Most infants can be fussy and will cry to communicate any number of things, including hunger, fatigue, and urine or feces in the diaper. These cries often sound different, depending on whether the child is hungry, tired or wants attention. The cries of an infant with colic may seem more intense or distressing than usual. They may be louder, higher pitched and more variable in pitch.

Colic involves prolonged periods of crying (more than three hours per day, at least three days a week, for more than three weeks). The crying begins suddenly and usually only ends when an infant appears exhausted. Crying occurs at the same time every day – most often during the late afternoon or evening. A child with colic will often be inconsolable. The normal methods of soothing the child will not stop the crying.

In addition, there will be no apparent trigger preceding the crying. The cries of a colicky baby do not appear to be related to what the infant was doing prior to the crying spell. It is important to note that crying that occurs after feedings may indicate another condition, such as reflux or allergies.

Colic occurs in otherwise well-fed, healthy babies. Infants with colic will have normal-looking stool and show no signs of illness. They will have a healthy sucking reflex and a hearty appetite, and will gain the appropriate amount of weight for their age and size. (If an infant refuses feedings, it may indicate another condition, such as an ear infection.)

Additional signs of colic in infants include:

• Face reddens and appears flushed
  
  
• Area around the mouth is pale
  
  
• Hands are clenched
  
  
• Arms and legs are pulled in close to the torso (but may also periodically extend and stiffen)
  
  
• Abdominal distension (abdomen bulges out)
  
  
• Tense abdominal muscles (abdomen feels hard to the touch)
  
  
• Feet are cold
  
  
• Flatulence and/or a bowel movement occur at the end of a crying episode

Parents should consult their child’s pediatrician if the infant experiences any of the following, which may indicate another medical condition:

• Fever
• Repeated or forceful vomiting
• Halt in weight gain
• Watery, bloody or hard stool