone Healthline(external link) on 0800 611 116 for advice. It’s okay to call them every night if you need to!
  • Hang in there! At the time it may seem that the crying will never end, but feel confident that this difficult period will pass.

Clinical pathways

Gastro-oesophageal reflux(external link) Starship Clinical Guidelines, NZ, 2012
Infant vomiting or regurgitating feeds (GORD)(external link) NICE Guidelines, UK, 2015

e-Learning

Guideline focus – gastro-oesophageal reflux disease in infants, children, and young people (NICE)(external link) BMJ Learn (1 hour) Feb 2016

PHARMAC update

Managing(external link) the unsettled baby, including colic and reflux(external link)

Is there any evidence for manipulative therapy for infants with colic symptoms? 

Read the plain English summary from a systematic review of manipulative therapies for infantile colic: Dobson D, Lucassen PL, Miller JJ, et al. Manipulative therapies for infantile colic(external link) Cochrane Database Syst Rev 2012; 12:CD004796.

Apps

Baby care apps

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Helen Kenealy, geriatrician and general physician, Counties Manukau DHB

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