Colic or abdominal pain or cramps are sudden attacks of gut irritation, bloatedness and discomfort. It may present as prolonged crying i.e. unsettled baby and can stop as suddenly as it starts. Crying often starts in the evening, especially before bedtime.\u00a0 The infant seems to be in pain and will show this by stretching, arching or lifting their legs.\u00a0 The abdomen may also be swollen and the infant may pass a lot of wind. \u00a0\r\n\r\nWhat causes colic?\u00a0 Is it real?\r\nThe exact causes are unknown but the pain is real. However, there are some factors which may contribute to the symptoms.\r\n\r\n \tOverfeeding without burping\r\n \tThe emotional stress of both baby and parents\r\n \tConstipation\r\n \tFood intolerance\/allergy\r\n\r\nWhat can I do when my baby has colic?\r\nThere is no specific treatment for colic and the management of colic is just a matter of trial and error. Sometimes whatever you try may just be in vain. However, comforting the child by holding him in an upright position to facilitate burping or by massaging the baby\u2019s abdomen can help to alleviate colic pain. You should also make sure to not overfeed or underfeed your baby and to treat constipation which can be an underlying cause. Probiotics, a good and friendly type of bacteria that is administered to your baby\u2019s intestine may be helpful.\r\nWhat are the warning signs that I should be worried about?\r\nInconsolable crying associated with:\r\n\r\n \tPersistent vomiting (especially greenish vomitus)\r\n \tSevere abdominal distension and hard on palpation\r\n \tFailure to gain weight\r\n \tPassing blood-stained stool or stool with mucous\r\n \tInactive and lethargic looking baby with poor feeding\/sucking\r\n\r\nWhen to bring my \u201ccolicky baby\u201d to see the doctor?\r\nYou should bring your baby to see a paediatrician immediately if he starts crying inconsolably, has abdominal distension and refuses to feed. Your baby\u2019s doctor will then make sure that nothing serious will happen to your baby. Additionally, the doctor will also reassure you with some good advise\/tips on good feeding techniques.\u00a0 If the symptoms worsen, your paediatrician may prescribe colic drops to ease the pain or probiotics to facilitate digestion and gut motility. Your baby\u2019s doctor will also try to exclude any possibility of food allergy\/intolerance in your baby, which may require further dietary modifications.\r\nWhat are the tips for mothers dealing with \u201ccolicky\u201d babies?\r\nAs mentioned above, there is no known cause of abdominal colic but there are some contributory factors that may lead to colic in infants. Exclusively breastfeeding with correct feeding techniques, right feeding position, smaller amount with more frequent feeding regime, especially for bottle-fed infants and burping in between the feeds are some of the ways to prevent the excessive accumulation of air in your baby\u2019s stomach. If you are too stressed out about handling your \u201ccolicky\u201d baby, it is advisable to take a break by asking for help. You will be able to handle your baby better after some respites from the crying episode, which is very important for both you and your baby.\r\n\r\nHowever, occasionally, your baby will just develop colic no matter what feeding practices you adopt. But the good news is that most infants will outgrow this \u201ccolic\u201d problem when they reach three months of age.\r\n\r\n\r\nAbout the Writer\u00a0\r\nDr Khoo is a consultant paediatrician and neonatologist at Sunway Medical Centre. He obtained his paediatric postgraduate membership from the Royal College of Paediatric and Child Health (MRCPCH) in Glasgow, UK in 2003. He continued his neonatal subspecialty fellowship training in 2005 at Liverpool Hospital and the Royal Hospital for Women (RHW), Sydney, NSW, Australia. In addition to his paediatric practise, Dr. Khoo also lectures part-time at the Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Sunway Campus.