Colic and reflux in babies explained

What colic is

Colic is the term for frequent, prolonged crying in a baby who is otherwise healthy, well-fed and growing. A common description is crying for more than three hours a day, on more than three days a week, often in the late afternoon or evening. During these episodes the baby may go red in the face, clench their fists, arch their back or pull their knees up, and seem impossible to soothe. Colic usually starts in the first few weeks of life and settles by around three to four months of age. The exact cause is not known, and despite how it looks, it does not mean the baby is ill or in danger. It is a phase, not a disease, but it can be very hard on parents.

What reflux is

Reflux is when milk comes back up from a baby's stomach, causing possetting (small, effortless bring-ups) or larger vomits after feeds. It is extremely common because the muscular valve at the top of a baby's stomach is still immature, so milk escapes easily, especially in a baby who mostly lies down and has a milk-only diet. Most reflux is simple and harmless — the baby is happy, feeding well and gaining weight, and it is sometimes called "happy spitting". It usually improves as the baby gets older and starts to sit up and eat solids, often resolving by around a year. A smaller number of babies are distressed by reflux or have feeding problems, which may need extra help.

Soothing and everyday measures

For colic, no single remedy works for every baby, but many parents find comfort measures help: holding and gently rocking your baby, a warm bath, white noise or gentle sounds, a walk in the pram, and calm, dim surroundings in the evening. Winding your baby during and after feeds and checking feeding technique can help too. For reflux, feeding your baby a little more upright, keeping them upright for a short while after feeds, and offering smaller, more frequent feeds can reduce bring-ups. Always place your baby on their back to sleep, even with reflux, as this is the safest sleeping position. Above all, look after yourself: take breaks, share the load, and it is fine to put a crying baby down safely for a moment if you feel overwhelmed.

Treatments and when they help

Most colic and simple reflux need no medicine and improve with time and comfort measures. For colic, some parents try anti-colic drops or probiotics, though the evidence that they help is limited; a pharmacist can advise. For reflux, if a baby is distressed, feeding poorly or not gaining weight despite simple measures, a GP or health visitor may suggest a stepwise approach — for example reviewing feeding, trying feed thickeners, and only sometimes medicines. Bottle-fed babies may be reviewed for how feeds are made and paced. Occasionally a suspected cow's milk allergy is considered if there are other symptoms. It is important not to start special formulas or medicines yourself; changes should be guided by a health professional so the right cause is treated.

When to seek medical advice

Colic and reflux are usually harmless, but some signs mean you should get medical help. Contact a GP or health visitor, or NHS 111, if your baby is not gaining weight or is losing weight, vomits forcefully or repeatedly, or brings up green or yellow vomit or blood. Seek advice if feeds are very distressing, your baby refuses feeds, has frequent diarrhoea, or has other symptoms such as a rash or breathing problems, which could suggest a cow's milk allergy. Get urgent help if your baby seems very unwell, is very sleepy or hard to wake, has a high temperature, has a swollen or tender tummy, or has signs of dehydration. Trust your instincts — if you are worried your baby is unwell, always seek advice.