Acupuncture for baby colic? – here’s my gripe

So, is acupuncture the “miracle cure” for babies with colic?

 

colic-crying-baby

 

Many parents will know that managing the common problem of colic, in an otherwise healthy baby, can be very distressing. Symptoms usually present as excessive, and frequent, bouts of crying, often from about 6 weeks of age. Although the exact cause of colic is not known, it is generally found to be a self-limiting condition.[1]

Few, if any, interventions have been found to be consistently effective in relieving the excessive bouts of crying associated with colic. A recent Cochrane review explored the impact of pain-relieving agents for infantile colic.[2] The review found no strong evidence, from 18 included studies, to recommend any of the interventions (including simethicone, dicyclomine, cimetropium, herbal remedies and sugar) that it examined. The review also identified two studies (of dicyclomine) that appeared to cause side effects, such as drowsiness, in the babies.

Systematic reviews have also pointed to a lack of evidence to recommend other treatments; such as manipulative therapies,[3] dietary changes,[4] and probiotics [5].

It was therefore somewhat surprising to read today that acupuncture may be an effective treatment option for babies with colic.[6,7]

In their linked paper, Landgren and Hallström report a three armed, single-blinded, randomised controlled trial of two types of acupuncture interventions versus no acupuncture.[8] They included 147 babies who met their criteria for colic and conclude that ‘acupuncture appears to reduce crying in infants with colic safely.’

Although their study has some merits, such as the attempt to blind parents to the intervention, the strength of the evidence presented in their study is weak and does not justify their conclusions. For example, the primary outcome was specified as a change in crying time.[9] However, the study found that acupuncture demonstrated no significant relative reduction in the total time that babies spent crying. Absolute changes in total crying time were, in general, inconsistent across the study as well. Furthermore, on 188 occasions, babies cried for a minute or longer, and bleeding occurred on fifteen occasions, as a result of acupuncture treatment.

The authors also highlight that their original hypothesis could not be tested. They report that they had to unexpectedly stop recruiting new participants to the study, as acupuncture became available to everyone. It is unclear when, in the course of the study, their hypothesis changed.

It is also worth noting that the corresponding author is an acupuncturist and appears to sell courses and a book on acupuncture.[10] Arguably, this could have been disclosed as a potential competing interest, particularly when the study conclusions appear to advocate acupuncture.

As the authors themselves point out, further research is needed before acupuncture can routinely be recommended for babies with colic. As a starting point, their study should be systematically placed in the context of other similar studies.[11] 

So is acupuncture the “miracle cure” for babies with colic? Based on the evidence thus far, no it is not.

Kamal R. Mahtani is an NHS GP, Director of the EBHC MSc in Systematic Reviews and  Deputy Director of the Centre for Evidence-Based Medicine


Declared interests

I have received funding from the NHS National Institute for Health Research to conduct independent research. I have no other relevant competing interests to declare.

Disclaimer

The views expressed in this commentary represent the views of the author and not necessarily those of his host institution, the NHS, the NIHR or the Department of Health.

References

1 Choices N. Colic – NHS Choices. Published Online First: 1 April 2017.http://www.nhs.uk (accessed 16 Jan2017).

2 Biagioli E, Tarasco V, Lingua C, et al. Pain-relieving agents for infantile colic. The Cochrane Library Published Online First: 2016. doi:10.1002/14651858.CD009999.pub2

3 Dobson D, Lucassen PL, Miller JJ, et al. Manipulative therapies for infantile colic. The Cochrane Library Published Online First: 2012. doi:10.1002/14651858.CD004796.pub2

4 Dietary management of infantile colic: a systematic review. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0049823/#d12012039884.summary

5 Anabrees J, Indrio F, Paes B, et al. Probiotics for infantile colic: a systematic review. BMC Pediatr 2013;13:186.

6 Two weeks of this treatment could stop your baby crying. The Sun. 2017.https://www.thesun.co.uk/uncategorized/2628354/two-weeks-of-acupuncture-treatment-could-stop-your-baby-crying-curing-colic/ (accessed 16 Jan2017).

7 Acupuncture helps young babies stop crying – new research. The Daily Telegraph. 2017.http://www.telegraph.co.uk/science/2017/01/16/acupuncture-helps-young-babies-stop-crying-new-research/ (accessed 16 Jan2017).

8 Landgren K, Hallström I. Effect of minimal acupuncture for infantile colic: a multicentre, three-armed, single-blind, randomised controlled trial (ACU-COL). Acupunct Med doi:10.1136/acupmed-2016

9 Acupuncture in Infantile Colic – a Three Armed Randomized Multi Center Trial (ACU-COL) – Full Text View – ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT01761331?term=NCT01761331&rank=1 (accessed 16 Jan2017).

10 Kajsa Landgren Akupunktör. http://www.kajsalandgren.com/Hem/index.html (accessed 16 Jan2017).

11 Acupuncture treatments for infantile colic: a protocol for a systematic review and meta-analysis of randomized, controlled trials. http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015023253 (accessed 16 Jan2017).

Image: Wikimedia Creative Commons 

Kamal Mahtani

About Kamal Mahtani

Kamal R. Mahtani is a GP and and Clinical Lecturer at the University of Oxford

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