Abstract
BackgroundChiropractic care is commonly used to treat infantile colic. However large trials with parental blinding are missing. Therefore, the purpose of this study is to evaluate the effect of chiropractic care on infantile colic.MethodThis is a multicenter, single-blind randomized controlled trial conducted in four Danish chiropractic clinics, 2015–2019. Information was distributed in the maternity wards and by maternal and child health nurses. Children aged 2–14 weeks with unexplained excessive crying were recruited through home visits and randomized (1:1) to either chiropractic care or control group. Both groups attended the chiropractic clinic twice a week for 2 weeks. The intervention group received chiropractic care, while the control group was not treated. The parents were not present in the treatment room and unaware of their child’s allocation.The primary outcome was change in daily hours of crying before and after treatment. Secondary outcomes were changes in hours of sleep, hours being awake and content, gastrointestinal symptoms, colic status and satisfaction. All outcomes were based on parental diaries and a final questionnaire.ResultsOf 200 recruited children, 185 completed the trial (treatment group n = 96; control group n = 89). Duration of crying in the treatment group was reduced by 1.5 h compared with 1 h in the control group (mean difference − 0.6, 95% CI − 1.1 to − 0.1; P = 0.026), but when adjusted for baseline hours of crying, age and chiropractic clinic, the difference was not significant (P = 0.066). The proportion obtaining a clinically important reduction of 1 h of crying was 63% in the treatment group and 47% in the control group (p = 0.037), and NNT was 6.5. We found no effect on any of the secondary outcomes.ConclusionExcessive crying was reduced by half an hour in favor of the group receiving chiropractic care compared with the control group, but not at a statistically significant level after adjustments. From a clinical perspective, the mean difference between the groups was small, but there were large individual differences, which emphasizes the need to investigate if subgroups of children, e.g. those with musculoskeletal problems, benefit more than others from chiropractic care.Trial registrationClinical Trials NCT02595515, registered 2 November 2015
Highlights
Chiropractic care is commonly used to treat infantile colic
Excessive crying was reduced by half an hour in favor of the group receiving chiropractic care compared with the control group, but not at a statistically significant level after adjustments
The mean difference between the groups was small, but there were large individual differences, which emphasizes the need to investigate if subgroups of children, e.g. those with musculoskeletal problems, benefit more than others from chiropractic care
Summary
Chiropractic care is commonly used to treat infantile colic. The purpose of this study is to evaluate the effect of chiropractic care on infantile colic. Infantile colic is a common condition that occurs in up to 25% of infants and is characterized by excessive crying and fussing in infants who thrive and develop normally in all other aspects [1]. Modifications of Wessels have included slightly different timeframes for the condition over time, but the cornerstone of excessive crying and fussing are unaltered in the new Rome IV criteria, with the addition that the babies are less than 5 months of age when symptoms start and stop [3]. Hypotheses of causes of gastrointestinal origin include an allergy to cows’ milk, immaturity of the intestines, and a different intestinal microflora [4,5,6,7], while hypotheses concerning non-gastrointestinal causes include prenatal factors, birth factors, biomechanical strains and disturbances in the parent-child relationship, among others [8,9,10,11,12]
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