saudigastro.com/patients/infant-colic
Category
Common
Red flags
6
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Infant colic means frequent, long episodes of crying or fussiness in a baby who is otherwise healthy, feeding well and growing normally. A commonly used guide is crying for more than 3 hours a day, on more than 3 days a week, for at least 3 weeks, though you do not have to meet these exact numbers to seek help.
The crying often starts in the evening, can seem to have no reason, and may come with a flushed face, clenched fists, a tight belly or pulled-up legs. Colic is not caused by anything you did wrong, and it does not harm your baby.
How common is it?
Colic is very common. It affects a sizeable share of healthy babies worldwide, and there is no reason to think Saudi babies are different. It usually begins at around 2 to 3 weeks of age, tends to peak at about 6 weeks, and generally eases by 3 to 4 months.
Why does it happen?
The exact cause is not known, and probably several things play a part: a baby's nervous system and gut still maturing, trouble settling and self-calming, swallowing air, and sensitivity to feeds in some babies. Colic is not caused by "bad milk" or by your cooking.
A small number of babies who seem to have colic actually have another cause, such as reflux disease or cow's milk protein allergy, which is why the warning signs below matter and why the doctor first checks that your baby is otherwise well.
Symptoms
- Intense crying spells, often in the late afternoon or evening, that are hard to soothe
- Crying that starts and stops suddenly without an obvious reason
- Red face, clenched fists, arched back or legs pulled up to the belly
- A tight or gassy belly during crying
- Baby feeds well, has normal wet nappies and gains weight normally between episodes
- Trouble settling to sleep in the evening
Red flags — seek urgent medical care
Fever (38°C or above), or a baby under 3 months who feels hot or unusually cold
Infection is possible, and young babies can become seriously ill quickly. See a doctor urgently.
Vomiting that is green or yellow-green (bile), or forceful repeated vomiting
May indicate a bowel blockage or another surgical emergency. Go to the emergency department now.
Blood in the stool or black stool
Can be caused by allergy, infection, a small anal tear, or something more serious. Needs prompt assessment.
Poor weight gain, weight loss, refusing feeds, or fewer wet nappies
The baby may not be getting enough milk or may have an underlying illness. This is not typical colic.
A bulging soft spot (fontanelle) on the head, unusual sleepiness or floppiness, or a high-pitched cry
Could signal raised pressure around the brain, such as meningitis. This is an emergency.
Inconsolable crying with a swollen, hard or very tender belly, or a swelling in the groin or scrotum
May point to a bowel problem (such as a twisted or trapped bowel or a hernia). Seek emergency care without delay.
How is it diagnosed?
Colic is diagnosed by listening to your story and examining your baby; there is no test for it. The doctor will check that your baby is feeding well, growing along their growth chart, and has a normal examination, and will look carefully for the warning signs above.
Tests such as stool tests, blood tests or scans are not needed for typical colic. They are only done if the history or examination suggests another cause. It can help to keep a short diary of feeds, sleep, crying and stools for a few days to show your doctor.
Outlook — what to expect
Colic is temporary. Most babies improve by 3 to 4 months, and almost all by 6 months, with no lasting effect on growth or health. The hardest part is often the strain on parents, so looking after yourself is part of treatment.
Treatment
Habits & Lifestyle
No single method works for every baby. These are safe things to try, one at a time, and you can stop any that do not help.
- Soothe with gentle, calming steps: hold and rock your baby, walk, use soft "shushing" or steady background sound, dim the lights, and swaddle only if you have been taught how to do it safely.
- Burp your baby during and after feeds, and keep feeds calm and unhurried. If you bottle-feed, check that the teat flow is right so your baby does not swallow too much air.
- Hold your baby upright for a while after feeds, and try gentle tummy-to-tummy skin contact or "tummy time" while awake and watched. Never leave a baby to sleep on the tummy.
- SAFE SLEEP: always place your baby on their back, on a firm, flat surface, with no pillows, loose blankets or soft toys, and not on a sofa or while you are drowsy.
- NEVER shake a baby, however frustrating the crying is. Shaking can cause permanent brain injury or death. If you feel you are losing control, lay your baby safely on their back in the cot, step away for a few minutes, and call a family member or friend. It is OK to put the baby down and take a break.
- Ask for help and rest when you can. Colic is exhausting, and it is not a sign that you are a poor parent.
Diet
Breast milk or standard formula remain the right food. Keep breastfeeding if you are doing so, and do not change milk or stop breastfeeding without medical advice.
- Feed on demand, in a calm place, and burp as above. Overfeeding or underfeeding can both add to fussiness, so ask about a good feeding routine.
- A mother with a breastfed baby does not usually need a special diet. Only if your doctor suspects cow's milk protein allergy might a short, supervised trial of removing dairy be suggested.
- For formula-fed babies, a change to a special formula should only be made on medical advice, and only if allergy is suspected.
- Do NOT give honey, herbal drinks, gripe water, sugar water, teas, or any home remedy. They are not proven, and honey in particular can cause serious illness (infant botulism) in babies under 12 months. Water is not needed before about 6 months.
Medications
There is no medicine that reliably cures colic, and most medicines have not been shown to help. Do not give your baby any medicine, drops or supplement unless your doctor or pharmacist advises it.
- Simethicone ("anti-gas") drops have not been shown to work better than placebo in studies, so they are not routinely recommended.
- Acid-reducing medicines are not recommended for colic and can have side effects; they are only for babies with confirmed reflux disease.
- Some probiotic products have been studied, especially in breastfed babies, but evidence is mixed. Discuss with your doctor before using any.
- Never give adult medicines, cough or cold medicines, or sedatives to a baby.
Procedures & Surgery
Procedures are not part of treating colic. Tests or imaging are only for babies with warning signs.
- No procedure is needed for typical colic.
- If your baby has warning signs, the doctor may arrange blood tests, stool tests or an ultrasound to look for another cause.
Living with the condition
- Remember: this is a phase. It will pass, and it is not your fault.
- Take turns with a partner or relative so each person gets a break and some sleep.
- If you feel overwhelmed, very low, or worried you might hurt your baby, talk to your doctor, nurse or a trusted person today. Mothers can also get postnatal depression; help is available.
In the Saudi context
In many families, relatives offer traditional drinks or herbal remedies for a crying baby. Please do not give them without asking a doctor, as some are unsafe for young infants. Your well-baby clinic or primary healthcare centre can check your baby's growth and advise on feeding.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Is my baby's crying typical colic, or could something else be going on?
- Is my baby growing and gaining weight as expected?
- Could cow's milk protein allergy or reflux be involved?
- Is my feeding technique and bottle or teat suitable?
- Which symptoms mean I should bring my baby in right away?
Trusted resources
Was this guide helpful?
Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide