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Colic - infantile - Evidence
Evidence for other treatments for infantile colic

  • Parenting style: a small observational study using parents from both London and Copenhagen examined whether there was any difference in crying between infant-demand parenting and conventional Western parenting [St James-Roberts et al, 2006]. It found that the two parenting styles are associated with different benefits and costs. Infant-demand parenting was associated with less crying per 24 hours, but increased night waking at the age of 12 weeks. Conventional Western parenting was associated with more crying per 24 hours, but less night waking at 12 weeks. An assessment of colicky crying bouts at 5 weeks of age found no difference between the styles of parenting.
  • Soothing strategies: current data do not suggest that increased carrying, car-ride simulators, or decreased stimulation are effective for infantile colic, but the quality of the available studies is very poor [Garrison and Christakis, 2000]. CKS could not find any studies that investigated the effect of white noise on infantile colic.
  • Infant massage: one randomized controlled trial of 25 infants with colic compared treatment with infant massage with treatment with a crib vibrator and found no statistically significant difference [Huhtala et al, 2000]. The authors suggest that the reduction in colicky crying seen with both interventions in this study reflects more the natural resolution of colic over time, rather than a specific effect of these interventions.
  • Intensive parent training: a recent study (reported twice) in 121 infants found that infant crying reduced over the 8-week study period, irrespective of whether infants were randomized to routine care or a home-based intervention program [Keefe et al, 2005; Keefe et al, 2006]. However, crying was reduced from an average of 6 hours a day to 1.3 hours per day in the intervention group, compared to a reduction from an average of 6 hours to 3 hours in the control group (p = 0.02).
  • Chiropractic spinal manipulation: a recent Health Technology Assessment (HTA) by the Canadian Coordinating Office for HTAs concluded that there is no convincing evidence that spinal manipulation can affect the duration of infantile colic symptoms [Husereau et al, 2003].
  • Cranial osteopathy: one open 4-week study of 28 infants found that cranial osteopathy reduced the amount of daily crying by about 1 hour compared with no treatment. However, the authors of the review suggest that a larger, blinded study is needed to confirm these results [Complementary and Alternative Medicine, 2006].
  • Gripe water: CKS found no randomized controlled trials that evaluated the effectiveness of gripe water.
  • Sucrose: sucrose seems to have a pacifying effect, but the benefit is so short-lived that it is not a practical treatment [Garrison and Christakis, 2000].
  • Probiotics: an open study with Lactobacillus reuteri in 90 infants suggests that compared with simeticone, Lactobacilli may reduce crying time [Savino et al, 2007]. However, the lack of blinding makes it difficult to be confident about the study results.
  • Herbal teas and infusions:
    • Japanese star anise is neurotoxic and has been reported to have poisoned babies [Minodier et al, 2003].
    • Herbal tea containing chamomile, vervain, liquorice, fennel, and balm-mint showed a marked reduction in crying in one trial, but there were methodological problems with the study, and the safety of the infusion has not been established [Garrison and Christakis, 2000].
    • Fennel seed oil emulsion: in a randomized placebo-controlled trial of 125 infants with colic, fennel seed oil emulsion eliminated symptoms in 65% of the treatment group and 24% of the placebo group (p < 0.01) but its safety has not been established [Alexandrovich et al, 2003].
  • Dicycloverine, an antimuscarinic antispasmodic, has historically been widely used. However, dicycloverine is not safe and the National Institute for Health and Clinical Excellence (NICE) recommends that it should not be used. Serious adverse effects include breathing difficulties, seizures, syncope, asphyxia, apnoea, muscular hypotonia, and coma [National Collaborating Centre for Primary Care, 2006].

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