A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic

Summary

In this open, controlled, prospective study, 28 infants with colic were randomized to either cranial osteopathic manipulation or no treatment; all were seen once weekly for 4 weeks. Treatment was according to individual findings, and administered by the same practitioner. Parents recorded time spent crying, sleeping and being held/rocked on a 24-hour diary. A progressive, highly significant reduction between weeks 1 and 4 in crying (hours/24 h) was detected ($P<0.001$) in treated infants; similarly, there was a significant improvement in time spent sleeping ($P<0.002$). By contrast, no significant differences were detected in these variables for the control group. Overall decline in crying was 63% and 23%, respectively, for treated and controls; improvement in sleeping was 11% and 2%. Treated infants also required less parental attention than the untreated group. In conclusion, this preliminary study suggests that cranial osteopathic treatment can benefit infants with colic; a larger, double-blind study is warranted.

Introduction

Infantile colic is a common cause of paroxysmal abdominal pains with resultant distress both to the child and parents alike; it usually commences between 2 and 3 weeks postnatally¹ and affects 8–40% of infants.2, 3 There are many possible aetiological factors, including incomplete lactose absorption4, 5 cow's milk intolerance,5, 6 familial and genetic factors7, 8 and dietary insults.⁹ Undigested lactose may create an osmotic gradient that facilitates intraluminal retention of water, resulting in relative physiological dehydration of intestinal tissues, and may encourage bacterial growth producing gas with subsequent bloating, flatulence, borborygmi and cramp.10, 11 Stress factors in pregnancy, childbirth and inadequate postnatal care may also be important determinants in the development of infantile colic1, 12 although the exact role of adverse environmental circumstances before and during birth has yet to be determined.¹³

The general lack of understanding and consensus on its development has led to a wide variety of treatment strategies for infantile colic, each with its own limitations and varying degrees of reliability.2, 14 As the repetitive, inconsolable bouts of colicky crying inevitably place a stress on family life, many parents turn to complementary therapies to help their child. Cranial osteopathy has gained a particular reputation in this regard even though evaluation by randomized controlled trials is lacking.¹⁵

Osteopathic treatment consists of the diagnosis of the musculo-skeletal strain patterns in the body, followed by techniques to release these strains. Specifically, the cranial osteopathic approach to infantile colic involves the application of gentle manual techniques to the head as well as any other areas of the infant body that demonstrate palpably increased ligamentous/muscular tone, or decreased/abnormal articular mobility. Very light tactile pressure is applied to the affected area until a palpable release of the relevant physical tensions and areas of dysfunction (including parts of the cranium) is achieved. Osteopathic treatment may alleviate the physical and biomechanical influences of childbirth. It is also feasible that by attempting to reduce the distortions and twists in the musculo-skeletal framework, improving joint mobility, and reducing apparent muscular hypertonia in the infant, manipulation may reduce the somatic afferent load into the central nervous system.¹⁶

The objective of this preliminary study was to investigate the effect of cranial osteopathic manipulative treatment on the pattern of increased crying, irritability and disturbed sleep associated with infantile colic, as reported by the parents.