Infant colic, while not a deadly disease by any stretch of the imagination, is an extremely troubling entity. Not only can it be quite distressing to caregivers, it is also a well-established risk factor for neglect and abuse of the child. Excessive crying in general, whether diagnosed as infant colic or not, is a frequent impetus for seeking advice from medical professionals. How science-based providers approach the evaluation of babies with excessive crying, and the management of infant colic if diagnosed, can have a powerful impact on how families perceive the health of their child and on future interactions with the healthcare system.
Infant crying is about as bread and butter as it gets in pediatrics. It is a problem which we are constantly exposed to during our training. We discuss it with families in our continuity clinics, where we learn how to truly be primary care providers. We address it on the inpatient wards, where children often cry because of illness or pain, and during our months of service in the newborn nursery. We frequently are called upon to talk anxious parents through it while taking overnight phone calls, and we learn over time with variable success the seemingly preternatural ability to understand what babies are trying to tell us with their cry.
Crying happens for a variety of reasons in young infants, ranging from the benign and expected to the life threatening. Discussing excessive crying, regardless of why it occurs, requires effective communication skills. And the evaluation of unexplained excessive crying often tests the limits of our ability to practice non-defensive medicine, avoiding unnecessary laboratory testing and imaging. Because of all this, I believe that infant crying, and in particular the entity known as infant colic, serves as a useful entry point into a discussion of the differences between a science-based approach to medicine and one based on pseudoscience like chiropractic.
Readers of this blog should be well aware of the push by alternative medical practitioners for recognition as primary care providers, with the chiropractic community leading the charge. In this post I will compare and contrast the common understanding of the etiology and treatment of infant colic held by conventional medical doctors and doctors of chiropractic. You will see that in some ways they do not differ as much as we might expect, but have little in common where it truly matters. (more…)