Baby Pulling Legs Up and Screaming

When to get help

Call emergency services or go straight to an emergency department — 999 in the UK, 112 or 999 in Ireland and across the EU, 911 in the US and Canada, 000 in Australia, 111 in New Zealand — if your baby's crying comes in waves with any of these:

• Episodes of intense screaming with the knees drawn up, coming and going roughly every 15 to 20 minutes, with your baby unusually pale, floppy, quiet or drowsy in between.
• Vomiting, especially if the vomit is green.
• A nappy containing blood, or a dark red jelly-like mucus sometimes described as redcurrant jelly.
• A swollen, hard or very tender tummy, or a lump you can feel in the tummy.
• A lump or bulge in the groin or scrotum that is firm, tender, or will not go back in.

Seek urgent same-day advice — NHS 111 in the UK, your GP or out-of-hours service in Ireland, your paediatrician in the US or Canada, healthdirect on 1800 022 222 in Australia, Healthline on 0800 611 116 in New Zealand — if your baby has an inconsolable cry that is not their usual cry, a fever alongside the crying, is refusing feeds, has fewer wet nappies than usual, or if you have been told this is colic but something about it does not feel the same as before.

Why leg-pulling on its own tells you almost nothing

Babies draw their knees up when they cry. They do it with wind, with a dirty nappy on the way, when overtired, when overstimulated, and when they are simply crying hard, because flexing at the hips is what a small body does under tension. It is one of the least specific signs in the first year, and building a diagnosis on it alone leads parents in circles.

What carries information is everything around it: the shape of the crying over an hour, what your baby is like between episodes, what is in the nappy, whether there is vomiting, and whether feeding has changed.

The colic pattern

Colic is intense, prolonged crying in a baby who is otherwise healthy, feeding and growing. It typically starts in the first weeks, peaks around six to eight weeks, and settles by three to four months. The crying often clusters in the late afternoon and evening, the baby is hard to console, the face reddens, the legs pull up and the fists clench.

The defining feature is what happens between the bouts: a baby with colic looks well, feeds, has normal nappies, and is alert and interactive when not crying. That is the single most useful distinction on this page.

The pattern that is not colic

Intussusception is when one part of the bowel slides inside the next, like the sections of a telescope. Great Ormond Street Hospital describes it as most common in babies and young children, with episodes of severe tummy pain during which a child draws the knees up and screams, separated by periods in which they may seem unusually quiet, pale or sleepy.

Three things separate it from colic. The rhythm: episodes arrive in waves, often every 15 to 20 minutes, rather than as one long stretch of crying. The state in between: a baby with colic is alert between bouts, while a baby with intussusception often looks drained, pale or floppy. And the extras: vomiting, which may become green as the blockage develops, and eventually blood and mucus in the stool, which is where the redcurrant jelly description comes from.

The redcurrant jelly stool is a late sign, not an early one. Do not wait for it. The wave pattern plus a baby who is not themselves between waves is enough to go on.

Treatment is often non-surgical if it is caught early: an air enema, done under X-ray guidance, can push the bowel back into place. Delay makes surgery more likely, which is the practical reason this page is not written calmly.

The groin is worth a look

A trapped inguinal hernia is another cause of screaming in bouts with vomiting, and it is easy to find if you look. Undress your baby and check both sides of the groin and, in a boy, the scrotum, for a bulge. A hernia that comes and goes and is soft is usually a routine referral. A bulge that is firm, tender, red or will not disappear when your baby is calm and lying down is an emergency, because the trapped bowel loses its blood supply.

Wind, straining and the ordinary explanations

Most babies who pull their legs up have something entirely mundane going on. Trapped wind responds to upright winding, a change of feeding position, slower feeding with pauses, and time. Straining to pass a soft stool, with grunting and a red face, is normal in the early months and is not constipation — NICE guidance on constipation in children turns on hard, painful stools and infrequent passage, not on effort. In babies who have started solids, a change of diet often shows up as a few uncomfortable days.

Cows' milk protein allergy is worth raising with a clinician if the crying comes with eczema, frequent vomiting, blood or mucus in the stools, or poor weight gain. It is a discussion about a proper diagnosis, not a reason to change formula on your own.

What to do while you work it out

Hold your baby upright against your chest, try skin-to-skin, and move — walking, rocking or a sling settles many babies who will not settle lying down. Offer a feed, since hunger and comfort overlap in the first months. Wind thoroughly and unhurriedly. Keep the room quiet and dim in the evening cluster hours.

Do not give gripe water or colic drops to a young baby without checking with a pharmacist which products are suitable for the age, and do not give any medicine intended for adults. If you are at the end of your patience, put your baby down somewhere safe, walk out of the room, breathe, and come back. That is a recognised piece of safety advice, not a failure.

When to go back

Go back if the crying changes character, if your baby becomes quiet and floppy rather than furious, if vomiting starts or turns green, if there is blood in the nappy, or if you were told colic and the pattern no longer fits. Being seen twice for the same thing is normal and expected in the first year.