Clinical, developmental and social aspects of infant crying and colic

Persistent unexplained infant crying in the first few months is a common source of distress for parents and is costly for the health services. The aim was to assess the merits of developmental and social conceptualizations of this phenomenon, compared to the clinical approach as represented by the concept of colic. From a community sample of 530 infants, 67 who met the ‘rule of threes’ definition of colic by fussing and crying for 3 or more hours per day at 4-5 weeks of age were chosen. To avoid confusion, these infants were called ‘persistent criers’. Groups of ‘evening criers’ (N = 38) and ‘moderate cries’ (N = 55) were also selected. These 160 infants were assessed by researcher measures of their consolability and by maternal diary measures of their amounts of fussing, crying and colic behaviour when 5-6 weeks old. The persistent and evening criers cried more than the moderate criers. However, irritable, ‘fussy’ behaviour was the predominant form of distress for all three groups of infants. Colic bouts–defined as ‘bouts of intense, unsoothable crying and other behaviour, perhaps due to stomach or bowel pain’–were rare even among the persistent criers and only 7% of these infants were found to be inconsolable. The results support growing evidence that normal infant developmental processes are central to this phenomenon. In addition, social interactions between infants and parents, and parental subjective variables, appear to be involved. Colic was distinguished as a rare and separate form of distress by the infants' mothers. Further evidence needs to determine whether colic is a distinct clinical phenomenon or an extreme degree of normal distress interpreted within a western cultural framework.