Effect of Reflexology on Infantile Colic

The effect of therapeutic touch on colic symptoms in infantile colic infants: A randomised controlled study

AIM

This study aimed to examine the effects of therapeutic touch (TT) on infantile colic symptoms (Infant Colic Scale (ICS) score, crying time and sleep time).

METHODS

This randomised controlled trial included infants aged 4-12 weeks diagnosed with infantile colic in a pediatric unit of a hospital. Infants were assigned to intervention or control groups using a stratified randomisation method. The intervention group received TT sessions six times, 3 days a week, in addition to usual care for 2 weeks. The control group received the usual care. Data were collected using Mother-Infant Information Form, ICS, Crying and Sleep Time Follow-Up Forms. The infants were followed up for two weeks.

RESULTS

A total of 64 infants who met the criteria were included in the study, including intervention (n = 32) and control (n = 32) groups. There was a statistically significant difference between the groups (intervention and control) in terms of ICS scores (U = 4.5; P < 0.001; d = 3.252; 95% confidence interval (CI) = 2.505-3.999), crying time (F = 57.097; ŋp 2 = 0.461; P < 0.001) and sleep time (F = 17.884; ŋp 2 = 0.211; P < 0.001). When the intervention group was compared with the control group at all time points, the size of the effect (group × time interaction) was found to be high.

CONCLUSIONS

TT effectively relieved symptoms, decreased crying time and increased sleep time in infants with infantile colic. TT is recommended to relieve colic in infants.

Comparison of Effectiveness of Manual Therapy for Infant Crying: systematic review and meta-analysis of randomized controlled trials

Objectives

The aim of this systematic review and meta-analysis is to assess and compare the effectiveness of manual therapy in alleviating infant crying, a common symptom of nocturnal crying (NC) and infantile colic (IC).

Methods

Total effective rate, crying time and adverse events were used as outcome indicators. To assess the quality, the risk of bias was determined for each study by two authors, using the Cochrane Collaboration's risk of bias tool. RevMan 5.0 was used for data analysis. A total of 98 articles were identified from 6 electronic databases.

Results

Among them, twenty-seven studies which included 13 NC and 14 IC were included. Meta-analysis showed favorable effects tuina therapy on total effective rate (TER) of NC (RR 1.20 [95% CI 1.05 to 1.37], p = 0.007), chiropractic therapy on crying time change of IC (SMD -0.83 [95% CI -1.61 to -0.06], p = 0.04) and massage on total crying time of IC (SMD -0.86 [95% CI -1.09 to -0.63], p < 0.00001). This systematic review compares different manual therapies for the treatment of NC and IC. While tuina, chiropractic, and massage show results in alleviating symptoms, the overall evidence remains limited due to the low quality and heterogeneity of the included studies.

Conclusion

Therefore, further high-quality research with unified control groups is needed to establish manual therapy as a recommended treatment option for NC and IC. Protocol registration number is CRD42022348143 01/08/2022.

Mothers' Awareness Towards Infantile Colic in Saudi Arabia

Background Infantile colic is defined as severe pain in the abdominal region of a baby primarily due to gastrointestinal implications and is believed to self-resolve with time. Recently established Rome IV criteria of diagnosis state that infantile colic should be diagnosed if there are symptoms like excessive crying, irritability and fussiness. Hence, this study aimed to assess the level of maternal awareness towards infantile colic in Saudi Arabia and to explore the relationship between the level of awareness and different socio-demographic factors like age, gender, nationality, etc. Methodology A cross-sectional study was carried out in Saudi Arabia from February to May 2021. An online self-administered questionnaire via Google Forms was used as the primary data collection tool. The generated link was randomly shared on electronic social media platforms including Facebook, WhatsApp, Telegram, and Twitter. Results A total of 425 participants were finally enrolled in the study. One-third of the participants (n=141, 33.2%) were aged more than 40 years and 399 were married (93.9%). Out of a total of 20 points, the mean score of maternal awareness was found to be 13.6±2.5. One-third of the participants (n=143, 33.6%) thought that rocking or carrying the baby would soothe the colic symptoms. Further, 175 participants (41.2%) used pain-relieving drugs and 7.8% sang lullabies. A total of 346 (81.4%) usually got frustrated/exhausted due to excessive crying sessions of the baby. Additionally, those who had received guidelines, educational programs or awareness sessions about the management of colic symptoms in babies had a significant awareness level (P-value = 0.032), while those who had not received education had poorer awareness. Conclusion Nearly one-third of the participants had good knowledge about infantile colic. More than one-third of the participants had previously received educational programs or awareness sessions about the management of colic symptoms in babies. More than half of the participants stated that postnatal maternal depression can occur as a result of infantile colic thereby psychological conflicts occur regarding the maternal role and inconsistent interaction styles with babies. Age, nationality, and marital status did not have a significant effect on the awareness level of the participants.

Treatment of infant colic with craniosacral therapy. A randomized controlled trial

OBJECTIVE

To evaluate the number of craniosacral therapy sessions that can be helpful to obtain a resolution of the symptoms of infantile colic and to observe if there are any differences in the evolution obtained by the groups that received a different number of Craniosacral Therapy sessions at 24 days of treatment, compared with the control group which did not received any treatment.

METHODS

Fifty-eight infants with colic were randomized into two groups of which 29 babies in the control group received no treatment and those in the experimental group received 1-3 sessions of craniosacral therapy (CST) until symptoms were resolved. Evaluations were performed until day 24 of the study. In this study crying hours served as primary outcome. The secondary outcome were the hours of sleep and the severity, measured by an Infantile Colic Severity Questionnaire (ICSQ).

RESULTS

Significant statistical differences were observed in favor of experimental group compared to the control group on day 24 in crying hours (mean difference = 2.94, at 95 %CI = 2.30-3.58; p < 0.001) primary outcome, and also in hours of sleep (mean difference = 2.80; at 95 %CI = - 3.85 to - 1.73; p < 0.001) and colic severity (mean difference = 17.24; at 95 %CI = 14.42-20.05; p < 0.001) secondary outcomes. Also, the differences between the groups ≤ 2 CST sessions (n = 19), 3 CST sessions (n = 10) and control (n = 25) were statistically significant on day 24 of the treatment for crying, sleep and colic severity outcomes (p < 0.001).

CONCLUSION

Babies with infantile colic may obtain a complete resolution of symptoms on day 24 by receiving 2 or 3 CST sessions compared to the control group, which did not receive any treatment.

Is foot reflexology effective in reducing colic symptoms in infants: A randomized placebo-controlled trial

OBJECTIVES

Infantile colic and its accompanying crying represent a major source of stress and have negative physiological, emotional and psychological effects on infants and parents. The aim of this study was to examine the efficacy of foot reflexology for reducing symptoms of infantile colic.

DESIGN

The study was conducted as a single-blind, randomized, placebo-controlled trial with a sample population of 45 infants diagnosed with infantile colic.

METHODS

Simple randomization was used to select a reflexology (study) group (n = 20) and a placebo group of infants with colic (n = 25). The parents and biostatistician were blinded to group assessment. Foot reflexology, or stimulating reflex points on the foot, was implemented with the reflexology group. Placebo foot reflexology, or noneffective touch, was used with the placebo group. Over a two-week period, both interventions were performed four times for 20 min each time by the researcher. The researcher collected data using the information form, the Infant Colic Scale (ICS), and a diary of daily crying duration.

RESULTS

The trial ended with the completion of the data. In each group, 20 infants were studied. The means of the Infant Colic Scale scores and daily crying duration were significantly lower in the foot-reflexology group than in the placebo foot-reflexology group (p < .001). Infants with colic in the reflexology group cried less and experienced fewer symptoms than before treatment.

CONCLUSIONS

Foot reflexology is a non-invasive and safe nursing intervention that is effective for reducing crying duration and symptoms in infants with colic.

Effects of reflexology on child health: A systematic review

BACKGROUND

It is known that the parents of one of every two children who need health care seek at least one complementary health-care approach. Reflexology, which is one of these, increases well-being while maintaining the continuity of homeostasis. As studies with children are limited, there is a need for evidence that includes the positive as well as the negative effects of reflexology that can be transferred to clinical practice and recommendations for future studies.

AIM

The aim of this study was to examine the effects of reflexology on child health by systematically summarizing the results obtained.

METHOD

In this study, which was structured as a systematic review, data were obtained by scanning CINAHL, Cochrane Library, Academic Search Complete, WoS, Scopus, Science Direct, PubMed, and ProQuest. According to MeSH terminology, (zone therapy OR reflexology OR foot massage OR hand massage) AND (pediatrics OR child OR infant OR baby) were used. Randomized controlled studies (RCTs), systematic reviews, and meta-analyses conducted with a pediatric population and accessible in English and full text up to 07.08.2019 (with no time limitation) were included. Exclusion criteria for the present study included applying a massage procedure different from reflexology, the inclusion of an adult sample, or publication of the article in a predatory journal. The Cochrane guidelines (Handbook for Systematic Reviews of Interventions Version 5.2.0, 2017) were applied and the article reported on according to the PRISMA checklist.

RESULTS

In all six of the RCTs, which included a total of 277 infants and children, the only method used was foot reflexology. Regarding the results of nine investigated outcomes, reflexology was found to be effective in infancy for reducing pain level and regulating heart rate, for increasing oxygen saturation, for relieving infantile colic symptoms, and neonatal abstinence symptoms. Reflexology was also found to decrease spasticity and improve motor skills in children with cerebral palsy, but it failed to produce positive change in regard to constipation and quality of life. Four of the studies were performed in a nursing context, one in midwifery, and one in physiotherapy.

CONCLUSION

As a common result of the studies conducted with different sample groups, it is possible that reflexology had positive effects on children. However, the absence of standardization related to reflexology, inadequate use of a study protocol and guidelines, the heterogeneity of the data, and the determination that half the studies were conducted with high-risk groups according to the bias analysis with RoB 2.0 indicate that it is too soon to generalize the results. Well-structured, randomized controlled double-blind trials are required.

A pilot study of parents' experiences of reflexology treatment for infants with colic in Finland

Background

Many infants under 4 months suffer from infantile colic. Infants with colic cry a lot, appear to be in pain, and it is difficult to sooth them. Colic is a painful condition for the infant and very stressful to parents. Parents in Finland get advice to try reflexology treatment for their infant, but there are no studies in Finland to support this advice.

Aim

The aim of the pilot study was to treat infants with reflexology and find out parents’ experiences of the effects of the treatment on colic symptoms and parental stress.

Method

A total of 33 parents of 35 infants diagnosed with colic participated to the pilot study. Three certified reflexologists with health care education background and extensive experience in infant reflexology were trained to give the reflexology treatment in a standardised manner. They treated each infant 3–4 times. The whole body reflexology treatment session consisted of gentle pressure treatment of soles and feet, hands, head, face, ears, back, neck and whole stomach area. One treatment session lasted about 20–30 minutes, and treatments were delivered within 8–12 days. The data were collected from the parents with semi‐structured questionnaires.

Results

The series of the treatments helped reduce the suffering of all the babies with infant colic. The colic symptoms disappeared on 43% of infants and decreased on the remaining 57%. The parents reported having pleasant experiences with the treatment, regardless whether the colic symptoms disappeared or continued. Parents stated that the treatment reduced the most typical colic symptoms; infants’ body tension, colic crying and restless movements, poor sleep quality and irregular bowel movements.

Conclusions

Reflexology treatment seems to be a safe and effective way to treat infants with colic when conducted by a health care professional with reflexology training and experience.