Signs and symptoms
Colic is defined as episodes of crying for more than three hours a day, for more than three days a week for at least a three-week duration in an otherwise healthy child. It is most common around six weeks of age and gets better by six months of age. By contrast, infants normally cry an average of just over two hours a day, with the duration peaking at six weeks. With colic, periods of crying most commonly happen in the evening and for no obvious reason. Associated symptoms may include legs pulled up to the stomach, a flushed face, clenched hands, and a wrinkled brow. The cry is often high pitched (piercing). Effect on the family
An infant with colic may affect family stability and be a cause of short-term anxiety or depression in the father and mother. It may also contribute to exhaustion and stress in the parents.Persistent infant crying has been associated with severe marital discord, postpartum depression, early termination of breastfeeding, frequent visits to doctors, and a quadrupling of excessive laboratory tests and prescription of medication for acid reflux. Babies with colic may be exposed to abuse, especially shaken baby syndrome.In 2019 Cochrane conducted a systematic review on parent training programs for managing infantile colic. Seven studies with over 1100 participants met inclusion criteria. Limited evidence was found for the effectiveness of such programs, one meta-analysis showed some reduction in crying time. Causes
The cause of colic is generally unknown.
Babies who cry may simply be hungry, uncomfortable, or ill. Less than 10% of babies who would meet the definition of colic based on the amount they cry have an identifiable underlying disease.Cause for concern include: an elevated temperature, a history of breathing problems or a child who is not appropriately gaining weight.Indications that further investigations may be needed include:
Vomiting (vomit that is green or yellow, bloody or occurring more than five times a day)
Change in stool (constipation or diarrhea, especially with blood or mucous)
Abnormal temperature (a rectal temperature less than 97.0 °F (36.1 °C) or over 100.4 °F (38.0 °C)
Irritability (crying all day with few calm periods in between)
Lethargy (excess sleepiness, lack of smiles or interested gaze, weak sucking lasting over six hours)
Poor weight gain (gaining less than  15 grams a day)Problems to consider when the above are present include:
Infections (e.g. ear infection, urine infection, meningitis, appendicitis)
Intestinal pain (e.g. food allergy, acid reflux, constipation, intestinal blockage)
Trouble breathing (e.g. from a cold, excessive dust, congenital nasal blockage, oversized tongue)
Increased brain pressure (e.g. hematoma, hydrocephalus)
Skin pain  (e.g. a loose diaper pin, irritated rash, a hair wrapped around a toe)
Mouth pain (e.g. yeast infection)
Kidney pain  (e.g. blockage of the urinary system)
Eye pain (e.g. scratched cornea, glaucoma)
Overdose  (e.g. excessive Vitamin D, excessive sodium)
Others (e.g. migraine headache, heart failure, hyperthyroidism)Persistently fussy babies with poor weight gain, vomiting more than five times a day, or other significant feeding problems should be evaluated for other illnesses (e.g. urinary infection, intestinal obstruction, acid reflux).