colic

Colic is a term used for recurrent, inconsolable crying in otherwise healthy infants. It is commonly defined by prolonged crying spells (often at least three hours a day), on several days per week, for three weeks or more, though exact criteria vary. Onset typically occurs in the first weeks of life, with peak crying around six weeks and resolution by about three to four months of age.

The cause of colic is not well understood and is believed to be multifactorial. Proposed factors include immaturity of the digestive system, gas or abdominal distension, feeding problems, sensitivity to cow milk protein in formula or maternal diet in breastfed infants, rapid changes in routines, and psychosocial stressors within the family. No single test can diagnose colic, and other medical conditions should be ruled out when warning signs are present.

Clinical features include episodes of inconsolable crying that may be high-pitched and occur in the late afternoon or evening. Infants may draw up their legs, clench fists, arch the back, appear flushed, or seem to be in visible discomfort. During a crying spell the infant otherwise looks well, with normal feeding and sleep between episodes; a normal physical examination supports the diagnosis.

Management centers on parental reassurance and soothing strategies. These can include holding, rocking, gentle motion, swaddling, white noise, and comfortable positioning. Feeding adjustments—such as slower feeds, more frequent burping, and consideration of formula changes if indicated—may help some infants. Some guidelines discuss probiotic therapy (for example, Lactobacillus reuteri in breastfed infants), though evidence varies and recommendations differ. Most cases resolve spontaneously over time.

Colic is typically self-limited and does not cause long-term health problems, though it can be stressful for families and may benefit from caregiver support and education.