Colic

Part of the confusion in this area arises because the word colic has historical and etymological connotations. It comes from the Greek word kolikos, the adjectival form of kolon (the intestine), so that it is often used not just to refer to the behavior— crying—but to infer the presumed cause: gastrointestinal disturbance and pain. The eminent English pediatrician Ronald Illingworth, for instance, referred in 1985 to "pain that is obviously of intestinal origin" (p. 981). In fact, whether or not most babies who cry in this way have indigestion, and whether they are in pain, are both uncertain.

The second source of confusion is that, for obvious reasons, the clinical phenomenon is parental complaint about infant crying, rather than infant crying itself. Not surprisingly, factors such as parental inexperience have been found to increase the likelihood of clinical referral, throwing the spotlight onto parental, rather than infant, characteristics. This has raised issues about individual parents' vulnerability and tolerance, and about the extent to which colic as a distinct condition might be a Western, socially constructed, phenomenon.

One way to resolve this confusion is to define colic strictly in terms of a specific amount of infant crying. Morris Wessel and colleagues' (1954) Rule of Threes ("Fussing or crying lasting for a total of more than three hours per day and occurring on more than three days in any one week," p. 425) has been used in this way. From a research point of view, the advantage is that infants can be identified for study in a standard way. The disadvantage is that the definition is arbitrary; it is unlikely to help parents to be told that their baby does not have colic because he or she fails to meet this research criterion. Moreover, it implies the need to measure crying for a week without intervening, which many parents are reluctant to do.

Rather than employing a single definition, a workable alternative is to define colic broadly as prolonged, unexplained crying in a healthy one- to three-month-old baby, and the impact of this on parents. Information about the infant and parental parts of this phenomenon, within and between cultures, can then be sought in a systematic way. The alternative—of abandoning and replacing the word colic—has also been proposed, but it is so ingrained that this seems unlikely to work in practice.