The Irritable Baby
Infantile colic is a common early childhood condition that affects approximately one in six infants and is characterised by ‘inconsolable crying and fussing in otherwise healthy thriving infants’1. There has never been agreement about how to diagnose colic due to the fact that there are many different clinical presentations. In view of these difficulties, it is preferred to use the term “Irritable Baby Syndrome” (IBS). There are numerous non-chiropractic treatments available, but most have been shown to be without effect, and most drug preparations have serious side effects. A common drug treatment still used is dicyclomine which helps reduce crying, but may have dangerous adverse effects.2
The cause of infantile colic still remains unknown, however there are several proposed theories which include: (1) gastrointestinal disorder; (2) cow’s milk protein or soy protein sensitivity; (3) infection. Babies are generally considered having “uncomplicated colic” if there is an absence of any other causative conditions. Therefore it is important that the baby has a full examination done by someone trained in paediatrics.
Cow’s milk protein sensitivity:
The clinical diagnosis of cow’s milk protein intolerance is made based on the presence of the “triad” of symptoms, which are: (1) Gastrointestinal disturbance, (2) Skin rash, (3) Respiratory ‘wet’ sounds. Common symptoms that are associated with cow’s milk protein intolerance include3:
- Gastrointestinal – Infant draws up their knees as if in pain and is often flatulent, bloating, chronic diarrhoea, constipation, or an alternating pattern of both
- Neurological – Disturbed sleep pattern with frequent waking and crying at night
- Respiratory – Crackles/wet sounds without obvious dyspnoea. Wheezing and rhinitis = snuffly breathing
- Skin – Maculopapular rash which can occur anywhere on the body. Most commonly found on the face, neck, buttocks or upper arms
Research behind Chiropractic care and colic:
There was a study conducted by Miller, Newell and Bolton in 20124 that looked into the efficacy of chiropractic manual therapy (CMT) for infants with unexplained crying behaviour. One hundred and four patients were randomised into two treatment groups; one that received CMT and one that received no treatment. The findings from this study demonstrated a greater decline in crying behaviour in the group that received CMT compared with the group that received no care. The researches further noticed that a majority of the participants that were placed in the group that did not receive treatment withdrew from this study as their child’s symptoms were not improving.
Other studies that have been conducted on the effectiveness of CMT for infantile colic include1, 4, 5:
- A British study in 2006 compared CMT with no treatment (not a blind study), which showed a drastic decline in crying behaviour in the CMT group
- A study conducted by Holm et al. (2018) looked at the effectiveness of chiropractic treatment and concluded that it may be unlikely to find one treatment that fits all due to the multifactorial aetiology of infantile colic.
- Another study found that infants who received manual therapy care had moderate reduction in crying, which approximated to 1 hour per day6.
- Holm, L.V., Jarbol, D.E., Christensen, H.W., Sondergaard, J., & Hestbaek, L. (2018). The effect of chiropractic treatment on infantile colic: study protocol for a single-blind randomized controlled trial. Chiropractic and Manual Therapies, 26(17), 1-9. https://doi.org/10.1186/s12998-018-0188-9
- Sung, V. (2018). Infantile Colic. Australian Prescriber, 41(4), 105-110. https://doi.org/10.18773/austprescr.2018.033
- Davies NJ. Chiropractic Pediatrics: A Clinical Handbook. Churchill-Livingstone. 2000
- Miller, J.E., Newell, D., & Bolton, J.E. (2012). Efficacy of chiropractic manual therapy on infant colic: pragmatic single-blind, randomized controlled trial. Journal of Manipulative and Physiological Therapeutics, 35(8), 600-607. https://doi.org/10.1016/j.jmpt.2012.09.010
- Ferrance, R.J., & Miller, J. (2010). Chiropractic diagnosis and management of non-musculoskeletal conditions in children and adolescents. Chiropractic and Osteopathy, 18(14), 1-8.
- Carnes, D., Plunkett, A., Ellwood, J., & Miles, C. (2018). Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analyses. BMJ open, 8(1), 1-14. https://doi.org/10.1136/bmjopen-2017-019040