Massage & Bodywork

MARCH | APRIL 2017

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48 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 7 education SOMATIC RESEARCH An infant's persistent excessive crying is one of the most upsetting problems for new parents. Absent of other symptoms, infantile colic is a diagnosis of exclusion using Wesley's "rule of three" criteria, meaning an infant who is well-fed and otherwise healthy cries for more than three hours per day, for more than three days per week, and for longer than three weeks. Typically, colic resolves within three months with no lasting effects. However, having an infant cry for this amount of time is extremely distressing to the parents, who fear there is something seriously wrong with their child. Parents with colicky babies are likely to seek treatment; however, few successful treatments are available. Dietary changes, medications, and parental behavior changes are effective for some, but are not proven to be effective for all. Therefore, some parents turn toward complementary care such as massage therapy, and research on massage therapy for colic is helping them justify that decision. MASSAGE VERSUS ROCKING In one recent study, the efficacy of infant massage therapy compared to infant rocking was tested in reducing colic symptoms. 1 This institutional review board (IRB)-approved Massage for Infantile Colic By Jerrilyn Cambron, DC, PhD the change in the duration of cries (reduction of 2.8 hours of crying), duration of sleep (increase of 2.9 hours per day), number of cries (reduction of 4.08 cries per day), and colic severity (improvement of 2.41 points on a visual analog scale). The only statistically significant pre- to post-treatment difference in the rocking group was for colic severity (reduction of 0.59 points on a visual analog scale). Between-group comparisons in this study demonstrated a greater improvement in all outcomes, favoring the rocking group, but this was interpreted with caution due to the statistically significant group difference at baseline. Baseline differences can greatly affect post-treatment outcomes due to an unfair advantage from the start of the study. These differences in baseline characteristics were considered a serious limitation in this study and the between- group outcomes were not considered valid. Another limitation of this study was that the mothers performed the massage or rocking without assessment as to whether the treatments were consistently performed correctly. To overcome this, the authors observed the mothers' massages three times during the week and were regularly in contact with the mothers to be sure that all questions were answered. The massage was not defined in the methods of this study, so we do not know how it was performed. However, with the regular checks by the investigators, we can assume there was a regular protocol and that consistency was encouraged. Further limitations of this study include the lack of blinding to treatment group by the mothers. Knowing which treatment group their infants were in could have potentially affected the way the mothers study included 100 infants who met Wesley's criteria for colic. Other subject enrollment criteria included being less than 12 weeks old and a full-term birth, as well as having no known diseases, medical treatments for colic, allergy to lactose, skin problems, limitations on receiving massage, maternal smoking, or mothers with severe anxiety. Subjects were randomized to either the massage intervention or the rocking control group. Mothers with infants in the massage group were taught to massage their infants and were asked to complete the massage for 15–20 minutes twice a day for one week. Mothers in the control group were asked to gently rock their infants for 5–25 minutes when the symptoms of colic appeared. In both groups, several outcomes were measured each day, including the duration of infant crying in minutes, the severity of crying using a visual analog scale, and the number of crying sessions. All mothers in both groups successfully completed the study interventions and documentation. The baseline demographic characteristics of the infants did not differ between groups in terms of infant weight, gender, breastfeeding, or type of delivery. However, there were significant baseline differences in terms of symptoms that favored the rocking group. For example, the pre- treatment measures on the day before the start of treatment showed a difference in cry duration (4.96 hours in massage and 3 hours in rocking group), sleep duration (9.29 hours in massage and 12.24 hours in rocking group), and colic severity (more severe symptoms in massage group). The results of this study demonstrated that there was a statistically significant difference in pre- to post-treatment outcomes in the massage group, including

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