Diagnostic Criteria for Infantile Colic (Intestinal Spasms) Infants from birth to 4 months of age must include all of the following: 1. Episodes of irritability, panic, or crying that start or stop without an obvious trigger; 2. Episodes lasting 3 hours or more per day, with at least 1 week of episodes occurring on all 3 days. 3. No growth retardation. Clinical evaluation of infantile colic Colicky crying is due to organic disease in less than 10% of cases. Persistent, extreme crying, postprandial crying with odd facial features, bloating, flushing, and body curls are not suggestive of pain or disease. The diagnosis of infantile colic is made if the crying of an infant under 4 to 5 months of age exhibits features of infantile colic-like transience, there are no central nervous system or intrinsic developmental problems, and the physical examination is normal, as is growth. Comforting methods, such as placing the child in a rocking bed in a quiet environment and rhythmically rocking and tapping the child 2 to 3 times per second can quiet the child. Common methods that do not stop the pain but do stop the crying (e.g., going for a drive) have diagnostic and therapeutic value. If milk intolerance or esophagitis is suspected, experimental treatments such as hydrolyzed protein formula or medications that inhibit gastric acid secretion are appropriate, but symptoms usually resolve within 48 hours. Progression and prognosis of infantile colic tends to improve spontaneously after 3 to 4 months, whereas in those born prematurely, it does not resolve until 3 to 4 months after the age of full term. In general, infantile colic has its peak attack at 6 weeks after birth and decreases at 12 weeks after birth.