Unsettled/Irritable Infant: Understanding Irritable Baby Syndrome (IBS)
The Irritable Baby
Infantile colic is a term used by various healthcare professionals to describe persistent and often intense crying in an otherwise healthy and thriving baby. However, there is no consensus on diagnosing colic, leading to its application to various clinical presentations. Colic is commonly thought to be related to abdominal or intestinal issues, but no definitive link has been established, and the true cause of the symptoms remains unknown. Given these challenges, we prefer the term “Irritable Baby Syndrome” (IBS). Many non-chiropractic treatments have been suggested, but most have proven ineffective, and common drug treatments, such as dimethicone, have shown no better results than a placebo.
Several conditions can complicate IBS, making a thorough examination by a pediatric specialist crucial. This helps rule out other potential underlying issues, such as cow’s milk protein or soy protein sensitivity, infection, gastroesophageal reflux, pyloric stenosis, intussusception, or bowel obstruction. If no other causes are identified, the baby is considered to have “uncomplicated colic.”
Cow’s Milk Protein Sensitivity:
Cow’s milk protein intolerance is diagnosed based on the presence of a “triad” of symptoms: gastrointestinal disturbances, skin rash, and respiratory issues. This intolerance is a primary cause of lactose intolerance in infants. Common symptoms associated with cow’s milk protein intolerance include:
- Gastrointestinal: Bloating, frequent gas, persistent crying or distress with leg pulling, chronic diarrhea, constipation, or alternating between the two.
- Skin: Maculopapular rash, which can appear anywhere but is most commonly found on the face, neck, trunk, buttocks, and upper arms; eczema.
- Respiratory: Crackling or wet sounds without obvious shortness of breath, wheezing, and rhinitis (a stuffy nose).
- Neurological: Disrupted sleep patterns with frequent waking and crying during the night.
References:
1. Klougart N, Nilsson N, Joacobsen J. Infantile colic treated by chiropractors: a prospective study of 316 cases. JMPT 1989;12(4):281-8.
2. Wiberg JMM, Nordsteen J, Nilsson N. The Short-term Effect of Spinal Manipulation in the Treatment of Infantile Colic; A Randomised Controlled Clinical trial with a Blinded Observer. JMPT 1999;22(8):517-522.
3. Wiberg KR and Jesper MM. A retrospective study of chiropractic treatment of 276 Danish infants with infantile colic. J Manipulative Physiol Ther 2010;33:536-541
4. Miller JE, Newell D, Bolton JE. Efficacy of chiropractic manual therapy on infant colic: a pragmatic single blind, randomized controlled trial. J Manipulative Physiol Ther 2012;35:600-607
5. Davies NJ. Chiropractic Pediatrics: A Clinical Handbook. Churchill-Livingstone. 2000