Somewhere around week three or four, the crying ramps up, and every article you read seems to describe either colic or reflux - sometimes both, sometimes neither, always slightly differently. It's one of the most common questions in the newborn stage, and one of the hardest to self-diagnose.
They're different things, they're managed differently, and there is a fairly reliable way to tell them apart - even if only a GP can properly confirm which one you're dealing with.
What colic actually is
Colic isn't a diagnosis so much as a description: intense, hard-to-settle crying in an otherwise healthy, well-fed baby, often described by the "rule of threes" - more than three hours a day, more than three days a week, for at least three weeks. It usually starts around two to three weeks and tends to peak around six weeks.
- Crying often clusters in the late afternoon or evening
- Baby's body may look tense - fists clenched, legs pulled up, back arched
- Between episodes, baby feeds and settles normally
- No single proven cause - it usually resolves on its own by 3-4 months
What reflux actually is
Reflux happens when stomach contents come back up the oesophagus, which can be uncomfortable enough to cause real distress - sometimes with visible spit-up, sometimes "silent" with no obvious mess at all.
- Fussiness or crying during or shortly after feeds, not just in the evening
- Frequent spit-up, hiccups, or wet burps (though silent reflux shows none of this)
- Arching away from the bottle or breast mid-feed
- Discomfort lying flat, especially soon after eating
- Usually starts around 2-4 weeks and tends to ease by 12 months as the digestive system matures
The clearest tell
Timing is the most useful clue. Colic crying tends to cluster at a predictable time of day regardless of feeding, while reflux crying tends to track with feeds - during, just after, or when laid flat. Neither is a home diagnosis, but this is usually the first question a GP or child health nurse will ask.
What actually helps
See a GP or your Maternal and Child Health nurse if crying is inconsolable for long stretches, baby isn't gaining weight, there's forceful (projectile) vomiting, blood in vomit or nappies, or you're finding it hard to cope - that last one counts as a real reason on its own.
- For reflux: smaller, more frequent feeds; holding upright for 20-30 minutes after feeding; keeping burps unhurried mid-feed
- For colic: white noise, gentle motion, a warm bath, and - honestly - accepting that some evenings are just going to be loud
- For both: a change of scene (even five minutes on the balcony) can reset an unsettled baby, and you
You're not doing anything wrong
Both colic and reflux are common, both are exhausting, and neither is caused by anything you did or didn't do. The evenings that feel unmanageable now are genuinely temporary - most colic resolves by 4 months, most reflux by 12.
If you're keeping track of feeds and settling patterns to describe to a GP, that record is useful - it's exactly the kind of detail that's easy to remember in the moment and impossible to recall accurately a week later.