In Reply We very much appreciate the complimentary letters in response to our article. The Kossowsky and Kaptchuk letter commented that the emotional response to a patient’s treatment could influence subjective complaints. Indeed, parents and health care professionals alike have a difficult time watching an uncomfortable child, perhaps even more so, an uncomfortable infant. Gassiness, perceived formula intolerance, and gastroesophageal reflux are other examples where an uncomfortable infant may have office visits outside of routine care that result in medical interventions that may not be supported by evidence and may not result in objective improvement. Alternatively, intervening commonly satisfies parental and, in many instances, health care professional instincts to help an uncomfortable child. In our study, it was unknown whether infants themselves had a response based on parent behavior as suggested in the text of the Kossowsky and Kaptchuk letter.
Paul IM. Placebo Effects in Infants, Toddlers, and Parents—Reply. JAMA Pediatr. 2015;169(5):505-506. doi:10.1001/jamapediatrics.2014.3801