Infants with colic - Parents’ experiences in short and long perspectives and the effect of acupuncture treatment on crying, feeding, stooling and sleep

Infantile colic, involving an otherwise healthy infant crying and fussing more than three hours per day and more than three days per week, is a common problem in Western countries. Both the infant and the parents suffer during the months of persistent crying and there is a risk that the establishing of the early relationship might be disturbed. Safe and effective treatment that provides relief in infantile colic is lacking. The aim of this thesis was to elucidate parents’ experiences of having, and having had, a baby with infantile colic and to evaluate the effect of acupuncture treatment on crying, feeding, stooling and sleep patterns in infants with colic. Individual interviews were conducted with 23 parents (12 mothers and 11 fathers) of infants with colic. The narratives were analysed using a phenomenological, hermeneutic method. The parents expressed that the colic overshadowed everything. Both fathers and mothers experienced they were living in an inferno and yearned for the scenario that they had dreamed of. They used various strategies to ease their child’s pain and thereby help them all get through the months of almost constant crying. The parents were disappointed when nothing they tried worked and when they did not receive help from the professionals. It was important for them to be able to share their burden. Four years later 17 of the parents were interviewed again, 13 of them individually and four in a focus group. These interviews were analysed with content analysis. The results showed that the parents vividly recalled the emotional and practical chaos they had lived in during the colic period and how relationships within the family had been strained. They had tried many recommended treatments but were frustrated when almost nothing helped. The lack of responsiveness from professionals and the experience that no one understood their situation was the worst part of the colic period. When the colic symptoms faded out relations healed and parents could enjoy the new family member. Parents’ confidence in the Child Health services was decreased and they suggested changes in treatment. To evaluate the effect of minimal acupuncture treatment on crying, feeding, stooling and sleep patterns in infants with colic, a blinded, randomised, controlled trial comprising 81 infants aged 2–8 weeks and fulfilling the criteria for infantile colic was conducted. The infants went through a structured programme comprising six visits to an acupuncture clinic, twice a week, where parents could ask questions as well as receive verbal support from a nurse. Subsequently the infants were carried to a separate room; here, another nurse handled all the infants in a similar way with the exception for the infants who were allocated to receive acupuncture being given minimal, standardised acupuncture for two seconds in the acupuncture point, LI4 on the hand. Parents registered their infants’ fussing, crying, feeding and stooling in a diary on a daily basis. The results indicated that minimal acupuncture shortened the duration and reduced the intensity of crying in infants with colic. There was a difference (p=0.034), favouring the acupuncture group, in the time that passed from inclusion until the infant no longer met the criteria for colic. The duration of fussing in the first and second week (p=0.029 and 0.047) and of colicky crying in the second intervention week (p=0.046) was lower in the acupuncture group. The total duration of fussing, crying and colicky crying (TC) was lower in the acupuncture group during the first (p=0.025) and the second intervention week (p=0.016). The relative difference from baseline throughout the intervention weeks showed differences between groups for fussing in the first week (p=0.028), for colicky crying in the second week (p=0.041) and for TC in the second week (p=0.024), demonstrating favour towards the acupuncture group. During the third week there were no statistical differences in crying. The infants had a higher stooling frequency than reported in healthy infants in previous reports. Minimal acupuncture showed no effect on feeding and only minor effect on stooling frequency. Parents in the acupuncture group more often described their infant to have normalised stooling, better sleep and improvement of colic compared to the control group. The results indicate that infantile colic affects most aspects of family life. Mothers and fathers alike felt powerless and were overwhelmed by strong feelings when they could not ease their child’s pain. Acupuncture may constitute a valuable treatment for reducing the duration and intensity of crying in infants with colic and thereby preventing disturbances in families. To improve acupuncture treatment, research into different acupuncture points, needle techniques and intervals between treatments is required. In order to be able to support parents and infants when a child has infantile colic individualised but structured guidelines are needed.