What Is Colic?

Author: Ronald G. Barr, MDCM, FRCP(C)

mom and baby

For many parents, grandparents, health professionals, and especially for a parent who has had a “high crying” infant before, a very common question would be: “But what is colic? Aren’t these typical features that are being described as normal infant crying behavior also called ‘colic’?”

Another great question, and an important one. And here is why it is important: because, for better or for worse, all sorts of people use the word ‘colic’ and, unfortunately, they use it for different things.

Some people say that infants that have colic have all of the crying features that we have described. And, if the word colic is used in this way, they would be right. But the problem with the word ‘colic’ is this: most people think some infants have colic, and others do not have colic.

What we now know is that all infants have those features of crying (the increasing and decreasing crying curve, the unexpected crying times, unsoothable crying, and so on). It is not that some infants have these typical features and some don’t; all infants do. But, as previously mentioned, some infants have more and some less, and the range of how much more or how much less is quite wide, but they all manifest them.

“The problem with the word ‘colic’ is this: most people think some infants have colic, and others do not have colic, but we now know is that all infants have those features of crying (the increasing and decreasing crying curve, the unexpected crying times, unsoothable crying, and so on).”

Some people say that infants have colic if they cry more than some specified amount of crying. By far the most common such definition is called Wessel’s “rule of threes.” This rule states that if your infant cries more than three hours a day for more than three days a week for more than three weeks, than your infant has “colic.” Although it is widely used, it is an unfortunate rule because (1) it does not tell you anything about your infant other than that he or she cries a lot (and you knew that already); (2) it does not explain anything and (3) it implies that something is wrong or abnormal with your baby, with you, or with the way you are caring for your baby. The point is that there is nothing different between a baby who cries three hours and five minutes a day or one that cries two hours and fifty-five minutes a day. And the irony is that Dr. Morris Wessel, who is credited with this definition, never ever intended it to say who did and did not have colic! He just made an arbitrary distinction between infants who cried more and those who cried less so that he could begin to try to understand the increased crying normal infants did in the first months of life.

“There is nothing different between a baby who cries three hours and five minutes
a day or one that cries two hours and fifty-five minutes a day.”

Some people reserve the word ‘colic’ to be used for infants who cry a lot and have an illness or something wrong with them. Sometimes (rarely) they reserve the term for those who have something wrong in their stomach or their intestines. That is a completely different use of the term colic, and is not at all the same as the crying we have described here in normal infants. These infants have an illness.

So, the summary of this is to say that the increased crying features that are typical of normal infants in the first weeks and months of life are different from almost all of the meanings of colic that are often described either because (1) these features occur in all infants, not just in high crying infants; (2) although the amount of crying that normal infants do is very wide and includes amounts that are sometimes used to define ‘colic,’ there is no specific amount of crying that is normal or abnormal; and (3) this crying is not due to illness or pain.