Understanding colic: The 333 rule

Colic is a condition that is very common in babies, but that doesn’t change how impactful it can be. 

While not dangerous for baby, the unrest and upset it causes both baby and parent is something we at Tommee Tippee want to help with.  

What is colic? 

Colic is when a baby cries a lot but there's no obvious cause. It usually starts when a baby is a few weeks old. 

Frustratingly, the exact cause of colic in babies isn't known, but it's thought that it may be caused by digestive upsets like a build-up of gas due to: 

• allergies 
• intolerances 
• baby's digestive system not being fully developed 
• an imbalance of gut bacteria 

In some cases, it may also be caused by overstimulation as baby adjusts to the world and their nervous system develops. 

The 333 Rule is used to help distinguish whether a baby is crying naturally or if they have colic.  

The rule isn’t a certain diagnosis, but it is helpful to identify if a baby has colic. 

The 333 Rule says that colic can be determined if a baby is otherwise healthy, but cries for: 

• more than three hours a day 
• more than three days a week 
• more than three weeks 

The NHS definition of colic differs slightly. It states that colic can be identified if the crying persists for more than one week, not three. 

How do I know if my infant has colic? 

There are various signs of colic, but the 333 Rule is a simple way to distinguish between crying and colic.  

You can also look for whether, while crying, your baby: 

• is hard to soothe or settle  
• clenches their fists 
• goes red or flushed in the face 
• brings their knees up to their tummy or arches their back 
• is very windy and has a rumbling tummy 

Your baby might not have colic - there are other reasons why your baby may be crying, such as: 

• hunger 
• dirty nappies 
• wind 
• reflux 
• constipation 
• allergies 

If you're not sure what's wrong, it's best to speak to your health visitor or see a GP to be sure. 

How long does colic last? When should colic stop? 

The good news is that colic doesn’t last forever. It’s very common in infants and not dangerous. Colic symptoms usually ease on their own by the time baby is around three or four months. 

When does colic peak? 

A baby's colic symptoms are typically at their worst when they're around six to eight weeks old. 

Although they can peak at different times of day for different babies, colic symptoms are mostly experienced in the late afternoon and evening. You can read more about when colic peaks here. 

What should I do if my baby has colic? 

Firstly, it’s important that you look after yourself, as caring for a colicky baby can be very stressful and upsetting.  

Your baby does not usually need to see a doctor if they have colic, but you might find it helpful to reach out to other parents, family, friends, your health visitor, or helplines such as Cry-sis for support. 

How to soothe your baby with colic: Feeding 

If your baby does have colic, continue to keep feeding your baby as usual. You do not need to make any changes to your diet if you're breastfeeding, but you might want to adjust your feeding position or change your bottle or teat if you are bottle feeding. 

Try sitting or holding your baby upright during feeding and tip the bottle high enough so that the milk fills the whole teat to stop them swallowing air and reduce the amount of gas in their tummy. 

You can also adjust your breastfeeding position. The straddle hold - also known as upright breastfeeding or the koala hold - requires a baby to sit straddled on their parent’s thigh or hip, with their head upright as they breastfeed. 

This position is suitable for babies of various ages (although younger babies will need plenty of head support).

You can also try winding them more often during feeds to help relieve trapped gas. Find more tips here.

Sources

• NHS - Colic 
• NHS Better Health Start For Life – Colic and bottle feeding 
• Hopkins Medicine - Colic