If your baby cries for longer than 3 hours a day, your baby might have colic. Colic is not caused by another medical problem. Many babies go through a fussy period. Some cry more than others.

If you have a baby with colic, you are not alone. One in five babies cry enough that people call them colicky. Colic usually starts when babies are about 3 weeks old. It gets worse when they are between 4 and 6 weeks old. Most of the time, colicky babies get better after they are 6 weeks old, and are completely fine by the time they are 12 weeks old.

Infantile colic - self-care; Fussy baby - colic - self-care

Colic normally begins at about the same time every day. Babies with colic are usually fussier in the evenings.

Colic symptoms often begin suddenly. Your baby's hands may be in a fist. The legs may curl up and the belly may seem swollen. Crying may last for minutes to hours. Crying often calms down when your baby is tired or when gas or stool is passed.

Even though colicky babies look like they have belly pain, they eat well and gain weight normally.

Causes of colic may include any of the following:

• Pain from gas
• Hunger
• Overfeeding
• Baby cannot tolerate certain foods or certain proteins in breast milk or formula
• Sensitivity to certain stimuli
• Emotions such as fear, frustration, or even excitement

People around your baby may also seem worried, anxious, or depressed.

Often the exact cause of colic is unknown.

Your baby's health care provider can often diagnose colic by asking you about the baby's medical history, symptoms, and how long the crying lasts. Your baby's provider will perform a physical exam and may do some tests to check your baby.

Your baby's provider needs to make sure your baby does not have other medical problems, such as reflux, a hernia, or intussusception.

Foods that are passed through your breast milk to your baby may trigger colic. If your baby is colicky and you are breastfeeding, avoid eating or drinking the following foods for a few weeks to see if that helps.

• Stimulants, such as caffeine and chocolate.
• Dairy products and nuts. Your baby may have allergies to these foods.

Some breastfeeding moms avoid eating broccoli, cabbage, beans, and other gas-producing foods. But research has not shown that these foods can have a negative effect on your baby.

Other possible triggers include:

• Medicines passed through breast milk. If you are breastfeeding, talk to your own provider about the medicines you take.
• Baby formula. Some babies are sensitive to proteins in formula. Talk to your baby's provider about switching formulas to see if that helps.
• Overfeeding or feeding your baby too quickly. Bottle feeding your baby should take about 20 minutes. If your baby is eating faster, use a nipple with a smaller hole.

Talk to a lactation consultant to learn more about the possible causes related to breastfeeding.

What comforts one baby may not calm another. And what calms your baby during one episode may not work for the next. But try different techniques and revisit what seems to help, even if it only helps a little.

If you breastfeed:

• Allow your baby to finish nursing on the first breast before offering the second. The milk at the end of emptying each breast, called the hind milk, is far richer and sometimes more soothing.
• If your baby still seems uncomfortable or is eating too much, offer only one breast as often as you want, over a 2 to 3 hour period. This will give your baby more hind milk.

Sometimes it can be really hard to stop your baby from crying. Here are techniques you may want to try:

• Swaddle your baby. Wrap your baby snugly in a blanket.
• Hold your baby. Holding your baby more may help them be less fussy in the evening. This will not spoil your baby. Try an infant carrier that you wear on your body to hold your baby close.
• Gently rock your baby. Rocking calms your baby and can help your baby pass gas. When babies cry, they swallow air. They get more gas and more stomach pain, which causes them to cry more. Babies get in a cycle that is hard to break. Try an infant swing if your baby is at least 3 weeks old and can hold their head up.
• Sing to your baby.
• Hold your baby in an upright position. This helps your baby pass gas and reduces heartburn.
• Try placing a warm towel or warm water bottle on your baby's stomach.
• Lay babies on their stomach when they are awake and give them back rubs. Do not let babies sleep on their stomachs. Babies who sleep on their stomachs have a higher risk of sudden infant death syndrome (SIDS).
• Give your baby a pacifier to suck on.
• Put your baby in a stroller and go for a walk.
• Put your baby in a car seat and go for a drive. If this works, look for a device that makes a car motion and sound.
• Put your baby in a crib and turn on something with white noise. You can use a white noise machine, a fan, vacuum cleaner, washing machine, or dishwasher.
• Simethicone drops are sold without a prescription and may help reduce gas. This medicine is not absorbed by the body and is safe for infants. Your baby's may prescribe stronger medicines if your baby has severe colic that may be secondary to reflux.

Your baby will most likely outgrow colic by 3 to 4 months of age. There are usually no complications from colic.

Parents can get really stressed when a baby cries a lot. Know when you have reached your limit and ask family members or friends to help. If you feel like you may shake or hurt your baby, get help right away.

Call your baby's provider if your baby is:

• Crying a lot and you are unable to calm your baby
• 3 months old and still has colic

You need to make sure that your baby does not have any serious medical problems.

Call your baby's provider right away if:

• Your baby's behavior or crying pattern changes suddenly
• Your baby has a fever, forceful vomiting, diarrhea, bloody stools, or other stomach problems

Get help right away for yourself if you feel overwhelmed or have thoughts of harming your baby.

Maheshwari A, Gupta SK. Colic and gastrointestinal gas. In: Wylie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Diseases. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 10.

Onigbanjo MT, Feigelman S. The first year. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 22.