title: Chiropractic management of cow's milk protein intolerance in infants with sleep dysfunction syndrome: a therapeutic trial.
abstract: OBJECTIVE
  In addition to the more usual cutaneous, gastrointestinal, and respiratory problems, infants with cow's milk intolerance (CMI) may present with a disturbed sleep pattern. Frustrated mothers may turn to their doctor of chiropractic for assistance. This pilot study shows how a therapeutic trial may offer a realistic, noninvasive approach to the chiropractic management of infants with this clinical problem.
  
  
  METHODS
  A pilot study to describe the presentation and treatment of infants presenting with disturbed sleep patterns to a chiropractic clinic was undertaken. Infants fulfilling a clinical screening protocol for CMI were selected for a therapeutic trial. The sleep behavior of subjects was monitored over a 4-week period during which they were managed by dietary change and a high-impulse, low-amplitude whole-of-body chiropractic management protocol.
  
  
  RESULTS
  Fifty-nine infants presented with disturbed sleep. Of these, 19 met the clinical criteria used to establish the diagnosis CMI. The mothers of breast-fed infants were counseled on how to implement a dairy-free diet, and those infants who were artificially fed were changed from cow's milk-based formulae to either a partially or wholly hydrolyzed formula. Fourteen achieved a stable sleep pattern within the study period. In 5 instances, the sleep pattern remained problematic, but other clinical evidence of hypersensitivity reactions attributable to CMI disappeared. By the end of the study, no subject had demonstrable evidence of either biomechanical derangement or functional neurologic imbalance.
  
  
  CONCLUSIONS
  CMI should be considered as a possibility in infants with disturbed sleep patterns who present for chiropractic care. This study describes how a therapeutic trial involving dietary modification, parental counseling, and comprehensive chiropractic care may offer a noninvasive approach to excluding and/or managing this condition. Further research is required before definitive recommendations can be made.
authors.affiliation: School of Chiropractic, Division of Health Sciences, Murdoch University, Perth, Western Australia.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Jamison
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Davies
mesh_terms: D003376:Counseling; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D026882:Manipulation, Chiropractic; D016269:Milk Hypersensitivity / Q000150:complications* / Q000178:diet therapy / Q000628:therapy*; D010865:Pilot Projects; D012893:Sleep Wake Disorders / Q000209:etiology*; D016896:Treatment Outcome