Baby Colic: Understanding Evening Crying and How to Soothe It

It is 7 p.m. Your baby has fed well, then the spell begins: he screams, goes bright red, clenches his fists and pulls his legs up to his tummy. You change him, you rock him, nothing works for long minutes, sometimes hours. If the scene repeats almost every evening, it is probably colic. Baby colic is common, impressive, and harmless in the vast majority of cases.

It remains poorly understood, though, and that is often where exhaustion begins: you look for the cause, the right milk, the right herbal tea. Here is what helps, what is useless, and the signs that mean you should see a doctor.

What do we mean by “infant colic”?

These are episodes of intense, prolonged crying that is hard to calm, in a baby who is gaining weight well and has no identified illness. The spells happen mostly in late afternoon and in the evening.

For a long time doctors used the “rule of 3”: more than 3 hours of crying a day, more than 3 days a week. The UK’s NHS still quotes it. French-speaking pediatric gastroenterologists of the GFHGNP, on the other hand, consider it outdated: under the current international criteria, known as Rome IV, what counts is a baby under 5 months who cries at length and repeatedly without being soothed, while healthy and developing normally. Whether he cries 2 h 45 or 3 h 10 makes no difference.

Colic affects about one baby in five. It appears a few weeks after birth, peaks around 6 weeks, then usually disappears around 3 or 4 months. In some babies it drags on to 6 months, according to the American Academy of Pediatrics (AAP). To decode the other reasons for crying, see our article on baby crying.

Where does colic come from?

Nobody knows for certain. Several leads exist side by side:

• a digestive system that is still immature, which digests with more difficulty;
• swallowed air during breastfeeds or bottles, but also during the crying itself;
• a particular sensitivity to stimulation: some babies find it harder to calm down alone after a busy day;
• more rarely, an allergy to cow’s milk protein.

That last point is often overestimated. According to the AAP, a food sensitivity explains less than 5% of colic-type crying.

The weeks after birth are rarely calm: visits from the family, being passed from arms to arms, noise until late in the evening. Keeping quiet moments at the end of the day can help a baby who is sensitive to stimulation.

What soothes a baby who cries in the evening

No technique “cures” colic, and the GFHGNP reminds us that none has been shown to shorten it. But several often soothe in the moment. Try them, keep what works for your child, and know that what works one evening can fail the next.

1. Hold him, against you, skin-to-skin if you like. Comforting him will not make him demanding.
2. Rock him or walk with him, in your arms, in the pushchair or in a baby carrier. Movement and the contact of your body calm many babies.
3. The “tiger in the tree” hold: baby face down along your forearm, head in the crook of your elbow, your hand between his legs. Or face down across your lap while you rub his back. If he falls asleep, lay him back down on his back.
4. Lower the light and the noise, then offer steady background sound: a radio at low volume, a fan, a soft song. Never place a baby on a running washing machine.
5. A lukewarm bath, which some babies find soothing.
6. A gentle massage of the back, arms or tummy, with warm hands. Tummy massage has no proven effect on colic, but it often relaxes the baby.

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Breast or bottle: should anything change?

In general, no. Keep feeding your baby as usual. A few adjustments limit swallowed air:

• feed him in a calm setting, fairly upright, without waiting until he is ravenous, because he then gulps;
• with a bottle, keep it tilted and check that baby takes the teat well;
• burp him after the feed and wait a little before laying him flat.

The “anti-colic” bottle may reduce swallowed air, but nothing shows that it makes colic disappear. If you are looking for a model, our guide to choosing a bottle and teat helps you find your way.

Infant formula: do not change it on your own. French-speaking pediatric gastroenterologists even consider repeated changes “to see” harmful. If a cow’s milk protein allergy is suspected, it is for the doctor to suggest a suitable formula.

When breastfeeding, the question of diet keeps coming up, and opinions differ. The NHS considers that the mother does not need to change her diet. Santé.fr and the AAP mention trying a dairy-free diet for one to two weeks, after talking to the doctor. The GFHGNP finds this exclusion “very debatable” given the stress it imposes. So no diet is done alone, nor continued if it changes nothing.

Probiotics, drops, herbal teas: what is proven and what is not

In Morocco, grandmother often suggests a little cumin water (kamoun) or green aniseed water (habbat hlawa). The gesture comes from inherited knowledge and real tenderness. But an infant needs nothing but milk, and no product, even a “natural” one, should be given without the doctor’s or pharmacist’s advice.

And if it is not colic?

Colic crying has nothing specific about it. Before concluding, you rule out the simple causes: hunger, dirty nappy, too hot or too cold, a need to suck or to be held. A baby who spits up a lot and arches during feeds may be suffering from reflux. Hard, infrequent stools suggest constipation. A fever, vomiting or an unusual cry point to an infection.

When the crying is too much

Colic is exhausting. It is normal to feel helpless, irritated, at the end of your rope, especially during the nfissa, the forty days when the body recovers from childbirth.

One absolute rule: never shake a baby. Shaking an infant can cause brain damage, blindness or death. If you feel you are losing patience:

1. lay your baby on his back in his cot, with nothing around him;
2. leave the room, close the door, breathe, call someone;
3. go and check on him about every 10 minutes, and only pick him up again once you have calmed down.

Leaving a baby to cry for a few minutes in a safe cot is not dangerous. Shaking him always is. Organise relays: dad, grandmother or an aunt can take the “crying shift” every other evening. And if sadness sets in beyond tiredness, talk to your doctor: our article on the baby blues and postpartum depression helps you tell the difference.