Colic: what we know about this frustrating infant condition

June 20, 2016 Uma Pisharody, MD, FAAP

Colic is a condition in infants, usually under 4 months of age, who cry inconsolably for long periods. The “rule of threes” is often used to describe colic: an infant under 3 months old, who cries for more than three hours a day, at least three days a week, for at least three weeks. 

Although there is no proven explanation for why some infants are more “colicky” than others, when a baby cries almost incessantly and become hard to soothe, it’s natural for parents and caregivers to worry that something in the infant’s digestive tract may be causing pain.

That being said, most infants with colic probably represent one extreme of the normal developmental “period of purple crying.” There’s no scientific proof that these infants cry because they are in pain. Rather, as explained in an earlier blog post, crying is part of normal infant development, a way that babies in their earliest stages of life learn to communicate.  


Nevertheless, since colic can lead to a sense of helplessness and frustration for caregivers, physicians often recommend various treatments in an attempt to do whatever they can to help alleviate the crying. Despite a lack of proof that colic is caused by gastrointestinal problems, infants with colic are often referred to pediatric gastroenterologists like me. Worries about whether infants have abnormal reflux, gas or even food allergies are very common considerations.  

A recent review of the research on colic summarized much of what we know so far. The authors concluded that probiotics (L reuteri, in particular) and preparations containing fennel oil may be effective in reducing colic, while dietary changes (reducing potential allergens, gas-producing foods, etc.) generally don’t help.

In reaching their conclusions, the authors:

  • Primarily focused on infants receiving partial or total breast milk feeds
  • Limited their findings to studies that met rigorous research criteria
  • Acknowledged that since the definition of colic can vary, it’s hard to compare results of all research on the condition 

While more research is needed on colic, the general guidance I give parents is that if an infant is otherwise healthy and growing well, colic is nothing to be worried about.  I provide reassurance and explain that colic will resolve on its own over time.  It’s said to peak at about 6 weeks of age, and gradually improves by the time an infant is 12 to 20 weeks old.   

If you believe that your infant cries a lot and wonder if colic may be the cause, talk to his or her pediatrician.  The pediatric gastroenterology team at Swedish is also available for help. Call 206-215-6005 for an appointment.

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