Colic or reflux? Why your baby cries and what can help

A baby who cries a lot or brings milk back up is worrying, and it can feel endless. Here’s how colic and reflux differ, what may help and when to get checked.

Colic

The NHS says colic is when a baby cries a lot but there’s no obvious cause. It is suspected when a healthy baby cries for more than 3 hours a day, on 3 or more days a week. Crying is often worse in the afternoon and evening. Other signs are clenched fists, a red face, knees drawn up and a rumbling tummy. It can start when a baby is a few weeks old and usually stops by 3 to 4 months.

What may help: holding or cuddling your baby, keeping them upright during feeds and winding them afterwards, gentle rocking, a warm bath, and background white noise. Keep feeding as usual. The NHS says breastfeeding mothers don’t need to change their diet, and that anti-colic drops and herbal or probiotic supplements aren’t recommended, as there’s no evidence that they help. It also advises against spinal manipulation or cranial osteopathy.

Reflux

Reflux is milk coming back up. Signs include vomiting during or after feeds, coughing or hiccupping while feeding, fussiness at feeds, and difficulty settling. The NHS says it usually starts before 8 weeks and resolves by about 1 year.

Hold your baby upright during and for a while after feeds, and burp them regularly during feeds.
Always put them to sleep flat on their back, and don’t raise the head of the cot or Moses basket.
Ask your health visitor about breastfeeding position or bottle-feeding technique.

Reflux and cow’s milk allergy can look alike, so a GP or specialist may want to check for an allergy. Don’t change your baby’s milk or your own diet without talking to your GP or health visitor first. See spotting the signs of cow’s milk protein allergy.

When to see a GP

See your GP or call NHS 111 if you’re worried, nothing seems to help, you’re struggling to cope, your baby isn’t gaining weight as expected, or symptoms continue after 4 months. For reflux, see a GP if it doesn’t improve with home measures, starts after 6 months, continues past 1 year, or your baby isn’t gaining weight.

Get an urgent GP appointment or call NHS 111 if your baby vomits green or yellow fluid or blood, vomits forcefully, has blood in their poo, has a swollen tummy, keeps vomiting and can’t keep fluids down, or refuses to feed. For any baby, a weak or high-pitched cry, or a cry that doesn’t sound like their normal cry, needs 999 or A&E.

Looking after yourself

Never shake a baby, however frustrated you feel. If you need a break, put your baby safely on their back in the cot and take a few minutes. Cry-sis offers support on 0800 448 0737 (9am to 10pm daily, according to the NHS), and the NCT support line is 0300 330 0700.

Questions people ask

Is colic caused by my diet?

The NHS says breastfeeding mothers don’t need to change their diet for colic. Talk to a GP before changing your baby’s diet.

Will my baby grow out of it?

Colic usually stops by 3 to 4 months, and reflux usually resolves by about 1 year.

Should I raise the head of the cot?

No. The NHS says not to raise the head of the cot or Moses basket for reflux.