Colic and the witching hour: what helps, and what to rule out

Colic is the least satisfying diagnosis in the first year, because it is not really a diagnosis. It names a pattern — a lot of crying in a baby who is otherwise well — without naming a cause, which is why nothing cures it and why every parent gets handed a different theory.

What follows is what the definition actually is, the shape crying takes over the first months, the small number of things that reliably help, and the list of things that mean this is not colic and needs looking at.

What counts as colic

The NHS puts it as crying for more than three hours a day, on more than three days a week, for at least a week, in a baby who is otherwise healthy. Around one in five babies fits that description at some point in the first months.

The pattern usually looks like this:

• Starts somewhere in the second to fourth week
• Crying that is intense and hard to interrupt, rather than a grizzle
• Often clenched fists, legs drawn up, a flushed face
• Clustered in the late afternoon and evening
• Feeding, weight gain and development all normal
• Stops by three to four months, occasionally continuing to six

That last point is the one worth holding onto at 6pm on day forty: this ends, on its own, and it ends completely.

Crying has a shape, and it peaks

Crying in the first months is not a flat line that colic raises. It has an arc that almost every baby follows — the AAP describes fussing that peaks at about three hours a day by six weeks and falls to one or two hours a day by three to four months.

Colic sits on top of that arc rather than replacing it. Which has one genuinely useful implication: if your baby is five weeks old and getting worse, that is the expected direction of travel and not evidence that something you changed has made things worse.

Why the evening is the worst of it

The witching hour is not a colic phenomenon — it happens to babies without colic too, and it arrives with the same timing. Three things stack up:

• The last stretch is the longest. The wake window before bedtime is typically the longest of the day, so a baby reaches the evening with the most accumulated tiredness.
• Stimulation has been accumulating since morning. A newborn nervous system has no way to discharge a day’s worth of input except by crying.
• Milk supply and flow change through the day for breastfeeding parents, and cluster feeding in the evening is normal rather than a sign of a problem.

The practical consequence: the evening is fixed from the afternoon. Shortening the last wake window by fifteen or twenty minutes, and getting the wind-down started before the crying begins, does more than anything attempted at 7pm.

What genuinely helps

Nothing on this list is a cure, and everything on it works some days and not others. The NHS list and the AAP list overlap almost entirely, which is a reasonable sign that this is what there is:

Two structural things help more than any single technique. Take shifts. One person doing the 5pm to 8pm stretch every night burns out; two people alternating survive it. And leave the house — a pram or a carrier outdoors in the late afternoon interrupts the cycle before it starts, and moves the worst hour somewhere with more air in it.

What to skip

• Spinal manipulation and cranial osteopathy. The NHS says explicitly that there is little evidence these work, and both involve handling a very young spine.
• Expecting much from drops. Simeticone preparations have generally not beaten placebo. Some probiotic strains show a modest effect in breastfed babies. Ask a pharmacist rather than reading reviews, and treat any of it as a maybe.
• Changing formula on a hunch, or cutting food groups from a breastfeeding diet without advice. Both are worth doing when there is a reason; neither is worth doing speculatively, because you end up unable to judge the result.
• Sleep training. Not applicable at this age, and the crying it is aimed at is a different thing entirely.

The three things worth ruling out

This is the part of the topic that actually matters, because colic is a label applied after other explanations have been considered — not instead of considering them.

Reflux

Some spitting up is normal in most babies. What points at reflux worth treating is arching or crying during feeds, refusing a feed they are clearly hungry for, frequent hiccups and wet burps, or discomfort that is worse lying flat rather than worse in the evening.

Cow’s milk protein allergy

A minority of babies labelled colicky have this instead. The signals are the ones colic does not produce: blood or mucus in the stool, eczema, persistent diarrhoea or constipation, poor weight gain, or a family history of allergy. It is managed with a specific change to formula or to a breastfeeding parent’s diet, and needs a professional to direct it.

Feeding mechanics

A shallow latch, a fast flow, a bottle teat that is too fast or too slow, or a tongue tie all produce a baby who swallows air, feeds inefficiently and cries. This is the most commonly missed of the three and the most fixable — a feeding assessment with a midwife, health visitor or lactation consultant is worth asking for before accepting colic as the answer.

When it is not colic

Contact a doctor the same day — or urgently, out of hours — if crying comes with any of these:

• A fever, particularly under three months
• Being difficult to wake, floppy, or unusually quiet between bouts
• Vomiting that is green, or projectile and repeated
• Blood in the stool, or stools that look like redcurrant jelly
• A tense or swollen abdomen, or a swelling in the groin
• Fewer wet nappies, or weight that is not going up
• A cry that has changed in character — high-pitched, weak, or continuous
• Crying that started suddenly in a baby who was previously settled

None of these are colic, and the list is short enough to keep in your head. Crying that started today, in a baby who was fine yesterday, is the one that gets seen today.

The person doing the soothing

Prolonged infant crying is one of the strongest predictors of parental depression and of the moments parents most regret, and it is the reason the safety advice exists in the form it does.

Tell your health visitor or GP how you are doing as well as how the baby is doing. Support exists for this specific situation, and asking for it is a normal part of the same conversation.

When to ask

Speak to your GP or health visitor if the crying is more than you can manage, if it is continuing past four months, if there is any sign on the list above, if you suspect reflux or an allergy, or if feeding is painful or difficult for either of you. Also ask if you simply want someone to confirm nothing else is going on — that reassurance is a legitimate reason for an appointment, not a waste of one.