Red flags & when to go in person for Colic (Infant) - Guidance

Audience: adult

Colic is common in infants and usually causes episodes of intense crying without an obvious cause. It often begins in the first few weeks of life and can be very distressing for both baby and caregivers. While colic typically improves on its own by 3 to 4 months of age, it is important for caregivers to recognize signs that need urgent medical attention. Telemedicine can help provide guidance on managing colic symptoms and support caregivers, but some situations require in-person evaluation to rule out other health issues. This guide helps adults understand when to seek immediate care and how telemedicine can assist with colic concerns.

Red flags — go in person / ER

• Infant has a fever above 38°C (100.4°F) especially if under 3 months old — seek immediate medical care.
• Persistent vomiting, especially if green or yellow, or blood in vomit or stool — go to emergency care.
• Baby is lethargic, difficult to wake, has trouble breathing, or shows bluish skin — seek urgent in-person evaluation.

What telemedicine can do

• Providing advice on soothing techniques for colic
• Answering caregiver questions about infant behavior
• Assessing symptoms to determine if urgent care is needed
• Supporting caregiver stress and concerns

What telemedicine cannot do

• Performing physical examinations
• Diagnosing underlying medical conditions
• Ordering or interpreting laboratory or imaging tests
• Treating serious illness or emergencies

What is Infant Colic?

Infant colic is frequent, prolonged crying in a healthy baby, usually starting within the first few weeks after birth. The crying often happens in the late afternoon or evening and may last for several hours. The exact cause is unknown, but it is not due to illness or poor parenting. Colic usually improves by 3 to 4 months of age.

Common Signs of Colic

Babies with colic may show:

These signs alone usually do not mean the baby is sick, but caregivers should watch closely.

When to Seek In-Person Care

Certain signs may indicate a more serious problem and need urgent medical evaluation:

If any of these occur, seek medical care promptly.

How Telemedicine Can Help

Telemedicine can provide:

However, telemedicine cannot perform physical exams or tests, so it cannot replace urgent in-person evaluation when red flags are present.

Tips for Managing Colic at Home

Caregivers may try:

Always consult a healthcare provider if unsure or concerned.

How to prepare for your tele-visit

• Have a list of the baby's symptoms and when they started
• Note any feeding or sleeping changes
• Prepare questions or concerns to discuss
• Ensure a quiet space for the tele-visit
• Have the baby's health records accessible if possible

After your tele-visit

• Follow the soothing and care advice given by the provider
• Monitor the baby's symptoms closely
• Seek in-person care if red flags develop
• Keep a record of any changes in symptoms
• Contact the provider again if symptoms worsen or new concerns arise

FAQs

What causes colic in infants?

The exact cause of colic is unknown. It may be related to digestive system development, sensitivity to stimulation, or temperament. It is not caused by poor parenting or illness.

How long does colic usually last?

Colic often starts within the first few weeks of life and typically improves by 3 to 4 months of age. The crying episodes usually become less frequent and less intense over time.

Can I prevent colic?

There is no sure way to prevent colic. Caregivers can try gentle soothing techniques and ensure proper feeding practices. If you have concerns, discuss them with your healthcare provider.

When should I worry about my baby's crying?

If your baby has signs like fever, vomiting, blood in stool, difficulty breathing, or is hard to wake, seek medical care promptly. Also, if the crying is very different from usual or you feel unable to cope, reach out for help.

Is telemedicine safe for managing colic?

Telemedicine can be a helpful way to get advice and support for colic. However, it cannot replace in-person exams when serious symptoms are present. Use telemedicine for guidance but seek urgent care if red flags appear.

Sources

1. Colic in Babies — MedlinePlus | U.S. National Library of Medicine.
2. Infant Colic — Mayo Clinic.
3. Crying and Colic in Infants — American Academy of Pediatrics.
4. Colic: Causes, Symptoms, and Treatment — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your infant shows any danger signs or you have urgent concerns, seek immediate medical attention.