‘Infantile Colic’

So much has been written about ‘infantile colic’ recently and there are so many so-called ‘cures’ available that it must be totally bewildering for parents of newborns that are crying persistently or distressed.

In our practice, with the help of a referring GP and the practice Health Visitors we have discussed the syndrome at length and have come up with the following definition. This is nothing new, and I feel churlish having to redirect you to our legal page at this point, but we thought it might just help disspell some of the myths out there surrounding colic.

‘Colic’ in infants (<6 months old) could be described as a collection of simple symptoms, (such as abdominal discomfort, increased hiccups, difficulty winding and flatulence) which is possibly caused by something as simple as a hypertonic thoracic diaphragm. In the absence of pathology and with medically qualified clinical leadership, simple musculoskeletal, short-term management of the hypertonic diaphragm using inhibition and a suitable feeding/winding/exercise regime might resolve the condition, although for this there is no evidence whatsoever. There is no evidence to suggest that ‘Colic’ is caused by a disruption of any form of neurovascular tissue, subluxation, lesion or allergy.

Hardly groundbreaking stuff. However, it’s a starting point and hopefully will promote discussion as we are really interested in people’s opinions. It would be very nice to hear from parents that have been through the ‘I have a collicky baby and I’m at the end of my tether’ as well as health professionals that either agree, disagree or something politely in between.

We are particularly interested in what evidence there is out there that people are using to base anything other than musculoskeletal treatment on. I’m not trying to offend – I just think that an enlightening debate is needed and this might help parents decide what is likely to help or not.

13 thoughts on “‘Infantile Colic’

  1. it’s great to see someone who works in the field finally taking a look at the evidence base for these practices, i hope to see thoughtful comments from other osteopaths / chiropractors soon, and will spread the word so that more of them are aware of this forum for debate.

    • A belated thank you, Ben for your comment. The original blog that this was posted on has been buried for the last 18 months so I am digging it up in the hope that I will get some proper debate started.

  2. Also this column in the Guardian by Oliver James is quite interesting re: colic. As a peer supporter for breastfeeding women, I’ve often seen these simple changes in feeding make a difference to babies described as ‘colicky’.

    Link

  3. Being a new dad and osteopath. I am also interested in the evidence. As far as I am aware there is one rather weak study from the ESO which shows some benefit from cranial ttt but is very underpowered and methodologically weak. Personally being on the receiving end of a whingy baby I can see why parents will try anything. I remain agnostic about crainial there seems to be vast amounts of anecdotal evidence for it but little else…

  4. Thank you for the comments so far – the post attracted many hits but still so few are willing to discuss this issue.

    I should clarify one point – by ‘exercise regime’ I’m referring to the use of simple traction techniques that parents perform to inhibit the diaphragm.

    JH

  5. Hello Jonathan I have also been a chiro for 20 years and have never seen a child under the age of 8 for chiro treatment let alone for colic. I’m not unusual I know of lots of chiros who have never treated a baby for colic. As usual the skeptics grab something and loudly shout ” OMG every chiro treats babies for colic with no evidence” I used gripe water when my children were young, not sure if there is any evidence for gripe water. I think fed up is fed up with something else, I know he was fed up many years ago!!

  6. Thank you, Liam.

    I’m trying to get debate going on lots of issues surrounding ‘physical’ therapy and evidence – on many fronts, actually – and I am failing miserably.

    By posting this, and discussing it with my colleagues in the NHS, I was merely trying to generate discussion on the topic although some have taken it as me advocating osteopathy as a treatment modality or, conversely, as me criticising others treating colic. I was doing neither, actually.

    I strongly believe that the ‘skeptics’ have a fair point about a great deal of what we do – I have taken the opportunity to engage with them but that has led to me being criticised within my profession. I have broad shoulders though!

    Spread the word – debate is good.

    Jonathan

    • Hi Jonathan, I love a debate! I have also engaged with the skeptics, but it’s a pointless exercise. They will always fall back on ” show me the evidence” and by evidence they mean gold standard RCTs which I can’t provide. They seem to dismiss all other forms of evidence, they only ever quote Prof Ernst, with whom I have debated many times. Blue wode has stated all chiro adjust the neck, cause stroke, all chiros treat colic etc etc. When I actually tweeted my working week proving that not all chiros work as his “evidence” suggests he blocked me, and said I was “twisting Things” I also am dismayed at the way some of my profession work and advertise themselves, but in the same way I can’t provide RCT’s I can’t stop some chiros from working.”

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