Osteopathic manipulation: promise for infantile colic.

To the Editor: As an osteopathic pediatrician who has used osteopathic manipulative treatment for patients with infantile colic, it was a pleasure to read about the research of Hayden and Mullinger1 that was summarized by Michael A. Seffinger, DO,2 in the May installation of “The Somatic Connection.” Hayden and Mullinger1 focused on the use of osteopathic manipulation by osteopaths in the United Kingdom to treat infants with symptoms of infantile colic. “The Somatic Connection”2 reported that preliminary findings led these researchers to conclude that osteopathic manipulation can help reduce infantile colic symptoms. It should be noted that there was a problem with the design of the study by Hayden and Mullinger.1 The infants in the study were eligible for osteopathic manipulation if they were no older than 12 weeks, and they were treated for 4 weeks1—implying that some of them were 16 weeks of age at the completion of the treatment period. In the normal course of events—with or without treatment—infantile colic usually resolves spontaneously by 12 weeks of age.3-5 Thus, the improvements in infantile colic symptoms observed by Hayden and Mullinger1 cannot be attributed to osteopathic manipulation with certainty. When studying treatment outcomes in the pediatric population, it is necessary to take into account changes that normally occur with physiologic and psychologic maturation. While I strongly encourage Hayden and Mullinger1 to continue their research to provide evidence-based data about the effects of osteopathic manipulation on patients with infantile colic, I suggest that they consider the above information when designing new studies.