Prognostic significance of subgroup classification for infant patients with crying disorders: A prospective cohort
1Anglo-European College of Chiropractic (Bournemouth University), 3-15 Parkwood Road, Bournemouth, Dorset BH5 2DF, UK.
Insights
Excessively crying infants are not a single group. This study identified subgroups, finding that infant colic babies showed the most improvement in crying and consolability with treatment.
Area of Science:
- Pediatrics
- Infant Health
- Clinical Research
Background:
- Limited effective treatments exist for excessive infant crying.
- Subgroup identification may improve treatment efficacy.
- This study explored a novel categorization protocol for crying infants.
Purpose of the Study:
- To subgroup infants with excessive crying.
- To compare treatment outcomes across identified subgroups.
- To investigate the association between subgroups and symptom changes.
Main Methods:
- Observational cohort study of 158 infants (July 2007-March 2008).
- Infants categorized into: infant colic, irritable infant syndrome of musculoskeletal origin (IISMO), and inefficient feeding crying infants with disordered sleep (IFCIDS).
- Manual therapy outcomes (crying, stress, sleep, consolability) assessed via questionnaires; multivariable analysis of covariance used.
Main Results:
- No significant demographic or baseline differences between groups.
- Subgroups were significantly associated with differential treatment outcomes.
- Infant colic subgroup demonstrated the greatest improvement in consolability and crying.
Conclusions:
- Excessively crying infants represent a heterogeneous population.
- Targeting specific infant subgroups may enhance treatment success.
- Subgrouping prior to intervention is recommended for improved outcomes.
Introduction:
Few convincing treatment options have been identified for the excessively crying infant. One explanation may be a lack of identification of patient subgroups. This study used a clinically plausible categorization protocol to subgroup infants and compared changes in symptoms between these subgroups during treatment.
Methods:
An observational cohort design was employed. All infants presenting with excessive infant crying between July 2007 and March 2008 were categorized into three subgroups, (A) infant colic, (B) irritable infant syndrome of musculoskeletal origin (IISMO) and (C) inefficient feeding crying infants with disordered sleep (IFCIDS) based on history and physical findings. Mothers completed questionnaires which rated their own and their child's characteristics prior to and at the end, of a course of manual therapy. Independent associations between infant subgroups and changes in continuous outcomes (crying, stress, sleep, and consolability) were assessed. Multivariable analysis of covariance was used to identify and control for potential confounders.
Results:
A total of 158 infants were enrolled. There was no significant difference in demographic profile between groups or any significant difference in infant crying or level of maternal stress at the start. Only the putative subgroups were significantly associated with differences in outcomes. In general, colic babies improved the most in consolability and crying.
Conclusion:
Babies with excessive crying should not be viewed as a homogenous group. Treatment outcomes may be improved by targeting appropriate subgroups prior to treatment.
