BMJ paper on manual care of infants
Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analyses. [Published in the journal BMJ Open]
Author affiliations:
- Barts and The London School of Medicine and Dentistry, Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
- Faculty of Health, Universtiy of Applied Sciences, Western Switzerland, Fribourg, Switzerland
- National Council for Osteopathic Research, London, UK
Results: "Nineteen studies were selected for full review: seven randomised controlled trials, seven case series, three cohort studies, one service evaluation study and one qualitative study. We found moderate strength evidence for the effectiveness of manual therapy on: reduction in crying time (favourable: −1.27 hours per day (95%CI −2.19 to –0.36)), sleep (inconclusive), parent–child relations (inconclusive) and global improvement (no effect). The risk of reported adverse events was low: seven non-serious events per 1000 infants exposed to manual therapy (n=1308) and 110 per 1000 in those not exposed".
Points to consider
A cost burden analysis found that the annual cost to the UK National Health Service of infant crying and sleeping problems in the first 12 weeks of life was £65 million. There are associations between unsettled infant behaviour and high maternal depression scores, and the natural crying peak at 6 weeks coincides with the peak age for severe infant injury or death as a result of child abuse.
Safety
Those infants who received manual care had an 88% reduced risk of having an adverse event compared with those who did not (adverse events defined as "worsening of signs & symptoms" or "seeking other care").
Citation
Carnes D, Plunkett A, Ellwood J, Miles C., Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analyses