Newborn
Wind pain and infant colic
Short clinical summary
Infantile colic describes recurrent, prolonged periods of irritability in a healthy, well-growing baby without an identifiable cause. It usually begins at 2–3 weeks of age, peaks around 6–8 weeks and decreases markedly by 3–4 months. Where there is poor weight gain, vomiting, blood in the stool or fever, the picture is not considered colic and requires investigation.
What is infantile colic?
Rather than being a disease name, colic describes a recognisable pattern of marked irritability in the first months of infancy. The baby typically cries inconsolably in the evening hours, draws the legs up to the abdomen, becomes flushed and may pass wind.
The exact cause is not fully known. Contributing factors are thought to include the maturation of bowel movements and gut flora, heightened sensitivity to stimuli, and air swallowing related to feeding technique.
The expected course
Irritability typically begins at 2–3 weeks of age, peaks at around 6–8 weeks, and decreases markedly in most babies by 3–4 months. Knowing this natural course helps families anticipate the process and avoid unnecessary searches for treatment.
Approaches that may help
- Correcting positioning during feeding, so the baby latches properly onto the breast or bottle.
- Holding upright after feeds and winding.
- If using a bottle, an appropriate flow rate and a technique that reduces air swallowing.
- Rocking, swaddling, and a calm environment with consistent stimuli.
- Gentle abdominal massage and leg movements.
- Establishing a support arrangement so parents can rest.
Practices with limited evidence
There are many colic products on the market, but the level of scientific evidence is limited for most. There are data suggesting certain probiotic strains may help, particularly in breastfed infants, but this does not apply to every baby. Herbal teas are not recommended for infants. Consult your physician before starting any product.
What is not colic?
Findings requiring investigation
- Slowing of weight gain, or weight loss
- Projectile or bile-stained (green) vomiting
- Blood or mucus in the stool
- Fever
- Refusal to feed, markedly weak sucking
- Excessive sleepiness or difficulty waking
- Irritability that continues and increases beyond 4 months
- Irritability together with a skin rash
Where these findings are present, conditions such as cow's milk protein allergy, reflux, infection or inadequate feeding should be assessed.
The burden on parents is also a clinical topic
Prolonged periods of crying are exhausting for parents and, combined with sleep deprivation, can lead to a sense of burnout. This is a topic that should be discussed; assessing the mother's mental health and strengthening support networks are part of caring for the baby.
It must be emphasised that a baby should never be shaken. If you feel overwhelmed, putting the baby down somewhere safe and stepping away briefly, and asking for help, is an appropriate response.
Frequently asked questions
When does infant colic resolve?
Irritability usually begins at 2–3 weeks of age, peaks at around 6–8 weeks, and decreases markedly in most babies by 3–4 months.
Do colic drops work?
The level of evidence is limited for many products. There are data suggesting certain probiotic strains may help, particularly in breastfed infants, but results do not apply to every baby. Any product should be discussed with your physician.
Should a breastfeeding mother change her diet?
Broad dietary restrictions are not routinely recommended and may leave the mother's own nutrition inadequate. If a link with a specific food is suspected, any trial should be carried out under medical supervision.
Is changing formula necessary?
Changing formula is not a routine solution and should not be done arbitrarily. If a specific condition such as cow's milk protein allergy is suspected, any change is planned after medical assessment.
References
- International consensus reports on the diagnostic criteria for infantile colic.
- Systematic reviews examining probiotic use in the treatment of colic.
- Chapters on infant irritability in current pediatric textbooks.
- Guidelines on the diagnosis and management of cow's milk protein allergy.
This content is provided for general information purposes and does not replace individual medical assessment, diagnosis or treatment.
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Author and medical reviewer
Ayça Sözen, MD
Specialist in pediatrics. Currently seeing patients at Acıbadem Ataşehir Hospital.