Colic refers to a condition of excessive crying and fussiness in an otherwise healthy baby, typically occurring during the first few months of life. The exact cause of colic is not known, but it is believed to be due to a combination of factors, including an immature digestive system, food allergies, and a heightened sensitivity to environmental stimuli.

Symptoms of colic may include crying for long periods of time, typically in the late afternoon or evening, arching of the back, clenching of the fists, and pulling up of the legs towards the abdomen. These symptoms can be distressing for both the baby and the parents and can lead to feelings of frustration, exhaustion, and anxiety.

While there is no cure for colic, there are a number of strategies that can help manage the symptoms and provide relief for the baby and the parents. These may include feeding the baby smaller, more frequent meals, keeping the baby upright during and after feeding, using a pacifier, and creating a calm, soothing environment for the baby. In some cases, medications, such as simethicone drops or probiotics, may also be recommended to help relieve gas and bloating.

While colic can be a challenging and stressful experience for parents, it is usually a self-limiting condition that resolves on its own within a few months. It is important for parents to seek support and guidance from their healthcare provider, as well as from family and friends, to help cope with the demands of caring for a baby with colic.

The cause of colic is unknown. It may result from numerous contributing factors. While a number of causes have been explored, it's difficult for researchers to account for all the important features, such as why it usually begins late in the first month of life, how it varies among infants, why it happens at certain times of day and why it resolves on its own in time.

Possible contributing factors that have been explored include:

• Digestive system that isn't fully developed
• Imbalance of healthy bacteria in the digestive tract
• Food allergies or intolerances
• Overfeeding, underfeeding or infrequent burping
• Early form of childhood migraine
• Family stress or anxiety

The primary goals are to soothe the child as much as possible with a variety of interventions and ensure that parents have the support they need to cope.

Soothing strategies

You may find it helpful to have a plan, a list of soothing strategies you can try. You may need to experiment. Some may work better than others, and some may work one time but not another. Soothing strategies may include:

• Using a pacifier
• Taking your infant for a car ride or on a walk in a stroller
• Walking around with or rocking your baby
• Swaddling your baby in a blanket
• Giving your baby a warm bath
• Rubbing your infant's tummy or placing your baby on the tummy for a back rub
• Playing an audio of heartbeats or quiet, soothing sounds
• Providing white noise by running a white noise machine, a vacuum cleaner or clothes drier in a nearby room
• Dimming the lights and limiting other visual stimulation

Feeding practices

Changes in feeding practices may also provide some relief. Bottle-feed your baby in an upright position and burp frequently during and after a feeding. Using a curved bottle will help with upright feeding, and a collapsible bag bottle can reduce the intake of air.

Trial changes in diet

If soothing or feeding practices aren't reducing crying or irritability, your doctor may recommend a short-term trial of dietary changes. If your baby has a food allergy, however, there would likely be other signs and symptoms, such as a rash, wheezing, vomiting or diarrhea. Dietary changes may include:

• Formula changes. If you feed your infant formula, your doctor may suggest a one-week trial of an extensive hydrolysate formula (Similac Alimentum, Nutramigen, Pregestimil, others) that has proteins broken down into smaller sizes.
• Maternal diet. If you're breast-feeding, you may try a diet without common food allergens, such as dairy, eggs, nuts and wheat. You may also try eliminating potentially irritating foods, such as cabbage, onions or caffeinated beverages.

Parent self-care

Caring for an infant who has colic can be exhausting and stressful, even for experienced parents. The following strategies can help you take care of yourself and get the support you need:

• Take a break. Take turns with your spouse or partner, or ask a friend to take over for a while. Give yourself an opportunity to get out of the house if possible.
• Use the crib for short breaks. It's OK to put your baby in the crib for a while during a crying episode if you need to collect yourself or calm your own nerves.
• Express your feelings. It's normal for parents in this situation to feel helpless, depressed, guilty or angry. Share your feelings with family members, friends and your child's doctor.
• Don't judge yourself. Don't measure your success as a parent by how much your baby cries. Colic isn't a result of poor parenting, and inconsolable crying isn't a sign of your baby rejecting you.
• Take care of your health. Eat healthy foods. Make time for exercise, such as a brisk daily walk. If you can, sleep when the baby sleeps — even during the day. Avoid alcohol and other drugs.
• Remember that it's temporary. Colic episodes often improve after age 3 to 4 months.
• Have a rescue plan. If possible make a plan with a friend or relative to step in when you're overwhelmed. If necessary, contact your doctor, a local crisis intervention service or a mental health help line for additional support.

Potential future treatments

One factor that may contribute to colic is an imbalance of the helpful bacteria in an infant's digestive tract. One treatment under investigation is the use of good bacteria (probiotics) to create an appropriate bacterial balance to improve overall digestive health.

Some studies have shown a reduction in crying times when babies with colic were treated with a bacterium called Lactobacillus reuteri. The studies have been conducted with small groups, and results have been somewhat mixed. Most experts agree there's not enough evidence at this time to support the use of probiotics to treat colic.