Colic and Reflux look very similar - Even doctors can have trouble telling them apart

What is Colic?
Colic is defined as excessive crying for at least three hours per day at least three days per week for at least three weeks with no other explanation for the crying.

What is Reflux?
Reflux is stomach acid bouncing up out of the stomach. It can be quite uncomfortable and some babies experience severe pain. Reflux is a common reason for excessive crying.

When a baby has colic and when he or she has reflux is a hotly debated topic in medical circles. Here are a bunch of links that will help you see both sides of the controversy.

Here is a excerpt from an issue of Reflux Digest that is a semi-humorous response to the "Rule of Threes" that doctors use to diagnose colic:

Beth’s Rule of Sixes – completely unscientific

If you can answer yes to six of these, maybe it isn't "just" colic... maybe it is acid reflux

  • Your baby cries six hours a day
  • For six days a week
  • It has been going on for over six weeks
  • The neighbor six doors down can hear the screaming
  • You tried six formulas or cut six foods from your diet if nursing
  • You and your baby need six changes of clothes per day
  • It takes six hours to feed six ounces
  • Your baby never sleeps for more than 60 minutes at a time
  • Your baby spits up six times after each bottle
  • You keep wondering if you overlooked a 666 birthmark
  • At the last six appointments doc said "colic" or “babies just cry”
  • You dread driving anywhere more than six minutes away
  • Your baby belches like a six year old
  • Six hours alone with the baby is the max anybody can take
  • You do six loads of laundry a week - just for you and the baby
  • By six pm you want a 7&7

To read the full newsletter about colic, click here. Or go to the Free Newsletter link on the left menu or in the Reading Room at the bottom of the page in the Newsletter section. It is the September 2006 issue.

A great article about colic from Zero to Three:

A discussion of colic vs reflux on Medscape:

Diagnostic Workup Before Diagnosing Colic:

Am I a Heretic if I Don't Believe in GERD? Cost is $25 if you don't subscribe to the Journal of Pediatric Gastroenterology and Nutrtition.

Infant colic and feeding difficulties. This journal article is very difficult to read but indicates that many kids with colic have both feeding issues and reflux issues.

Medicalizing Normal:

NPR did an interview with Dr. Barry Lester who runs the Colic Clinic at Brown University. Here are some excerpts from the interview.

Lester rejects a generally accepted definition of colic, which is based on the so-called "rule of threes." If your infant cries for three hours a day, three days a week, for three consecutive weeks, it's diagnosed as colic.

First of all, Lester says, no parent should endure three weeks of that sort of crying before getting help. Secondly, he says, it doesn't address the quality of the cry. Babies who have colic are most definitely in pain, Lester says.

"A pain cry is different than a non-pain cry," he says. "Just talking about time isn't addressing the quality of the cry."

Lester says just letting colic run its course is a bad idea. "Early experiences change a baby's development and life forever," he says, leading to consequences such as a baby's inability to properly bond with a mother... emotional and behavorial problems... and in worst-case scenarios, child abuse.

Babies' cries are the primary trigger for shaken baby syndrome and other forms of child abuse.

Lester says he'd like to see pediatricians everywhere take colic more seriously: treat physical causes, get the family organized in a time of chaos and give parents the emotional tools they need to get through it.

This link is for the clinic:

Check with your
doctor first!