Baby with stomach ache (colic)

Infant colic is a condition in which an otherwise healthy, well-fed baby experiences long periods of inconsolable crying, often in the evening, without any clear medical explanation. The condition typically begins between 2 and 4 weeks of age, peaks at around 6 weeks and resolves in the vast majority of babies by the age of 3–4 months. Infant colic is not dangerous and usually does not require treatment.

What Exactly Is Infant Colic?

Infant colic is a term used to describe frequent, prolonged episodes of crying in an infant who is otherwise healthy, thriving and gaining weight normally. The classic definition (Wessel's criteria) describes colic as crying for more than 3 hours a day, more than 3 days a week, for more than 3 weeks.

It is important to understand that colic is not a disease in itself but rather a description of a pattern of symptoms. Its cause is not fully understood, and there is no treatment with proven effectiveness against colic itself. However, this does not mean that parents cannot do anything to comfort and soothe their baby or that they should avoid having their baby examined.

How Many Babies Develop Colic?

The prevalence of infant colic varies depending on the definition used and where studies have been conducted. In general, it is estimated that approximately 10–20% of newborns in Denmark develop colic according to the classic Wessel criteria. Other estimates suggest a wider range of 8–40% when parents' own perceptions of whether their baby has colic are included.

It is worth noting that when parents believe their baby has colic, only about one-third actually meet the strict diagnostic criteria. Many babies who cry frequently in the evening therefore fall within the broader spectrum of completely normal infant crying.

What Are the Symptoms of Abdominal Pain in Babies (Colic)?

The symptoms of infant colic typically include:

• Long periods of intense, inconsolable crying, often in the late afternoon or evening.
• The baby pulls their legs towards their abdomen, tenses their body or curls up.
• A red face and a tense, firm abdomen.
• The baby may be difficult to comfort, even through breastfeeding, being held or other usual soothing methods.

An important characteristic is that, outside these crying episodes, the baby is usually calm, feeds and sleeps normally, and gains weight as expected. It is precisely this combination of intense crying episodes and an otherwise healthy, thriving baby that distinguishes infant colic from conditions in which the baby is generally unwell or failing to thrive.

When Does Colic Start, and When Does It Go Away?

Infant colic typically begins between 2 and 4 weeks of age. Symptoms often peak at around 6 weeks, when most babies — whether or not they have colic — tend to cry the most.

After this, crying episodes gradually decrease. In approximately 60% of babies, the most severe symptoms have disappeared by 3 months of age, and in 80–90%, they have resolved by 4 months. In almost all babies, colic has stopped by around 5 months of age.

This natural improvement has given rise to the term "three-month colic", although for some babies it may take a little longer to resolve.

What Causes Abdominal Discomfort in Babies in the Evening?

The exact cause of infant colic is unknown, and there is probably no single explanation that applies to all babies.

Several factors have been suggested as possible contributors, including the immaturity of the baby's digestive system, swallowing air during breastfeeding or bottle-feeding, and the fact that late afternoon and evening are generally the times when all infants — with or without colic — cry the most.

It is important to emphasise that infant colic is not caused by anything the parents have done wrong. It is a well-recognised and normal part of development for some babies during their first few months of life.

Can Colic Be Caused by Milk Allergy or Something in the Diet?

For most babies with colic, there is no connection to specific foods, and colic is not the same as milk allergy or lactose intolerance.

However, if the baby also has other symptoms - such as skin rashes, vomiting, poor weight gain or blood in the stool (the baby should always receive urgent medical assessment to rule out intussusception or volvulus) -it may be appropriate to investigate whether another underlying condition is causing the discomfort.

A doctor or health visitor should always assess whether further investigation of the baby's diet is necessary. Parents should not introduce a restrictive diet for their baby or a breastfeeding mother without professional assessment.

What Can You Do When Your Baby Has Abdominal Pain?

Although there is no treatment with proven effectiveness against colic itself, several approaches may help comfort your baby and ease discomfort during difficult periods:

• Hold your baby close to your body, for example in a baby carrier, and use gentle movement and rhythm.
• Give your baby a warm bath or place a warm hand on their abdomen.
• Gently massage your baby's abdomen using calm, soothing movements.
• Allow regular breaks for burping during and after feeds.
• Create a calm environment in the evening with dim lighting and minimal noise.

Many parents find that different methods work for different babies, and it may take some trial and error to discover what works best for your child.

Is Infant Colic Hereditary?

No clear hereditary cause of infant colic has been identified. The condition occurs in babies regardless of their family medical history, and it cannot be reliably predicted or tested for in advance.

If an older sibling had colic, this does not necessarily mean that a younger sibling will also develop it — and vice versa.

How Does Colic Affect Parents?

Having a baby who cries inconsolably for several hours every day can be extremely demanding. Many parents become worried and exhausted and may feel helpless when they cannot comfort their child.

It is completely normal to need support during this period, and it is important to understand that parents are not doing anything wrong, even if their baby continues to cry.

Regular contact with a health visitor can be very helpful — both to confirm that the baby is developing and thriving normally and to provide support and practical relief during what can be a difficult time for the whole family.

When Should You Seek Medical Advice for a Baby Who Cries a Lot?

Most babies with colic do not require a medical examination, but it is always a good idea to have your baby assessed if you are uncertain.

You should contact a doctor or health visitor if your baby is not gaining weight normally, is not thriving, or if you are finding your baby's crying particularly difficult to cope with.

If your baby has a fever, vomiting, blood in the stool, unusual drowsiness or other signs of illness rather than simply being unsettled, or if the crying changes and becomes different from their usual pattern, you should seek urgent medical attention.

A medical assessment can rule out other causes of your baby's discomfort and reassure parents that the symptoms are consistent with normal, harmless infant colic.

Abdominal Pain in Babies (Colic) at Charlottenlund Privathospital

At Charlottenlund Privathospital, your baby can be examined by a medical specialist if you are concerned about their crying, abdominal symptoms or general well-being.

The doctor begins with a thorough discussion of your baby's symptoms, sleeping patterns, diet and weight development. Based on this assessment, the doctor determines whether further examinations are necessary or whether the symptoms are consistent with common, harmless infant colic.

The aim is to provide parents with clarity and reassurance while determining whether there are any other underlying conditions that require further investigation.

You can book an appointment online or contact us if you would like your baby's symptoms to be assessed.

Experience and Expertise at Charlottenlund Privathospital

At Charlottenlund Privathospital, your baby can be assessed by a specialist in paediatrics if you have concerns about crying, abdominal symptoms or general well-being.

The assessment focuses on your baby's symptoms, weight development and diet, with the aim of providing clarity and ruling out other possible causes.

You can find an overview of all departments on our departments page.

Sources:

- Ugeskrift for Læger (Danish Medical Journal): Chiropractic Treatment of Infant Colic Lacks Evidence