Case #3 Discussion

Case Review:

GR is a 6-week-old infant born at 34 weeks estimated gestational age whose post delivery course was complicated by a stay in the NICU including brief intubation, temperature instability and poor feeding. He was discharged from the hospital on day of life #14. He did well initially but has had progressive increasing periods of crying that have left his parents exhausted. They present to the office looking for options.

Questions to consider:

Is there evidence for massage therapy in this clinical situation?
Is there risk associated with a trail of massage therapy?
Will there be a delay in diagnosis by trying an alternative therapy such as a massage?

Discussion:

The data for massage in infants is mixed. Some studies suggest benefit for colic and crying. Others suggest no benefit over swaddling. The risk, however, is minimal. For parents interested in massage, there is no reason they should not be encouraged to experiment with it, in particular, because we do not have many other successful interventions for colic. As long as, clinically, you are not suspicious of another underlying cause of his symptoms, there is no contraindication to a trial of massage. It would be reasonable to also look at other techniques for calming an infant such as swaddling.
A good resource for parents for other soothing techniques is found in Harvey Karp's book, Happiest Baby on the Block.