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Patient Education2 min read

Infant Colic

Overview

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.

Symptoms

1

Intense crying spells, often in the late afternoon or evening, that are hard to soothe

2

Crying that starts and stops suddenly without an obvious reason

3

Red face, clenched fists, arched back or legs pulled up to the belly

4

A tight or gassy belly during crying

5

Baby feeds well, has normal wet nappies and gains weight normally between episodes

6

Trouble settling to sleep in the evening

Self-Care Tips

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.

When to See a Doctor

Seek medical care promptly if you notice: Fever (38°C or above), or a baby under 3 months who feels hot or unusually cold; Vomiting that is green or yellow-green (bile), or forceful repeated vomiting; Blood in the stool or black stool; Poor weight gain, weight loss, refusing feeds, or fewer wet nappies; A bulging soft spot (fontanelle) on the head, unusual sleepiness or floppiness, or a high-pitched cry; Inconsolable crying with a swollen, hard or very tender belly, or a swelling in the groin or scrotum.

Why it happens

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.

How common it is

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.

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.

How it is 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.

Lifestyle and daily habits

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.

Medicines

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 and 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.

Outlook

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.

Questions to ask your doctor

• 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?

Source and review

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.

Frequently Asked Questions

What is Infant Colic?
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.
How is Infant Colic 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.
What is the outlook for Infant Colic?
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.
When should I see a doctor about Infant Colic?
Seek medical care promptly if you notice: Fever (38°C or above), or a baby under 3 months who feels hot or unusually cold; Vomiting that is green or yellow-green (bile), or forceful repeated vomiting; Blood in the stool or black stool; Poor weight gain, weight loss, refusing feeds, or fewer wet nappies; A bulging soft spot (fontanelle) on the head, unusual sleepiness or floppiness, or a high-pitched cry; Inconsolable crying with a swollen, hard or very tender belly, or a swelling in the groin or scrotum.

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