Saturday, June 14, 2008

Chiropractic and Colic

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Chiropractic and Colic




Picture: Chiropractic adjustment at six hours old.

Colic: Chiropractic can help

Colic is defined as an unexplainable and uncontrollable crying in babies from 0 to 3 months old, more than 3 hours a day, more than 3 days a week, for 3 weeks or more, usually in the afternoon and evening hours. The incidence is thought to be about 22.5%. Colic places babies at a high risk for child abuse, including CNS damage or death from shaken baby syndrome.

A recent study in the Journal of Manipulative and Physiologic Therapeutics (1) has concluded, "Spinal manipulation is effective in relieving infantile colic". For a period of two weeks, half of the subjects underwent chiropractic spinal manipulation, while the other half received the drug dimethicone. All of the adjusted babies stayed in the study, while only 64% of the dimethicone babies completed the two-week study. In the course of the study, the children being adjusted saw a 67% reduction in crying and the drug therapy group saw only a 38% reduction in crying. The mean number of adjustments given during the two-week study was 3.8.

One might question the effect of the dropouts from the drug group. The authors commented on this as follows: "By excluding data from the dropouts, we are excluding more severe cases from the dimethicone group, and this has the effect of making that group appear better than it actually was. Thus we are introducing a serious bias against showing a positive effect of spinal manipulation, and despite this, the manipulation group did significantly better."

The findings of this report echo the results of another recent report entitled "The efficacy of chiropractic spinal adjustments ments as a treatment protocol in the management of infantile colic" by Mercer and Cook of South Africa.

Thirty infants from the general public between the ages of 0-8 weeks were randomly divided into two treatment groups. All participating infants were diagnosed as suffering from infantile colic by pediatrician before inclusion into the study. The infants were allocated into the placebo or the experimental group according to the random sampling technique.

The results obtained from the study demonstrated a significant difference in the response to treatment by the experimental group as opposed to the control group. Complete resolution of symptoms was found by 93% of the infants within the two-week treatment period with a maximum of six treatments. In addition, no recurrence of the infantile colic was observed in any experimental infant between cessation of treatment and the follow-up interview one month later.

Similar results have also been found in a study of 316 children where a satisfactory result occurred within 2 weeks in 94% of the cases receiving chiropractic care. 51% of these infants had prior, unsuccessful treatment, usually drug therapy (83%). (2) In yet another study of 132 infant's with colic, 91% of the parents reported an improvement, which occurred after an average of two to three manipulations, and one week after the treatment started. (3)

References:

1. Wiberg JMM, Nordsteen J, Nilsson N. The Short-Term Effect of Spinal Manipulation in the Treatment of Infantile Colic: A Randomized Controlled Clinical Trial with a Blinded Observer J Manipulative Physiol Ther 1999 (Oct); 22 (8): 517-522

2. Klougart N, Nilsson N, Jacobsen J Infantile Colic Treated by Chiropractors: A Prospective Study of 316 Cases J Manipulative Physiol Ther 1989 (Aug); 12 (4): 281-8

3. Nilsson N Infant Colic and Chiropractic Eur J Chiropr 1985; 33 (4): 264-265

ICPA4KIDS.org To find more information about how chiropractic can be beneficial to your child visit icpa4kids.org.Click here for more information on Chiropractic and Colic.

By Peter N. Fysh, DC

Infantile Colic
Sally was concerned. Her new two month old baby son, Brendan, did not seem to be the normal, happy, and contented baby that she had hoped for. He cried a lot; sometimes for six or seven hours each day and it seemed that nothing Sally did to comfort him would help. She had tried feeding him, changing his diaper, cuddling and rocking him, putting him to bed, but nothing seemed to help.
When Sally took her baby to the pediatrician, the problem was identified as infantile colic, a problem common to newborns in the first few months of life. Sally was advised to watch her diet, as she was breast-feeding Brendan, to avoid rich and spicy foods and to burp him regularly during feeding. This she did as advised but still her baby continued to cry for hours each day. Sally and her husband Bob were getting little sleep and the whole house was affected by the baby's condition.

When Bob visited his chiropractor on the way home from work one afternoon, for his regular spinal adjustment, he happened to mention their baby's plight to the doctor. "Why don't you bring Brendan in and let me evaluate his spine," said the doctor. "His colic may be related to a problem in his spine." At this point, Bob and Sally were looking for any alternative to help their baby.

The following day Sally took her baby to the chiropractor to have his spine evaluated. The doctor evaluated Brendan's spine and found two areas which needed to be corrected. A couple of light, finger-tip adjustments and the job was done. "How could my baby have spinal problems at his young age," Sally asked. "Well," said the chiropractor, "it can often be the trauma from a difficult birth, a long labor or perhaps even the way we burp the baby or pick the baby up from the crib, that produces spinal problems at such a young age."

The following day, Brendan was somewhat better. Sally took him to the chiropractor again for a further adjustment, similar to the ones performed the previous day. Three days after Brendan's first spinal adjustment, Sally just couldn't believe how much her son had improved. He now slept like a baby, only cried when he was hungry or wet, and was once again the perfect baby that Sally knew he was. And Bob slept happily ever after.

What Is Colic?
Infantile colic is the term commonly used to describe an otherwise healthy infant who exhibits persistent, forceful crying for no apparent reason. The crying usually persists for several hours each day and is usually evident at least five days in each week. Parents' attempts to comfort the infant by holding and rocking the child, changing the diaper or by offering nourishment have little or no effect on the condition. The affected infant will have a tense, rumbling abdomen, with knees flexed, tight paraspinal musculature and will emit an excessive amount of gas. Occasionally the head and neck will be arched backwards.
Colic affects about 20 percent of all infants with symptoms most commonly occurring at one to four weeks of age and ending spontaneously at around three to four months. The cause of this condition has not been precisely determined, although many infants have been shown to respond well to chiropractic care.

Research studies into the effects of spinal adjustments for infants with colic have shown excellent results. The most significant study of this condition showed satisfactory improvement in over 90 percent of the infants who received chiropractic care.1

In this study, 316 infants with colic received spinal evaluations and were adjusted as necessary. Improvement was noted within a two week period in 94 percent of the infants treated, on average, after only three treatments.


Evaluation of the Infant's Spine
An infant's spinal evaluation involves examining the entire spine, from the upper cervical region down to the pelvis. The examination includes motion palpation of the spine, to detect areas of decreased movement of the spinal articulations (subluxations), as well as identification of areas of unilateral, asymmetrical muscle spasm.
In the previously referenced study, the findings of the 73 chiropractors involved showed the following:

All but six percent of the infants responded to the chiropractic treatments. Fifty-three percent of the infants responded to adjustment of the upper cervical vertebrae only. Forty-one percent required adjustment of the upper cervical area in addition to the mid-thoracic articulations (T4-T9), while the remaining six percent received adjustments in other regions of the spine (lower cervical, thoracolumbar, lumbosacral and sacroiliac articulations) or a combination of two or more of the above-mentioned areas.


Adjusting the Infant's Spine
The chiropractic treatment of a young infant's spine differs from that which would be necessary for an adult. The infant's spine is more flexible, primarily due to ligament laxity. The immature spine also contains abundant cartilage which will eventually ossify into mature bone. This cartilage is quite strong and flexible, however the adjustive process is modified to ensure that only the lightest thrust is used to correct the subluxated segments. Not only is the force of the adjustment greatly decreased, the contact is usually only lightly applied with the finger tips and the thrust, if used at all, is very modest. The sound of the spine being adjusted, usually heard as a "crack" or "pop" in the adult spine, is frequently absent when adjusting the spine of a young infant. Babies usually tolerate spinal evaluation and adjusting quite well, with no more discomfort than that caused by a physical examination.

Results
The rapid improvement seen after adjusting the spine of an infant with colic suggests that the spine is intimately involved with the digestive process. Research in this field, called the somatogastric reflex, has been developing over the past 15 to 20 years, however, the exact mechanism of involvement of the spine with colic is yet to be determined.
References

Klougart N, Nilsson N, and Jacobsen J: Infantile colic treated by chiropractors: a prospective study of 316 cases. JMPT, August 1989, Vol 12;4.
Peter N. Fysh, DC
San Jose, California

Editor's Note:

Dr. Fysh is currently conducting pediatric seminars. He may be contacted at (408) 720-8042.

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