The difference between a colicky vs. fussy baby

Colicky vs. Fussy Baby: The Difference, Why It Matters, and What to Do About It

Colic is one of the most misused and incorrectly defined labels ascribed to babies. In fact, it’s SO commonly misapplied that many of the top search results on Google for “colicky baby” are wrong.

You’ve probably heard “colicky” and “fussy” used interchangeably, but the truth is, they are not synonymous! Colicky babies fuss, but not all fussy babies are colicky.

And actually, it’s a really big deal. Big enough that I’ve dedicated an entire article to the issue. If you want to know what the difference is between colicky and fussy babies, and why this distinction is so important, keep reading.

In this post, I’m going to share with you the actual definition of colic and what it looks like so that you know if your baby has it, and some tactics you can use to help mitigate it. I’ll also share with you what a fussy baby looks like and give you unique strategies to calm your baby’s fussing, even if you don’t have a “fussy baby” per se.

By way of disclaimer, I am not a medical professional, licensed or otherwise, so absolutely consult with a physician about issues your baby is experiencing and trust your instincts.

Is Your Baby Colicky or Fussy? There is a Difference!

The Colicky Baby Defined

Before I get into the explanation for why it’s so critical to understand the difference between colic and fussiness, you need to know what that difference is. Let’s start by defining colic.

The wrong/incomplete definition for colic

Just about any Google result (and even some medical/academic journals) will tell you that a colicky baby is one who cries frequently or for prolonged periods of time even though otherwise healthy. Well sure, that’s true, but it doesn’t give you the full picture. Yet, that’s where the explanation all too often stops, leaving parents with the impression that a baby who cries “too much” should be labeled as colicky.

What colic actually is

If you search “colic definition” as opposed to “colicky baby” in your search engine, you will get startlingly different results. Or at least, I did. When you search for colicky baby, your browser brings up the standard “healthy baby who cries a lot” answer.

Even the Mayo Clinic says, “Colic is frequent, prolonged and intense crying or fussiness in a healthy infant.” No. That is a symptom or result of colic. It is an indicator of colic, not colic itself. Colic is not just prolonged or intense crying. If that’s the case, I get colic watching Grey’s Anatomy.

Colic is pain. The very word colic is derived from the Greek word kolikos, meaning suffering in the colon. The dictionary definition of colic is:

“Severe, often fluctuating pain in the abdomen caused by intestinal gas or obstruction in the intestines and suffered especially by babies.”

from the Lexico Oxford Dictionary

A colicky baby is a hurting baby. The reason for “prolonged, intense crying” isn’t unknown as so many outdated sources cite. The cause is medical: it’s pain.

While colic is not a specific diagnosis of a singular condition, it is a medical problem, not just an undesirable behavior.

How can you tell if a baby has colic?

Wondering if your baby has colic? Practically any parent with a truly colicky baby can tell you: You don’t have to wonder. When a baby is in the type of excruciating pain caused by colic, there is no doubt your baby is hurting.

Here are a few definitive signs your baby has colic:

  • Your baby won’t be calmed or soothed by even your best efforts/doesn’t respond to attachment parenting
  • Your baby suffers through obvious “attacks” of pain or spasms
  • Your baby arches and stiffens through the attack
  • Your baby shrieks and screams far beyond the intensity of normal crying
  • Your baby pulls his knees up toward his chest/tummy
  • Your baby wakes up in pain
  • Crying spells are not limited to the evening or “witching hour” (they occur during the night as well)
  • Your instincts tell you your baby is in physical pain

Possible causes of colic

Until fairly recently, doctors had no idea what caused colic, or why babies could scream violently without comfort.

Some schools of thought (around the mid-twentieth century or so) even believed that colic was caused by a mother’s over-handling (i.e. holding a baby too much) and that colic could be reduced if “over-anxious” mothers were properly educated on infant care (translate: trained to harden their hearts the their babies cries).

We know now (and many instinctive mothers knew even then) that such an explanation is preposterous. Colic is not a result of spoiling.

The traditional understanding of colic is that it is pain caused by a kink or spasm in the intestine, but the reason itself is unknown, or at least, not directly related to one single cause.

While colic is not an exclusive diagnosis, there are a few specific medical causes that could be behind colic or cause colic-like symptoms.

Spasms or kinks in the intestines

For quite some time, physicians and researchers have recognized gut problems as the common denominator in colic, and early on, identified the occurrence intestinal spasms and/or kinks. These may or may not be related to gas, depending on the baby, but they are very likely causes behind a baby’s painful crying.

Food sensitivities or allergies

Extensive research has been done over the last several decades as to whether colic is directly related to food allergies or sensitivities, with most of the focus being on lactose. If you and/or your pediatrician suspect a certain food or food group as the culprit, experiment with your own diet (if breastfeeding) or try using a different infant formula (if formula fed or supplemented). (Do note that many formulas use soy as the alternative to dairy, and soy can have long term negative health consequences for your baby).

GERD (reflux)

GERD stands for gastroesophogeal reflux disease. Reflux is when acids from the stomach back up into the throat and cause an uncomfortable, burning sensation or pain in the chest. You might have experienced something similar during pregnancy.

Unlike the more general term colic, GERD is a specific diagnosis, and has more symptoms than just those associated with colic. Since this isn’t an article devoted to GERD, I won’t go into much more detail for this post, so if you think your baby could have reflux, definitely Google the symptoms and talk to your child’s doctor about it. If your baby has GERD, you will need to make certain changes to ensure your baby’s health and safety.

Gas

A common misconception is that colic/colic-related symptoms are caused by gas, yet the vast majority of babies are gassy while only 1 in 5 suffer from colic. However, it is possible that colic symptoms for some babies could be from gas. Specifically, if a breastfeeding mother has a strong, overactive letdown, a baby may take in too much air trying to keep up with the flow of milk. It should be noted, though, that isolated cases of discomfort caused by gas to not a colicky baby make.

Hypersensitivity/Sensory Processing Disorder

Babies who are hypersensitive to stimulation or have Sensory Processing Disorder may exhibit colic-like symptoms as well. Before attempting more involved changes like diet adjustments or switching formulas, you might want to try reducing stimuli in your baby’s day-to-day routine and see if that helps. Such stimuli may include:

  • Light
  • Scratchy/irritating clothing (even taggies in clothing)
  • Noise
  • Disorganization/mess/clutter

If you suspect or are concerned about Sensory Processing Disorder, it’s definitely something to bring up with your pediatrician as it may warrant additional treatment through directed therapies (later on).

The Fussy Baby Defined

Fussy babies are known for being more temperamental and demanding than their laid back, happy-go-lucky counterparts. A kinder label for such infants is “high-need.”

I’ve written an entire post on the profile of a high-need baby, so I will give you a brief(er) synopsis in this article, and you can go check out that post for more detail.

Here are some of the most common qualities of a high-need/fussy baby:

  • Can’t be put down
  • Goes to sleep with difficulty and wakes up too easily
  • Constantly needs physical contact, but may not be cuddly/affectionate
  • Won’t self-soothe
  • Fussy throughout the day, not just during a distinct “witching hour”
  • Wants to feed ALL. THE. TIME.
  • Sensitive to separation from primary caregivers
  • Constantly active (even during feeds)
  • Exhibits a strong personality (and willpower)
  • Difficult to please/particular/needs things just so
  • Easily angered and prone to tantrums
  • Observant/clever/alert/sensitive
  • Has a knowing/intelligent expression

Think of high-need babies as the go-getters of the baby world. Other babies might have the same desires, but don’t work as hard to communicate them, or will settle for alternative solutions. Not your high-need baby! They know exactly what they want and they will “communicate” those needs to you with painstaking persistence.

Because of this, they are often confused with colicky babies because they tend to cry a lot more than babies are “supposed” to. The main difference is, these babies do not only fuss from physical pain, although a high-need baby absolutely could suffer from colic on top of her neediness. A baby could even develop a more high-need personality because of colic.

Again, if you want to know more about high-need/fussy babies in detail, I’ve written extensively on it in my Profile of a High-Need Baby, so definitely check that out. Besides describing high-need babies, I also discuss the ramifications for moms and the things you can do make your life a heck of a lot easier living with a high-need baby.

The Important Distinction Between Colicky and Fussy

Now that you know the difference between a colicky baby and a so-called “fussy” or high-needs baby, you still might be wondering…What’s the big deal if I call a fussy baby colicky, or vice versa?

Let me share with you 4 huge reasons why it’s imperative we keep our labels straight:

1. Using “colicky” as a general catch-all term for crying means we don’t look for a medical cause

When we consider colicky babies little more than fussing babies, we forget that colicky babies are hurting babies. If we believe colic is no more than “prolonged, intense crying in an otherwise healthy baby,” our best hope is to abide it and try to ignore it until the infant seems to age out of the condition. We have little motivation to search for an answer–a medical explanation–if we believe there isn’t one.

If your instincts tell you your baby is hurting, don’t stop searching for an answer. You are your baby’s best advocate.

2. Colicky and fussy babies have distinct needs that aren’t met when grouped together

Unlike a high-need baby, a colicky baby is in significant physical pain, and simply hoping to wait it out without responding appropriately to the baby’s discomfort is a great disservice to an agonized baby. While we can’t always cure colic or even truly treat it, the way we respond to a baby we know is in pain, from our handling to our tone of voice to our daily routines, will be very different than if we are led to think our babies are crying for the sheer sake of it, or to manipulate us.

Even if we can’t make the colic go away, there are things we can do to help lessen the discomfort (which I’ll go over later). By the same token, there are also many steps we can take to help lessen a high-need baby’s fussiness. However, the tactics for one may not work to help the other. Some of these strategies are specific to helping a colicky baby, while others may work for a fussy baby, but not a hurting one.

Knowing the difference between colic and high-need is critical to applying the proper response to each type of baby and their unique needs.

3. Considering colicky and fussy babies one-and-the-same impacts our attitude towards our babies

Similar to the way that our understanding affects our outward responses toward our babies, it also impacts our inward feelings. If I believe that my baby is screaming just to hear his own voice, or fussing to manipulate me into doing his bidding, then I am likely to be much more tense in my interactions with my child and far less merciful.

On the other hand, recognizing a baby that is in physical pain for whatever reason is more likely to soften our hearts to their plight and cause us to react in gentleness and patience.

All babies deserve our compassion and attentiveness, but it can be particularly helpful to our mindset to know which cries are from emotional or physical needs and which cries are because of pain.

4. Incorrectly applying the label “colic” leaves parents under-informed and does not educate them to the needs of their child

I firmly believe that parents should seek to educate themselves thoroughly on as many topics relating to their children as absolutely possible, and I believe that physicians should provide as extensive and accurate information as a consultation allows.

“Colic” as a term for fussiness or crying does not serve anyone’s needs: not the baby’s need, nor the parents’. In order to best support and further the relationship between parent and child, parents need to accurately understand what’s going on with their babies. Lazily or ignorantly misdefining or misapplying colic only confuses a sensitive issue in the formative months of a fresh bond between parent and infant.

How to Help a Colicky Baby

Shift your mindset

Even if you do nothing else for your colicky baby, the best thing you can do is to shift your mindset from “fussy” to “hurting.” When your baby’s shrieking shreds your very last nerves, which it will, this will help you to remain merciful by remembering why your baby is crying. It will also help you to remain firm in seeking answers with your infant’s pediatrician because you know that inconsolable crying is not normal: there is a medical reason.

Prone position + gentle pressure

When your baby is suffering from an attack, it may help to ease the discomfort by placing your baby in a prone position that applies gentle pressure to his tummy/gut/abdomen.

My high-need baby was not colicky per se, but I could tell when her fussiness was from physical discomfort rather than one of her many other needs. One position that helped her was if I reclined longways on the couch with my knees at an angle (feet still on the couch) and leaned her over my knees. While she was in this position, I would rub her lower back and sides, and it would usually help her to stop crying.

Another great position to put pressure on a hurting tummy is the football carry. With your baby horizontally facing the floor, carry him on your forearm with his face at the crook of your elbow. If my description isn’t clear to you, you can also just Google ‘baby football hold.’

Shower or bathe together

The worst part about this trick is that you can’t stay in the bath or shower the entire day. Otherwise, this one is a lifesaver for both colicky and fussy babies. The heat is very soothing and relaxing for mom and baby alike.

Whenever I was at my wit’s end, I took a shower with my baby and it worked 100% of the time. Now again, mind you, my baby wasn’t colicky, but this trick worked like magic even at her fussiest and most uncomfortable. She even went to sleep almost every time. My personal secret (which I don’t keep secret at all) is that I ordered a special ring sling to be able to babywear in the shower.

Knees-to-tummy positions (colic hold, kangaroo carry)

If your baby is colicky, you may find her pulling her knees up toward her stomach on her own to try and ease the discomfort. Holding, carrying, or wearing your baby in a similar position can help. There are a couple of ways you can do this.

One is the colic hold. Set your baby facing outward on your arm like it’s a chair with your body supporting her back. Let her bum slide down so that she’s slouched against you, and her knees are about even with her tummy. You can walk around, bounce, or dance with Baby in this position. If it doesn’t seem to help, or she doesn’t like it, by all means, try something else.

To free up your hands, you can also place Baby in the “kangaroo carry” position in your ring sling. Here is a helpful tutorial from WildBird Ring Slings on how to correctly place your baby in this position. Note that you should already be familiar with using a ring sling before attempting.

Bicycle legs

For this trick, lay your baby on his back with his feet up in the air, bum toward you. This could be in your lap, or on a soft surface in front of you. Holding his feet, pedal his legs slowly as if he’s riding a tiny, upside down bicycle.

I L U massage

Picture your baby’s large intestine as a large upside down U. Beginning with your baby’s left side (your right side), massage a single downward stroke as though writing an “I.” Next, massage an upside down “L,” retracing the path of your previous I on the downstroke. Finally, draw an upside down letter U, beginning on the baby’s right side and ending on the left.

Again, if you’re not sure what this looks like, you can Google “I L U baby massage” and find both images and video instructions.

Reduce stimulation

When you’re feeling sick or in pain, you don’t want to be sitting somewhere busy, crowded, noisy, or brightly lit, do you? Neither does your baby. Even if you can’t make your baby’s pain go away, you can do a lot to help by reduing excess stimulation. Keep to calm his environment, speak in a slow, calm, quiet voice, dim lights/lower window shades, etc. Processing a barrage of stimuli on top of pain is a lot to ask of anyone, let alone a baby.

Experiment with diet

While not the case for every colicky baby, food sensitivities or allergies could be contributing to or causing your baby’s physical discomfort, one of the biggest known culprits being lactose. For breastfed babies, you can experiment with eliminating dairy/lactose from your own diet, and for bottle fed/supplemented babies, you can try a different formula. If this change doesn’t help over time, it could be a different food or ingredient causing problems, or it might not be a food issue at all. Work with your pediatrician to try and figure out if an elimination diet is the right course of action.

Collect evidence for the doctor

We mamas tend to downplay our babies’ symptoms, whether consciously or subconsciously believing that our babies’ crying is a direct reflection on our parenting abilities. However, this doesn’t help the pediatrician properly evaluate our babies, or find the answers we’re so desperately looking for.

To help give your child’s doctor an accurate accounting of symptoms, begin a colic journal where you record your impression of the symptoms in the moment (or shortly thereafter), as well as details like the times of day attacks occur, how long they last, and anything that might have precipitated the attacks. You should also take video of your baby in the midst of an attack since it might not conveniently happen during your short consultation at the doctor’s office.

Listen to your intuition

Finally, listen to your intuition. If your gut says something is wrong in your baby’s gut, then investigate. If your instincts say your baby is hurting, don’t ignore it or write it off as paranoia.

A great resource I recommend to help you evaluate your baby’s symptoms is “The Portable Pediatrician,” from the Sears Family. This book is an alphabetical, encyclopedia-style reference guide on the most common conditions, topics, and symptoms that could affect your child from birth through the teen years.

How to Help a Fussy Baby

A fussy baby, better termed a “high-need baby,” fusses for a multitude of reasons other than recurrent/chronic pain. (Unless that high-need baby is ALSO a colicky baby, of course.) And while a fussy baby might not be suffering physical pains, their needs are just as legitimate.

Soothing tricks

Meeting the endless needs of a high-need baby can be overwhelming, exhausting, and all consuming…so much so, I wrote an entire post on the top nine ways I soothed my fussy baby. These aren’t your typical tips, the strategies that you’ve read on 17 other blogs. These tricks are not only tried and true, but also unique.

The best part is, you don’t have to have a full-on “high-need baby” to use these tactics; they can help any fussing baby. If you want all of the details, definitely check out the full post, but if you want a shortcut, you can get all 9 tips wrapped up in a pink and blue printable straight to your inbox.

how to soothe a fussy baby
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If you’re not sure whether you have a high-need baby, here’s the super thorough post I wrote on the profile of a high-need baby, which should help you figure things out.

Attachment parenting

In addition to specific soothing tactics I mentioned above, many moms have found that fussy/high-need babies (and their frazzled mamas) greatly benefit from attachment parenting principles. Even if you’re not interested in being an “attachment parent” per se, learning and applying some of these principles can really save your butt and give you both some much needed relief.

Some of those strategies are:

  • Babywearing
  • Responsive parenting (believing that baby’s cries signal legitimate needs)
  • Nursing on-demand
  • A lifestyle that promotes and prioritizes a strong parent-baby bond
  • Cosleeping

I would highly discourage you from any methods which either promise a “quick fix” or require Baby to work out his issues on his own. Your high-need or fussy baby doesn’t need training; he needs a responsive parent. I want to reassure you that responding to and meeting your baby’s needs, even if there seem to be way too many of them, will not spoil your baby.

Final Thoughts on Colicky vs. Fussy Babies

I believe with 100% of my being that whatever kind of baby you’ve found yourself with is a blessing. When our babies cry frequently or for extended periods of time, it’s really easy to wonder, “Why does my baby hate me?” “What am I doing wrong?” or feel like we’ve been cursed with a fire-breathing dragon when Monica Jones at church has such an angel (and a great sleeper! she lets everyone know).

One, your baby doesn’t hate you, two, you probably aren’t doing anything significantly wrong, and three, in no universe is your precious infant a curse (we’ll revisit the issue during toddlerhood).

Remember to trust your instincts on whether your baby is in physical pain, or fussing for a different reason, and if you suspect a medical issue, don’t hesitate to pursue it. Our mom genes know a thing or two.

And now that you know the REAL meaning of colicky and fussy baby labels, you’ll be able to help correct the misunderstanding that these distinct issues are one and the same.

Tell me in the comments…do you have a colicky or fussy baby? Or BOTH? What has your experience been?

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