Infantile colic

General Overview

  • Crying for no apparent reason that lasts for ≥3 hours per day and occurs on ≥3 days per week in an otherwise healthy infant <3 months of age
    • Worse from 6-9 weeks of life
  • Exclude other causes with history and physical
  • Investigations are generally not necessary


  • Development
  • Weight gain r/o failure to thrive
  • Fever, recent illness
  • Decreased movements, lethargy, seizure
  • Medications
  • Refusal to feed, vomiting, diarrhea/constipation, bloody stools

Physical Exam

  • Vitals
  • General
    • Signs of hypovolemia/undernutrition (sunken fontanelle, dry mucous membranes, decreased subcutaneous fat)
    • Signs of trauma/injury
  • Cardio
  • Resp
  • Abdo
  • MSK/Neuro
  • Skin


  • Parental support
    • Reassurance, 90% spontaneously resolve by 9 weeks
    • Ensure strong support network
    • Frequent follow-up (eg. weekly-monthly) to ensure they are coping well
  • Soothing techniques (try for several minutes each technique over several days)
    • Pacifier
    • Ride in car/stroller
    • Rocking/Swing
    • Minimize visual stimuli
    • Warm bath
    • Rubbing abdomen
    • White noise (clothes dryer) or audiotape of heartbeats
    • Hip healthy swaddling
  • Feeding technique
    • Feed baby in vertical position
    • Lactation specialist
    • May consider time-limited trial of hydrolysate formula for formula-fed infants or hypoallergenic diet for breastfed infants
    • May consider probiotic Lactobacillus reuteri (strain DSM 17938)
    • Cconsider probiotic Bifidobacterium animalis subsp. lactis BB-12 (NNT 2)