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Comparison Between Chiropractic and Lactobacillus in the Reduction of Crying Time for Infants with Colic

Should Chiropractic Treatment be Included in The Treatment

Protocol of Infant Colic? by: Adrian Isaza, DC, DACBN, CCAP


ABSTRACT: Colic in infants causes one in six families (17%) with children to consult a health professional. The author is unaware of any study comparing the effects of chiropractic treatment and probiotics (lactobacillus) for the treatment of infant colic.

OBJECTIVE: This study compared chiropractic treatment and lactobacillus in reducing crying time in babies with infantile colic.

METHODS: A search of literature reviews for the treatment of infant colic using chiropractic and lactobacillus was made using the Cochrane collaboration software program, review manager (RevMan) (RevMan 2008). A search of literature reviews, systematic reviews and meta-analysis using the pubmed and google scholar database was also performed. Chiropractic treatment and lactobacillus were compared in the mean difference of the reduction of crying time for babies with infantile colic after 21 days of probiotic treatment. Literature or systematic reviews and meta-analysis were found by a search of the pubmed and google scholar electronic database.

and exclusion criteria was performed. Only chiropractic data with low risk of selection bias (random sequence generation and allocation concealment), low risk of performance blinding (parental blinding) and low risk of attrition bias (selective reporting) were included.

RESULTS: Chiropractic was more effective than lactobacillus at reducing crying time when considering


only studies with low risk of selection bias (random sequence generation and allocation concealment) (1.24 and1.20/56.03) and low risk of attrition bias (selective reporting) (1.95/56.03). Chiropractic was similar to lactobacillus at reducing crying time when considering only studies with low risk of performance bias (participant/ parental blinding) (0.58/56.03).

CONCLUSION: The inclusion of spinal manipulative therapy as part of the protocol for the treatment of infantile colic is promising. Based on the lack of efcacy and safety of certain drugs and the lack of evidence for overall treatment options, physicians may want to consider chiropractic treatment as part of the management of infantile colic. A possible treatment protocol could be the combination of chiropractic and probiotics (L. reuteri ATCC 55730 and L. reuteri DSM 17938) which were both shown to reduce crying time in this study. Further studies conrming these ndings are warranted.

INTRODUCTION Colic is often dened by the rule of three: crying for more than three hours per day, for more than three days per week, and for longer than three weeks in an infant who is well-fed and otherwise healthy. Medications available in the United States have not been proved effective in the treatment of colic, and most behavior interventions have not been proved to be more effective than placebo.1

treatment for infant colic relies on the unknown etiology of the condition. In 2004, Shenassa, et al, conducted a review of six studies and concluded that new epidemiologic evidence suggests that exposure to cigarette smoke and its metabolites may be linked to infantile colic.3

Gelfand, et al, conducted a systematic review and meta- analysis and concluded that infant colic was associated with increased odds of migraine.4

The condition of infantile colic was selected because of the evidence of efcacy for both chiropractic and probiotics in reducing crying time. In 1999, Wiberg, et al, conducted a randomized controlled trial comparing chiropractic to dimethicone and found that by trial days 4 to 7, hours of crying were reduced by 1 hour in the dimethicone group compared with 2.4 hours in the manipulation group. On days 8 through 11, crying was reduced by 1 hour for the dimethicone group, whereas crying in the manipulation group was reduced by 2.7 hours. From trial day 5 onward the manipulation group did signicantly better that the dimethicone group.5

An inclusion

randomized controlled trial of 104 patients and found that in chiropractic manual therapy improved crying behavior in infants with colic. The ndings showed that knowledge of treatment by the parent did not appear to contribute to the observed treatment effects in this study. Thus, it is unlikely that observed treatment effect is due to bias on the part of the reporting parent.7

THE ORIGINAL INTERNIST JUNE 2016 (Continued on page 68)

a systematic review of 26 articles and concluded that chiropractic care is an alternative approach to the care of the child with colic.6

In 2012, Miller, et al, conducted a In 2011, Alcantara, et al, conducted In 2015,

Infantile colic causes one in six families with children to consult a health professional.2

The complexity of the

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