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Midwestern University/Arizona College of Osteopathic Medicine Glendale

To the Editor:

As an osteopathic pediatrician who has used osteopathic manipulative treatment for patients with infantile colic, it was a pleasure to read about the research of Hayden and Mullinger¹ that was summarized by Michael A. Seffinger, DO,² in the May installation of "The Somatic Connection."

Hayden and Mullinger¹ focused on the use of osteopathic manipulation by osteopaths in the United Kingdom to treat infants with symptoms of infantile colic. "The Somatic Connection"² reported that preliminary findings led these researchers to conclude that osteopathic manipulation can help reduce infantile colic symptoms.

It should be noted that there was a problem with the design of the study by Hayden and Mullinger.¹ The infants in the study were eligible for osteopathic manipulation if they were no older than 12 weeks, and they were treated for 4 weeks¹—implying that some of them were 16 weeks of age at the completion of the treatment period. In the normal course of events—with or without treatment—infantile colic usually resolves spontaneously by 12 weeks of age.^3-5 Thus, the improvements in infantile colic symptoms observed by Hayden and Mullinger¹ cannot be attributed to osteopathic manipulation with certainty.

When studying treatment outcomes in the pediatric population, it is necessary to take into account changes that normally occur with physiologic and psychologic maturation. While I strongly encourage Hayden and Mullinger¹ to continue their research to provide evidence-based data about the effects of osteopathic manipulation on patients with infantile colic, I suggest that they consider the above information when designing new studies.

References
1. Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic [published online ahead of print February 8, 2006]. Complement Ther Clin Pract. 2006;12:83 -90.[Medline]

2. Seffinger MA. Osteopathic manipulation: promise for infantile colic [abstract of Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic. Complement Ther Clin Pract. 2006;12:83-90]. J Am Osteopath Assoc. 2008;108:234. Available at: http://www.jaoa.org/cgi/content/full/108/5/234. Accessed August 28, 2008.

3. Medical encyclopedia: colic and crying. Medline Plus Web site. July 26, 2007. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000978.htm#Expectations%20(prognosis). Accessed August 28, 2008.

4. Rosen LD, Bukutu C, Le C, Shamseer L, Vohra S. Complementary, holistic, and integrative medicine: colic. Pediatr Rev. 2007;28:381 -385.[Free Full Text]

5. Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: WB Saunders;2007 : 222.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Friedman, S. J. PubMed PubMed Citation Articles by Friedman, S. J.