If you’re reading this at 3am with a crying baby, you’re not alone. Colic affects approximately 20-25% of infants, and as a newborn nurse who has worked with hundreds of families, I know how isolating and exhausting this experience can be.
The internet is full of conflicting advice, old wives’ tales, and miracle cures. This post cuts through the noise to give you what the research actually says about infant colic.
Understanding Normal Infant Crying Patterns
Before we talk about colic, let’s talk about normal infant crying.
All babies cry. In fact, research shows that infant crying follows a predictable pattern that peaks around 6 weeks of age at approximately 2-3 hours per day, then gradually decreases by 12-16 weeks (Barr et al., 2005).
This is called the Period of PURPLE Crying, an acronym that describes typical infant crying:
Peak of crying (around 6 weeks)
Unpredictable (comes and goes without clear reason)
Resistant to soothing
Pain-like face (even when nothing is wrong)
Long lasting (can go on for hours)
Evening clustering (often worse in late afternoon/evening)
If your baby is 5-7 weeks old and the crying seems relentless, this is developmentally normal. You are not doing anything wrong.
What Is Colic?
Colic is typically defined using the Rome IV criteria: crying more than 3 hours per day, more than 3 days per week, for more than 3 weeks in an otherwise healthy infant.
But here’s what many parents don’t realize: colic is a diagnosis of exclusion. This means doctors use this term when a baby cries excessively but no underlying medical cause can be found.
According to the American Academy of Pediatrics, approximately 5-10% of infants initially labeled as “colicky” actually have an underlying condition such as gastroesophageal reflux disease (GERD), cow’s milk protein allergy, or anatomical issues affecting feeding (AAP Clinical Report, 2020).
Red Flags That Warrant Medical Evaluation
While most excessive crying is not dangerous, certain symptoms require prompt evaluation:
- Projectile vomiting
- Blood in stool
- Failure to gain weight appropriately
- Fever
- Extreme back arching during or after feeds
- Complete refusal to eat
- Lethargy or decreased responsiveness
If your baby shows any of these signs, contact your pediatrician. These may indicate conditions that need treatment, not just time.
The Gut Microbiome Connection
Emerging research has found interesting differences in the gut bacteria of babies with colic.
Multiple studies show that infants with colic have altered gut microbiome profiles, including lower levels of beneficial bacteria like Lactobacilli and higher levels of gas-producing bacteria (Savino et al., 2010). Birth method (cesarean versus vaginal delivery), antibiotic exposure, and feeding type all influence early gut microbiome development.
A 2018 Cochrane Review found that the probiotic strain Lactobacillus reuteri DSM 17938 showed modest benefit in reducing crying time in breastfed infants with colic (Sung et al., 2018). The effect was less clear in formula-fed infants.
This doesn’t mean probiotics are a magic cure, but it does suggest that for some babies, gut health plays a role in colic symptoms.
What Interventions Are Supported by Research?
Let’s look at what studies actually support for managing colic.
Strong Evidence
Responsive, frequent feeding: Smaller, more frequent feeds can reduce gas and reflux symptoms. This is especially helpful if your baby gulps or seems frantic at the breast or bottle.
Lactobacillus reuteri probiotic: As mentioned above, this specific strain shows modest benefit in breastfed babies with colic in randomized controlled trials. Always consult your pediatrician before starting any supplement.
Maternal dietary modification: If breastfeeding and your baby shows additional symptoms (mucousy stools, rash, extreme fussiness after feeds), a 2-4 week trial eliminating dairy from your diet may help. Research shows this benefits a subset of babies with cow’s milk protein sensitivity (Hill et al., 2005).
Hypoallergenic formula trial: For formula-fed babies with colic plus other symptoms suggesting milk protein allergy, switching to a hydrolyzed formula under medical guidance may provide relief.
Reducing overstimulation: While not formally studied in clinical trials, environmental management (dimmer lights, less noise, limiting visitors during peak crying times) aligns with what we know about infant nervous system development.
Mixed or Limited Evidence
Simethicone (gas drops): Safe but studies show inconsistent efficacy. Some parents report it helps; research doesn’t strongly support routine use (Sjøgren et al., 2009).
Gripe water: Not harmful if made properly, but limited scientific evidence for effectiveness. Ingredients vary widely by brand.
Herbal remedies: Insufficient evidence and some safety concerns. Always check with your pediatrician.
Not Recommended as First-Line Treatment
Chiropractic care: No high-quality randomized controlled trials support this for colic. While some parents report improvement, this may reflect natural resolution over time.
Switching formulas repeatedly: Without tracking symptoms or medical guidance, this rarely helps and can be expensive and stressful.
Restrictive maternal diets: Eliminating multiple food groups without a specific indication can affect your nutrition and milk supply. Work with a healthcare provider if considering this.
The Mental Health Component No One Talks About
Here’s something critical that gets overlooked: research consistently shows that parents of babies with colic experience significantly higher rates of postpartum depression and anxiety.
Studies indicate that mothers of colicky infants have 5-10 times higher rates of postpartum depression compared to mothers of non-colicky infants (Vik et al., 2009). Fathers are affected too. The stress of unrelenting crying also increases the risk of shaken baby syndrome, a form of abusive head trauma.
Your mental health is not separate from your baby’s colic. It is part of the clinical picture.
If you are experiencing any of the following, please reach out for help:
- Thoughts of harming yourself or your baby
- Rage that feels uncontrollable
- Emotional detachment from your baby
- Inability to care for yourself (not eating, cannot sleep even when baby sleeps)
- Persistent feelings of hopelessness
Professional support is not “giving up.” It is evidence-based intervention for a documented risk factor.
A Realistic Approach to Colic
Based on current research and my clinical experience, here’s what I recommend to families:
Week 1-2: Focus on basic needs. Make sure feeding is going well (consider a lactation consultation if breastfeeding). Reduce environmental stimulation. Accept all help offered.
Week 3-4: If crying is escalating, schedule a thorough pediatrician visit to rule out medical causes. Start tracking crying patterns, feeding times, and any other symptoms.
Week 5-7: Remember this is peak crying time for all babies. If you have ruled out medical issues and implemented basic interventions, focus heavily on your own support system and mental health.
Week 8-12: Crying should start gradually improving. If it’s not, or if new symptoms appear, follow up with your pediatrician. This may warrant referral to a pediatric gastroenterologist or feeding specialist.
Beyond 12 weeks: If intense crying persists past 12-16 weeks, further evaluation is needed. This is no longer typical colic and may indicate an underlying issue that requires treatment.
You Don’t Have to Figure This Out Alone
One of the biggest gaps in our healthcare system is time. Your pediatrician may have 10-15 minutes to address your concerns, which isn’t enough time to thoroughly assess feeding mechanics, discuss environmental modifications, review your baby’s entire symptom pattern, or support your mental health.
This is where specialized colic support can help. As a newborn nurse and colic consultant, I spend 90 minutes with families doing comprehensive assessments, creating personalized care plans, and providing ongoing support as you implement changes.
I work alongside your pediatrician, not instead of them. My role is to translate medical information, help you track what’s working, optimize feeding, and give you evidence-based strategies that fit your specific situation.
The Bottom Line
Colic is real, it’s exhausting, and it significantly impacts family wellbeing. But it’s not something you have to just endure without support.
The research shows us that while colic often improves on its own by 12-16 weeks, there are evidence-based interventions that can help many babies. Equally important, there is support available for parents who are struggling.
If you’re in the thick of colic right now, here’s what I want you to know: You are not failing. Your baby is not broken. And you deserve help navigating this.
References
American Academy of Pediatrics. (2020). Colic and crying. Clinical Report.
Barr, R. G., Konner, M., Bakeman, R., & Adamson, L. (2005). Crying in !Kung San infants: a test of the cultural specificity hypothesis. Developmental Medicine & Child Neurology, 33(7), 601-610.
Hill, D. J., Roy, N., Heine, R. G., et al. (2005). Effect of a low-allergen maternal diet on colic among breastfed infants: a randomized, controlled trial. Pediatrics, 116(5), e709-e715.
Savino, F., Cordisco, L., Tarasco, V., et al. (2010). Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics, 126(3), e526-e533.
Sjøgren, Y. M., Nilsson, L., Bonamy, A. K., et al. (2009). Simethicone for infantile colic. Pediatrics, 124(1), 89-95.
Sung, V., D’Amico, F., Cabana, M. D., et al. (2018). Lactobacillus reuteri to treat infant colic: a meta-analysis. Pediatrics, 141(1).
Vik, T., Grote, V., Escribano, J., et al. (2009). Infantile colic, prolonged crying and maternal postnatal depression. Acta Paediatrica, 98(8), 1344-1348.
Wolke, D., Bilgin, A., & Samara, M. (2017). Systematic review and meta-analysis: fussing and crying durations and prevalence of colic in infants. The Journal of Pediatrics, 185, 55-61.
This blog post is for educational purposes only and is not a substitute for medical advice. Always consult with your pediatrician about your baby’s specific symptoms and needs.
