Few things are harder in early parenthood than a baby who won't stop crying and you can't find the reason. Colic and reflux are two of the most common culprits, and they're also two of the most misunderstood.
What is colic?
Colic isn't a diagnosis in the traditional sense. It's a description: crying for more than three hours a day, more than three days a week, for more than three weeks, in an otherwise healthy baby. It typically starts around 2–3 weeks, peaks around 6 weeks, and usually resolves by 3–4 months.
No one knows exactly what causes it. The theories include gut immaturity, gas, overstimulation, and temperament. None of them have strong evidence. What we do know is that it's common (affecting roughly 1 in 5 babies), it isn't caused by bad parenting, and it does pass.
Signs that fit colic:
- Crying that starts predictably, often in the late afternoon or evening
- Baby pulls up their legs, clenches fists, and appears to be in pain
- Difficult to settle through feeding, holding, or movement
- Crying stops as suddenly as it starts
- Between episodes, baby feeds and gains weight normally
What is reflux?
Reflux happens when stomach contents come back up into the oesophagus. In babies, the muscle at the top of the stomach (the lower oesophageal sphincter) is immature and doesn't always close properly after feeds.
Silent reflux is the same process, but without visible spitting up. The milk comes up and then goes back down, which can be harder to identify.
Most reflux in babies is normal and resolves by 12–18 months as the digestive system matures. However, it can cause real discomfort.
Signs that suggest reflux:
- Frequent spitting up or vomiting, especially after feeds
- Back-arching or pulling away from the breast or bottle during feeds
- Crying or distress during or just after feeding
- Hiccups and gulping
- Seeming hungry again very soon after feeding (comfort feeding to soothe the discomfort)
- Poor weight gain in more significant cases
The difference matters
Colic and reflux often overlap. A baby with reflux may have the same inconsolable crying pattern as a colicky baby. What's useful to track is the relationship between feeding and crying. If the distress is consistently tied to feeds, reflux is more likely. If the pattern is more tied to time of day, colic is a better fit.
Neither diagnosis changes the fundamental picture in most cases: this is a developmental phase, not a sign something is wrong with your baby.
What helps with colic
The honest answer is that the evidence for colic remedies is weak across the board. That said, some things are worth trying:
- Skin-to-skin and movement: carrying, rocking, or wearing your baby in a sling can help some babies settle during crying episodes
- White noise: consistent background sound (a fan, a white noise machine) seems to help some babies
- Winding thoroughly: try different positions, over the shoulder, sitting upright with support, gentle back rubbing
- Reducing stimulation in the evenings: overstimulation can contribute to the late-day crying pattern
Infacol and Colief are widely used. Infacol (simethicone) has limited evidence. Colief (lactase drops) has a small evidence base for breastfed babies. Neither are harmful, but don't expect a cure.
What doesn't help: going through every possible formula, changing your diet constantly while breastfeeding without evidence of food sensitivity, or sleep training a 6-week-old.
What helps with reflux
- Smaller, more frequent feeds if bottle feeding
- Keeping baby upright for 20–30 minutes after feeds
- Feeding in a more upright position if possible
- Burping gently but thoroughly during and after feeds
- Raising the head of the moses basket or cot slightly by placing a rolled towel under the mattress (not a pillow, which is a safety risk)
If breastfeeding, there is no evidence that cutting dairy from your diet helps with reflux unless your baby has a confirmed cow's milk protein allergy (CMPA), which has additional signs.
When to speak to your GP
Contact your GP if your baby:
- Is not gaining weight, or is losing weight
- Seems in significant pain that isn't easing
- Is vomiting forcefully or in large quantities after most feeds
- Has blood in their vomit or stools
- Has difficulty swallowing or is refusing feeds
- Seems unwell in other ways alongside the crying
In some cases, a GP may prescribe Gaviscon Infant (a thickener) or, less commonly, a proton pump inhibitor. These have a role in more severe cases, but they are not the first line for normal reflux.
You will get through this phase. Tracking when your baby cries, how long, and its relationship to feeds can help you spot patterns and give your GP useful information rather than trying to describe it from memory at an appointment.