Baby Colic: What Could Be Behind Your Baby’s Crying?
Updated: Sep 30
By: Dr Jennifer Harris
If you have a baby who cries for hours, is incredibly difficult to settle, draws their legs up, arches their body or seems uncomfortable much of the day, you may have been told:
“It’s just colic.”
For some families, that explanation is reassuring. Colic is common in young babies, it generally improves with time, and many babies who experience periods of excessive crying are otherwise completely healthy.
But for other parents, the word “colic” doesn’t feel like an answer at all.
You may look at your baby and think:
But why are they crying?
That is an important question. "Colic” describes a pattern of excessive crying but it doesn’t necessarily explain why that particular baby is crying. In my practice as a pediatrician I like to say that colic is a description, not a diagnosis. And while there are certainly babies whose crying fits the typical pattern of infantile colic and who are otherwise healthy and thriving, there are also babies whose crying deserves a closer look.
What is colic?
Traditionally, infantile colic has been associated with the “rule of threes”: crying for approximately three or more hours per day, on three or more days per week, for at least three weeks.
Definitions have evolved over time, but the general picture remains similar: an otherwise healthy young baby experiences recurrent periods of prolonged crying, fussiness or irritability without an obvious cause.Colic commonly begins within the first few weeks of life, often becomes most noticeable at around six weeks, and typically improves during the first few months.
The important part of that description is otherwise healthy. A baby with typical colic should not automatically have significant feeding difficulties, concerning vomiting, breathing problems, poor growth or other signs of illness explained away because they also cry a lot.
Why do I say colic is a description, not a diagnosis?
Because the word tells us what we are seeing: A baby who cries excessively and is difficult to soothe.
It doesn't necessarily tell us why it is happening.
Think about crying as communication.
A young baby can't tell us:
“My stomach hurts.”
“Swallowing is uncomfortable.”
“I’m exhausted.”
“I’m overwhelmed.”
“I’m hungry.”
“Feeding hurts.”
“I’m having difficulty managing this milk.”
They cry.
Our job is therefore not necessarily to eliminate every episode of crying—crying is a completely normal and essential form of infant communication.
Instead, when crying becomes excessive, persistent or is accompanied by other symptoms, we need to look at the whole baby.
Doesn't every baby cry?
Absolutely.
Crying is normal.
Newborn babies cry when they're hungry, tired, overstimulated, uncomfortable, cold, hot, lonely or simply in need of closeness and regulation. Some babies also cry considerably more than others. Normal crying tends to increase during the early weeks of life before gradually decreasing as babies mature. So a baby crying frequently doesn't automatically mean there is a medical problem. The question is whether the crying fits a typical developmental pattern—or whether there are additional clues suggesting something else may be contributing.
What could be hiding behind the “colic” label?
There isn't one universal cause of excessive infant crying. Sometimes, after an appropriate medical assessment, there genuinely isn't an underlying disease or feeding problem identified. The baby is healthy, growing and feeding appropriately, and the crying gradually improves with maturation.
But sometimes there are other pieces of the puzzle. Depending on the baby's symptoms and history, a healthcare professional may need to consider factors such as:
Cow's milk protein allergy or another food-related reaction
Feeding difficulties
Swallowing or oral-motor problems
Constipation or gastrointestinal discomfort
Airway or breathing concerns
Infection or illness
Feeding volume, flow or technique
Overstimulation or difficulty regulating
Other sources of pain or discomfort
This doesn't mean that every baby diagnosed with colic needs extensive testing.
It means that persistent crying should be considered in context. The crying itself is only one piece of information.
Could reflux be causing my baby's crying?
Sometimes reflux can contribute to significant discomfort, particularly when it is associated with troublesome symptoms or feeding difficulties. However, reflux is also extremely common in infancy. Many babies reflux stomach contents without experiencing pain or needing treatment.
So I wouldn't diagnose problematic reflux simply because a baby cries. Instead, I would look for the broader pattern.
For example, does the baby:
Arch or stiffen during or after feeding?
Repeatedly pull away from the breast or bottle?
Seem hungry but struggle to continue eating?
Cough, gag or frequently clear their throat?
Become distressed shortly after feeds?
Have frequent vomiting or regurgitation?
Appear uncomfortable when feeding?
Begin refusing feeds?
Feed substantially better while sleepy?
Those additional details help us understand whether feeding or reflux-related discomfort might be contributing to the crying.
What about silent reflux?
Parents are sometimes told that reflux cannot be causing discomfort because their baby doesn't spit up. But reflux doesn't always result in milk coming out of the mouth.
At the same time, we need to be cautious about attributing every crying baby who doesn't spit up to “silent reflux.” Symptoms such as arching, crying, coughing, disrupted sleep and feeding difficulties can have multiple causes.
The goal isn't to replace the label “colic” with the label “silent reflux.”
The goal is to understand what is actually happening with this baby.
Could an allergy or intolerance look like colic?
In some babies, gastrointestinal or feeding symptoms related to cow's milk protein or another food-related reaction can coexist with significant fussiness or crying.
When considering this possibility, I wouldn't look at crying alone.
The wider history matters.
A healthcare professional may want to know about symptoms involving feeding, stools, vomiting, skin, growth and the timing of symptoms. Again, the important point is that one symptom rarely gives us the entire answer. A baby who cries for several hours every evening but otherwise feeds comfortably, grows well and seems content between episodes presents a very different picture from a baby who cries throughout feeds, refuses milk and has additional gastrointestinal symptoms.
Feeding behaviour can give us important clues
One of the areas I pay particularly close attention to is how the baby feeds.
Feeding is one of the most frequent activities a young baby does. If feeding consistently causes pain or discomfort, it can affect far more than the feed itself.
A baby might begin a feed eagerly because they're hungry, then suddenly pull away, arch or cry.
The parent understandably tries again because the baby has barely eaten.
The baby becomes more distressed.
The parent becomes more worried.
And before long, every feeding session feels like a battle.
If this pattern is happening repeatedly, I don't want to simply say:
“Your baby has colic.”
I want to understand why eating appears to be difficult.
What if my baby is gaining weight?
Growth is extremely important.
But weight gain isn't the only measure of whether feeding is going well.
Some babies maintain adequate growth despite very difficult feeding experiences.
Parents may be offering feeds constantly, feeding while the baby sleeps, walking or bouncing during bottles, using distraction, or spending enormous amounts of time trying to achieve a daily intake target.
A growth chart doesn't capture any of that.
So when evaluating an unsettled baby, I want to know:
Is the baby growing?
But I also want to know:
Are they comfortable?
Can they feed while awake?
Are feeds calm or stressful?
Do they seem to enjoy eating?
How much work is required from the parent to maintain their intake?
These details matter.
When is crying more likely to be typical colic?
Typical colic tends to occur in a baby who is otherwise healthy. Between crying episodes, the baby may be content and behave normally. They should be feeding and growing appropriately and shouldn't have concerning signs of illness. The crying also follows a developmental pattern, generally appearing during the early weeks and improving as the baby gets older.
If your baby has been appropriately evaluated, is feeding and growing well, has no concerning associated symptoms and fits this pattern, reassurance and practical support for getting through this incredibly demanding period may be exactly what your family needs. Because even when nothing medically dangerous is happening, caring for a baby who cries for hours every day is hard.
Parents deserve support too.
When should “colic” get a closer look?
I would encourage parents to speak with their baby's healthcare provider when the crying is accompanied by other changes or symptoms.
For example:
Feeding has become difficult or your baby is refusing feeds
Your baby appears to be in pain during or after feeding
Intake has decreased substantially
Your baby isn't gaining weight as expected
There is persistent or concerning vomiting
Your baby regularly coughs, chokes or struggles during feeds
There is blood in the vomit or stool
Your baby's behaviour has noticeably changed
Your baby seems unwell between crying episodes
The crying is persistent, unusual or significantly different from your baby's normal behaviour
You don't need to diagnose the cause yourself.
You simply need to communicate that there is more happening than crying alone.
Are there symptoms that need urgent medical attention?
Yes.
Some symptoms should not be attributed to colic.
Seek prompt medical care if your baby has concerning symptoms such as difficulty breathing, blue or grey colour, is unusually difficult to wake, appears very unwell, has significant dehydration, frequent forceful vomiting, green or bile-stained vomiting, or other acute changes that concern you.
A fever in a young infant also requires appropriate medical assessment.
If your baby appears seriously unwell, seek urgent medical attention rather than waiting to see whether the crying settles.
Does colic need treatment?
There isn't one universal “colic treatment,” because there isn't one universal reason that babies cry excessively. For a healthy baby with typical infantile colic, treatment may primarily involve reassurance, soothing strategies, practical support and helping parents cope while the baby's nervous and digestive systems mature.
But when another problem is contributing to the crying, the approach should be directed toward that problem. That might mean addressing a feeding difficulty.
It might mean investigating concerning swallowing symptoms.
It might mean assessing whether allergy-related symptoms fit the clinical picture.
It might mean appropriately managing clinically significant reflux.
Or it might mean reassuring a family that their baby has been carefully assessed and there are no signs of an underlying medical problem.
The goal is not to medicalize every crying baby. But the goal also isn't to dismiss every distressed baby as “just colic.” There is an important middle ground.
You know your baby's normal
Parents sometimes worry that they're overreacting when they keep asking questions after being told their baby has colic.
You don't need to know exactly what is wrong in order to say:
“Something about this doesn't feel right.”
You spend more time observing your baby than anyone else.
You know whether they seem comfortable between episodes.
You know whether feeding has changed.
You know whether you're suddenly having to work much harder to get them to eat.
You know whether this feels like ordinary fussiness—or whether something has shifted.
That information is valuable.
The question isn't simply “How do we stop the crying?”
When I evaluate a baby with persistent crying, I don't want to focus exclusively on making the crying stop. I want to understand what the crying is communicating.
Sometimes the answer really is that this is a healthy young baby going through a very intense developmental period. Sometimes there are feeding, gastrointestinal or other medical factors that deserve attention.
And sometimes several things are happening at once.
That's why I describe colic as a description, not the end of the diagnosis.
“Your baby cries a lot” may describe what you're experiencing.
The next question should be:
Why?
Need Help Understanding Your Baby's Crying?
At Crying, Colic & Beyond, we work with families whose babies are experiencing persistent crying, reflux, digestive discomfort and feeding difficulties.
Our Reflux & Colic Consultation takes a detailed look at your baby's symptoms, feeding patterns, medical history and previous treatments to help make sense of the bigger picture.
The aim isn't to attach another label to your baby. It's to understand what may be contributing to their discomfort and determine appropriate next steps.
Learn more about our Reflux & Colic Consultation →
About Dr. Jennifer Harris
Dr. Jennifer Harris is a board-certified pediatrician with extensive experience evaluating and treating babies and children with reflux, gastrointestinal symptoms, persistent crying and feeding difficulties.
Through Crying, Colic & Beyond, she works with families via telehealth using an individualized, evidence-informed approach that looks beyond individual symptoms to understand the whole child.
This article is intended for general educational purposes only and does not constitute medical advice, diagnosis or treatment. Always discuss concerns about your baby's health, feeding or medication with an appropriately qualified healthcare professional.
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