Is it colic, reflux, or just crying?
Every new parent has stood over a crying baby at two in the morning wondering what is actually wrong. Here is how to think about it clearly enough to know what to watch and when to call someone.
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I am a therapist, not a pediatrician.
Nothing on this page diagnoses anything, and it is not a substitute for your child's doctor. What I can help with is the part nobody else addresses: how to observe usefully, what to write down, how to be taken seriously at an appointment, and how two exhausted parents get through it without turning on each other.
Call your pediatrician today, not after reading more, if there is fever, vomiting that is forceful or green, blood in stool, poor weight gain, fewer wet diapers, floppiness, or a cry that sounds different from the usual one.
How to think about it
Work through it in this order.
The goal is not a diagnosis. It is a clear enough picture that your doctor can give you one.
Write down the pattern, not the incidents
When does it start, how long does it last, what is happening just before, what helps even slightly, and what time of day is worst. Three days of notes is worth more than three weeks of worrying, and it is the single most useful thing you can bring to an appointment. Memory at four in the morning is not reliable, and yours is being asked to do too much.
Know roughly what distinguishes the common explanations
Ordinary newborn crying tends to peak around six weeks and cluster in the evening. Colic is usually described as prolonged, intense crying in an otherwise healthy, well-fed baby. Reflux is often associated with spit-up, discomfort during or after feeds, and a baby who seems happier upright than lying flat. These overlap, and telling them apart is your doctor's job, knowing what to report is yours.
Check the feeding side before you change anything
Position, pace, latch, burping, how much and how often. A great deal of newborn distress traces back to feeding mechanics rather than to anything wrong with the baby. If you are breastfeeding, a lactation consultant is often more useful here than anyone else. If you are formula feeding, do not switch formulas on your own theory, ask first.
Take the pattern to your pediatrician, and ask directly
Bring your notes. Ask: what do you think this is, what should I watch for, what would change your mind, and when should I come back. Those four questions turn a rushed appointment into a plan. If you feel dismissed and your instinct says something is wrong, ask again or ask someone else, that is not being difficult.
Look after the two adults
This is the part I actually do. Sustained infant crying is one of the most destabilizing things a new family goes through: sleep deprivation, guilt, the conviction that everyone else finds this easier, and two people blaming themselves and occasionally each other. Shifts, a plan for the worst hour, and someone to put the baby down and walk away to, none of that is indulgent. It is what keeps everyone safe.
Exhausted and not sure what you're even looking at?
One hour, and you will leave with a pattern log, the questions for your pediatrician, and a plan for the hardest part of the day.
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The whole system is written down.
Every tool used on a call comes from these. You can do this yourself with the book, or do it with me on a call.
Questions
Newborn crying, common questions.
How can I tell colic from reflux?
Only your pediatrician can tell you, but the descriptions differ: colic is typically prolonged, intense crying in a baby who is otherwise healthy and feeding well, while reflux is more often associated with spit-up, discomfort during or after feeds, and a baby who settles better upright than lying flat. The two overlap, and plenty of babies have neither. What helps your doctor most is a written record of when the crying happens and what surrounds it.
When should I call the doctor about a crying baby?
Straight away for fever, forceful or green vomiting, blood in the stool, poor weight gain, fewer wet diapers, unusual floppiness or a cry that sounds different from normal. Also call if you are frightened, or if you have reached the point of feeling you cannot cope, that is a legitimate reason to ask for help and clinicians would far rather hear from you.
Should I switch formula?
Ask your pediatrician before you do. Parents frequently change formula several times on their own theory, which makes it very hard for anyone to work out what is happening, and most switches are not what resolves it. If a genuine sensitivity is suspected, your doctor will tell you what to try and what to watch for.
Is it normal to feel this overwhelmed?
Yes, and it is extremely common, sustained infant crying is genuinely one of the harder things new parents go through. If the feeling persists beyond the hard hours, or you are struggling to feel much of anything, that is worth raising with your own doctor as well as your baby's. Postpartum mental health is treatable and taken seriously, and asking is not an admission of anything.
What if I feel like I might lose my temper with the baby?
Put the baby somewhere safe, like a crib, leave the room, and take a few minutes. That is the correct response, not a failure. Then call someone, a partner, a friend, your doctor. Every experienced parent has been closer to that edge than they say out loud, and never shaking a baby matters more than anything else on this page.
One call. For the part the pediatrician doesn't cover.
The observing, the questions, the shift plan, and the two adults holding it together.
Book the callTammy Gold, LCSW · Licensed clinical social worker · Columbia University MSW · Coaching and consulting only. Not therapy, legal advice or tax advice. Employment, wage and tax rules vary by state, confirm yours with a qualified professional.