Colic is the word used to describe when babies cry a lot or have long periods of time where they fail to settle. Colic can be very demanding on parents, and very exhausting.

The crying and fussing with colic can happen at any time, but often occurs in the late afternoon and early evening, especially in babies between two weeks and four months of age.

It is very common for young infants to have crying and unsettled times, and the usual soothing techniques just don't seem to work. This type of crying happens in babies in all cultures, all over the world.

What causes colic?

Some babies seem to cry more or need more soothing than others. This does not mean there is anything wrong with them – all babies respond differently to their environments.

Medical

Sometimes there is a medical reason for a baby's crying, and this may need to be checked by a doctor or nurse. Having a health professional check your baby can be very reassuring, because it is hard for parents to comfort their baby if they are worried that their baby is unwell.

In most babies, no medical cause is found. Crying is a communication from the baby to their caregiver that they are not comfortable or are distressed. This is a normal part of their growth and development.

New experiences

Newborns have to adapt to a range of new experiences, and every baby differs in how sensitive they are to physical and emotional events inside and outside their bodies.

Sometimes the causes of the discomfort may be a wet nappy, being too hot or cold, wind (gas in their stomach or bowel), hunger, tiredness, feeling anxious or unhappy, or needing company.

Differences and changes

Some babies are easily frightened by normal physical sensations, such as digestion or normal reflux. Others take a long time to adapt to the world and cope with changes. Babies are very attuned to the emotional world of their family and can be affected by family distress. 

Parent confidence

Some parents worry that their baby’s crying is caused by something they have done, and this may affect their confidence in handling and looking after their baby. Parents who have experienced mental health difficulties, family stress, or a difficult time in their own childhood, may have less confidence when caring for their own baby, which makes it hard to feel responsive or playful with their baby.

If you have a baby who is difficult to soothe, and you are worried about the way you are handling it, rest assured that support is available, and there are many things you can try to help comfort your baby.

Care at home

The following strategies may help if you are having difficulty soothing your baby:

• While it may be easier said than done, try to stay calm. Although you may not be able to stop the crying, you can help your baby to cope with their distress. It is hard to think clearly or provide reassurance to your baby if you are feeling panicky.
• Let your baby suck at the breast or bottle. It may help them to settle for a short period. Your Maternal and Child Health Nurse or GP can advise you on feeding and the amount of milk your baby needs.
• Offer a dummy. Sucking may provide comfort and help your baby to settle.
• Try and adopt a 'baby-centred' approach, and think from the baby's point of view.
• Remember, you cannot spoil your baby by too much cuddling or feeding.  
• Select some soothing strategies that seem to suit your baby and use these regularly. This will help your baby to anticipate what happens when they are upset.  
• Gently rock or hold your baby in your arms or in a baby carrier or sling.
• Continue to speak softly to your baby. Your voice and presence may help soothe them.
• Try playing some soft music.
• Give your baby a warm bath.
• Give your baby a gentle massage with some nut-free baby massage oil. This may calm your baby and also help you to relax.

The demanding evening time may be easier if you plan around it. For example, plan to eat earlier if your baby is often unsettled at dinner time. If possible, have an afternoon nap so that you are better able to cope with the challenging evening hours.

Some babies seem to need to be with their primary carer all the time. If this is the case with your baby, try not to fight this. As your baby develops more confidence, they will learn to self-soothe. In the meantime, keep separations to a minimum, try to remain in view of your baby, for example, carry them in a sling or move them in a pram when you go from room to room.

Try placing a doll or teddy outside the bassinet or cot that your baby can see when they wake from a sleep so that they do not feel so alone.

Try not to get caught up in a campaign to get your baby to sleep in a rigid routine. As babies get older they become more alert and stay awake for longer periods. Their interest in you and the world can help distract them from what is going on inside their bodies.

When your baby is awake and alert, make the most of this time for some enjoyable interaction for you both.

It is understandable that parents can sometimes feel extremely frustrated when nothing they try seems to help stop their baby’s crying. If you are feeling very frustrated or angry, it is OK to leave your baby in a safe place, such as their cot, for a few moments while you go outside and calm down. Never shake a baby. Shaking babies, even gently, can cause brain damage and life-long disability.

Getting support

• If your baby is crying for most of the day, it is important to talk to a health professional, such as your Maternal and Child Health Nurse or GP. You may be referred to a paediatrician, infant mental health specialist or counsellor. Getting support is important during this difficult time.
• If possible, try and get support from family and friends. Some parents find it helpful to have a short break from the baby so that they can relax. For others, help with family chores is most useful because then they can concentrate on comforting their baby. If help is not available, safely place your baby in their cot and have a few minutes to relax.
• Talk with other parents about things that have helped them.

When to see a doctor

See your GP or Maternal and Child Health Nurse if:

• you need reassurance that there is no medical cause for your baby’s crying
• your baby is refusing feeds or is having less than half their normal feeds
• your baby does not seem to settle or continues to cry for long periods, no matter what you try
• you feel you are not coping
• you feel the crying is impacting on your relationship with your baby or you are finding it hard to feel positive about them
• your mental health or your relationship with your partner is being affected
• you are worried for any other reason.

Key points to remember

• Being unsettled and crying is very common in young babies up to four months old.
• Sometimes there is a medical reason for a baby's crying, but usually it is normal infant behaviour that settles as the baby gets older.
• All babies are different – some cry for longer periods and are more unsettled than others. This is normal.
• Try different strategies to comfort your child, and if your baby seems to want to be with you all the time, try not to fight it.
• Seek help from your Maternal and Child Health Nurse or GP, and ask family and friends for support whenever possible.

For more information

• See your Maternal and Child Health Nurse or GP.
• Dr Margie: Crying babies: Tips to settle your baby if they won't stop crying
• Raising Children Network: Colic - what is it? and  Colic - what to do?
• The Period of Purple Crying

Developed by The Royal Children's Hospital Centre for Community Child Health and General Medicine and Infant Mental Health departments. We acknowledge the input of RCH consumers and carers.

Reviewed March 2018.

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit  www.rchfoundation.org.au.