Needle acupuncture in small children is controversial, not least because the evidence that it works is negative or weak, and because small children are unable to consent to the treatment. Yet it is recommended by some acupuncturists for infant colic. This, of course, begs the questions:
- Does the best evidence tell us that acupuncture is effective for infant colic?
- Are acupuncturists who recommend acupuncture for this condition responsible and ethical?
This systematic review and a blinding-test validation based on individual patient data from randomised controlled trials was aimed to assess its efficacy for treating infantile colic. Primary end-points were crying time at mid-treatment, at the end of treatment and at a 1-month follow-up. A 30-min mean difference (MD) in crying time between acupuncture and control was predefined as a clinically important difference. Pearson’s chi-squared test and the James and Bang indices were used to test the success of blinding of the outcome assessors [parents].
The investigators included three randomised controlled trials with data from 307 participants. Only one of the included trials obtained a successful blinding of the outcome assessors in both the acupuncture and control groups. The MD in crying time between acupuncture intervention and no acupuncture control was -24.9 min at mid-treatment, -11.4 min at the end of treatment and -11.8 min at the 4-week follow-up. The heterogeneity was negligible in all analyses. The statistically significant result at mid-treatment was lost when excluding the apparently unblinded study in a sensitivity analysis: MD -13.8 min. The registration of crying during treatment suggested more crying during acupuncture.
The authors concluded that percutaneous needle acupuncture treatments should not be recommended for infantile colic on a general basis.
The authors also provide this further comment: “Our blinding test validated IPD meta-analysis of minimal acupuncture treatments of infantile colic did not show clinically relevant effects in pain reduction as estimated by differences in crying time between needle acupuncture intervention and no acupuncture control. Analyses indicated that acupuncture treatment induced crying in many of the children. Caution should therefore be exercised in recommending potentially painful treatments with uncertain efficacy in infants. The studies are few, the analysis is made on small samples of individuals, and conclusions should be considered in this context. With this limitation in mind, our findings do not support the idea that percutaneous needle acupuncture should be recommended for treatment of infantile colic on a general basis.”
So, returning to the two questions that I listed above – what are the answers?
I think they must be:
- No.
- No.
11 Responses to Some recommend acupuncture for infant colic, yet the evidence tells us that it ‘should not be recommended’
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Moreover, parents who take their children to have needles put in them unnecessarily should be charged with child abuse/neglect/a conspiracy to cause bodily harm (fortunately, not too grievous).
Your child cries more than average, what do you do?
1. Go find an amateur of acupuncture who will stick it with needles.
2. Relax and cuddle the child, tend to its needs and look forward to the “colic” period to recede by itself as it always does before six months of age. To be sure, find a pediatrician who can check that there is no underlying problem that needs medical attention.
I know what my choice would be.
The Times had an article on baby ear piercing yesterday. A petition to ban the practice in the UK has nearly 90,000 signatures.
https://www.thetimes.co.uk/article/80-000-sign-petition-for-ban-on-baby-ear-piercing-wdtm73mzx
I would like to see all forms of infant immolation banned – circumcision, ear-piercing and acupuncture included.
Parents should protect their children’s right to bodily integrity until such time as a child can assume that right for themselves. Would any adult hand over the right to decide whether to pierce or remove parts of their body to another person for any other reason than medical necessity?
Rather than sticking useless needles into infants, if parents must employ ritual “healers”, let them be of the magic hand-waving variety. Reiki is equally useless as far as medical benefits go but at least it does not inflict gratuitious bodily damage upon its clientele.
Immolation?
Don’t they do traditional child-burning round your way, Julian? Every full moon night on Southsea Common round these parts.
Ritual sacrifice.
At the very least, it should be banned during wildfire season.
I could have sworn I replied to some of the above comments. Odd.
Anyway, as soon as I have a chance I’ll post my response to this post and link to it here for anyone that might be interested.
https://www.tomtheacupuncturist.com/blog/2019/1/12/acupuncture-for-infant-colic-worth-considering-or-is-it-child-abuse
Sorry, Tom. Your blog post response merely repeats the tired old bromide about clinical trials not being the only form of evidence worth considering, the tu quoque bleat about many conventional treatments being given without solid evidence and the pseudo-technical complaint about treatment and control groups in trials not using the right needle-sticking points.
You state that you see shades of grey in the question of acupuncture’s role in infant colic, “and indeed in life in general” — as do most people. And indeed, infant colic is a condition for which the ‘shades of grey’ aspect certainly pertains: definitions vary for both diagnosis and clinical response to treatments.
But this shouldn’t permit a reasonable person to afford every possible idea, however fundamentally silly, equal consideration. A quick google with the words “XXX for infant colic” swiftly reveals that it’s not just acupuncture that claims it ‘may’ effect cures of colic: XXX can also be reiki, chiropractic, homeopathy, reflexology or herbal medicine. I’m sure the list could be longer, but the point is: why should sticking needles into babies be afforded any more credibility that touching/waving hands, manipulating spines, sugar pills, foot massage or mixed herbs?
Or, while we’re at it, asfoetida, basil, fennel, chamomile tea, peppermint, orange blossom water or apple cider vinegar, all of which are listed on this website among 25 ‘effective’ home remedies for infant colic?
It seems very obvious that a condition as clearly ‘grey’ as infant colic can appear to respond to just about anything. To use this condition as a means of supporting your particular religious belief (that acupuncture is a medically relevant procedure) seems a rather pathetic barrel-scrape, to say the least.
I’m sorry you find the points I tried to make ‘tired’ etc. I felt they were important to mention.
‘…why should sticking needles into babies be afforded any more credibility that touching/waving hands, manipulating spines, sugar pills, foot massage or mixed herbs?’
I’m not necessarily saying it should – acupuncture is my area of interest, and I haven’t looked into the evidence for those other interventions in any detail. But as I tried to outline in my post, I think the current evidence for acupuncture is at least promising. The website you link to doesn’t seem to discuss the evidence for their claims much at all, and I don’t see what relevance it has to my post.
‘It seems very obvious that a condition as clearly ‘grey’ as infant colic can appear to respond to just about anything’
That’s the point of clinical trial design, isn’t it? Hopefully we’ll see more in the future, taking the best aspects from these trials and adding further clarity.
Your subjective opinion that acupuncture is ‘fundamentally silly’ hardly informs the debate.