Chiropractic Can Help A Baby with Colic
Thank you to Dr. Rodney White for providing this article. If you would like to learn more about Sarpy Chiropractic, please visit https://www.sarpychiro.com/.
Anytime a baby is upset, seemingly in pain, and crying inconsolably it will create heartache for the parents. The heartache becomes so much worse when it's happening consistently due to their baby suffering from infantile colic.
So what is infantile colic? The medical diagnosis of colic is given when a baby cries inconsolably for more than 3 hours a day; for 3 or more days a week; for at least 3 weeks (The 3/3/3 rule)
It affects up to 40% infants worldwide, peaks at 6 weeks and usually resolves by 3-6 months of age
It often causes physical and emotional stress for the parents and can regularly lead to marital or job disruption, and it is even linked to child abuse!
Possibly the most frustrating thing of all is that we don’t even know the true cause. Also frustrating is that medical interventions are generally ineffective.
A number of theories do exist as to why some kids experience colic, including: alterations in fecal microflora; lactose intolerance; maternal smoking; poor feeding techniques; and a whole variety of other combined causes. But the reality is we really don’t know why it happens.
Current medical treatment often involves various different medications, but the current systematic reviews in the literature show the outcomes of these medications to be no better than placebo (meaning that in the various studies conducted, the group of infants receiving an actual medication had no different outcome to the group that received the "sham" or control medication, which is usually a benign sugar pill).
There is some support in the literature that probiotics may be helpful for breastfed infants but may not be as useful in formula fed babies. Please note that from a clinical perspective we have often noted that many babies (both breastfed or formula fed) do improve when a good quality probiotic is used, but not enough research has been done on specific types to really test how effective it is for colic, but it's a very safe first step to try, in our opinion.
So the current primary medical treatment outside of prescribing medication is to offer parental reassurance that colic is relatively benign and that their child will likely grow out of it.
This answer isn’t a good enough solution for most parents so they start turning to alternative options like Chiropractic. And the good news? There’s a growing body of literature suggesting that Chiropractors can in fact help!
A 2011 article in the Journal Explore by Dr. Joel Alcantara reviewed the literature relating to Chiropractic and colic. They reviewed the 26 different pieces of literature that they could find, which included:
- 3 clinical trials
- 2 survey studies
- 6 case reports
- 2 case series
- 4 cohort studies
- 5 commentaries
- 4 literature reviews
From these 26 articles they were able to conclude that Chiropractic is both safe and effective for treating infantile colic. They did acknowledge that there were some design flaws in some of the studies, as is often the case in research.
A Cochrane review in 2012 looked at spinal manipulative therapy and colic. The Cochrane Reviews are widely considered the gold standard of systematic reviews. However, they are also notorious for excluding anything but Randomized Control Trials (or RCT's) and they tend to ignore a lot of results because of a perceived bias, meaning they’re very, very conservative.
In this Cochrane review the authors identified 6 studies that met their inclusion criteria. 5 suggested that spinal manipulative therapy was beneficial for infantile colic. The combination of all 6 studies combined showed a significant positive effect: an average decrease in crying time of 1 hour and 12 minutes per day.
These results were even sustained when they excluded studies where they felt a risk of performance bias, meaning the parents knew if their child was in the treatment group or control group (meaning there could be a risk of placebo effect).
By excluding all of those study results, there was still a reduction in crying of 35 minutes a day, but the reviewers concluded that it’s too significantly small a number to definitively declare whether manipulative therapy can help colic.
This review then often gets touted as proof that Chiropractic doesn’t work for colic by the naysayers. However, that’s not what the reviewers said at all. So if you hear that statement, know that it’s false! An absence of evidence does not mean evidence of absence.
The reviewers actually said there was insufficient evidence to make a conclusive opinion. While it must be acknowledged that the placebo effect can greatly determine research results when it's regarding someone's own pain, in our opinion it is far less likely that a parent will "imagine" that their baby is crying less purely because that's what they hope to see.
After this review, a great study was published in The Journal of Manipulative & Physiological Therapy (JMPT) in 2012 by Miller et al. They investigated the effect of Chiropractic on colic, but purposely set up the study so they could also measure whether the parents knowledge of the treatment actually did sway their opinion (so essentially removed any risk of the placebo effect).
This is important because it’s the main criticism from the Cochrane review and is why they excluded so many results that showed Chiropractic could help colic.
So the researchers performed a Randomized Control Trial. They had 104 babies who were 8 weeks old or younger present to the Chiropractic Teaching Clinic in the UK. They randomly put the babies into 3 groups:
Group 1. The babies received Chiropractic care and the parents knew their child was getting real treatments.
Group 2. The babies received Chiropractic care but the parents didn’t know whether their baby was getting a real treatment or was in the control group (or "fake" treatment group).
Group 3. The babies were part of the control group and therefore received fake treatment, but the parents didn’t know either way if they were receiving real Chiropractic care or not.
The babies were adjusted daily over a 10 day period and the parents completed a crying journal. The results were quite amazing!!
Both of groups 1 and 2 showed up to 3 hours less crying per day, and 10 days after the care still averaged 2 hours a day less. This is a massive improvement for stressed and frazzled parents who can't stand watching their babies cry uncontrollably for hours at a time. And most important was the fact that both Chiropractic treatment groups responded equally well regardless of whether the parents knew that they were actually receiving treatment or not.
This confirms and strengthens many previous studies (most of which were excluded by the Cochrane review) that show babies with colic respond very well to Chiropractic. It especially confirms that in those previous studies the babies were more likely responding to the Chiropractic care rather than a case of the parents “thinking” they were getting better (which was the main reason the Cochrane review excluded so many.)
This study also showed that after 10 days of Chiropractic care, excessively crying babies were almost 12 times as likely to cry significantly less than babies who did not receive Chiropractic care. So it’s very likely that Chiropractic care really does help babies who suffer from colic. The study also revealed that the babies adjusted by a Chiropractor had a 50% reduced crying time than babies not adjusted, or 1.5 hours less crying a day, on average.
Every study has some strengths and some limitations. The strengths of this study are it’s a Randomized Control Trial (the current gold standard in research) that took into account parental bias and therefore provides support for all of the other Chiropractic colic studies that didn’t necessarily exclude parental bias.
The limitations were that patients were discharged once they showed significant reduction in crying so if there was a relapse the researchers wouldn’t know when or how many relapsed; and it was only 10 days of Chiropractic care (sometimes that's not enough treatment time to really make an effect.)
Even better, the study was performed by student interns and they still were able to make a real difference to the families involved. Imagine then what a highly trained, experienced Pediatric Chiropractor could do for these babies suffering from infantile colic?!! This study shows that the positive effects of Chiropractic for colic are probably greatly under-documented, and in our opinion we would expect to see even better results in the real world when the babies are adjusted by highly trained and experienced Pediatric Chiropractors.
So what does this mean to you the reader? This study suggests that it’s VERY likely that chiropractic will helps babies suffering from infantile colic. Parents of children who suffer from colic should definitely consider getting their child checked by a Chiropractor, preferably one who is highly trained in treating the pediatric population, because it could really make a difference to your child and your entire family, and it continues to be proven to be both a safe and effective option.
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