There are over 1 million visits by children to Australian chiropractors every year. In the USA this figure is as high as 30 million. The majority of these visits are for the treatment of muscle and joint problems that may produce back pain, hip pain, knee pain and others. Sporting injuries and developmental problems are other reasons parents bring their children to see a chiropractor.
Children are not just little adults. Consideration of their unique clinical presentation is vital for high quality chiropractic care. In addition, chiropractic techniques need to be tailored to the individual needs of the child.
Spinal adjustments for children are performed using gentle fingertip pressure or instrument-assisted techniques. Best practice dictates that techniques used for young children are never FORCEFUL, but are modified suitably for the age and developmental stage of the child. Most children find receiving an adjustment relaxing and enjoyable. Most parents are happy to see that the examination is very thorough and the techniques are very gentle.
In a 2015 study published in the Journal of Manipulative and Physiological Therapeutics it showed that serious adverse events in children are exceedingly rare, but real..
Infantile Colic (Unsettled Baby)
The most common reason parents bring children under the age of one to our practice is for the treatment of colic, also known as Unsettled baby. Despite its popularity, in some medical circles, chiropractic care for colic is considered controversial.
Colic is a blanket term that describes a set of symptoms that may include:
- Persistent crying
- Flushing of the face
- Distended and tense abdomen
- Legs curling up to abdomen
- Symptoms often prominent at certain times of the day/night (the witching hour)
- Relief often seen with passage of wind (flatus) or following a bowel motion
Infantile colic is unexplained persistent crying in an otherwise well baby and affects 10-30% of all infants. Although this is not a serious pathology, it can have a very distressing effect on the entire family. Most cases of colic reach their peak at 6weeks of age, then slowly abate. More than half of ‘colicky’ babies are settled by 6months of age.
Chiropractic is holistic approach that seeks to explore all aspects of health. One vital aspect is the balance of the spine and subsequent functioning of the nervous system. This can easily be upset at the time of birth – especially in more complicated deliveries such as forceps, breech or caesarian.
Other important factors include nutrition, the presence of allergies or food intolerance and sleep/wake cycles.
There have been 4 randomised studies looking into the effect of chiropractic care for the unsettled baby. Three of these studies showed favourable results, but one showed chiropractic care to be no better than placebo.
The most recent study was performed in 2012 in the UK. Miller and colleagues took 104 colicky infants under 8 weeks of age and separated them into 3 groups:
1) Infant treated – parent aware
2) Infant treated – parent unaware
3) Infant not treated – parent unaware
After 2 weeks the decrease in crying for the treatment group was 51% (parent aware) and 44% (parent unaware). The non-treatment group only improved by 19%.
The results suggest chiropractic care may be effective in reducing crying time in colicky infants and goes against the findings of a 2001 study that suggested it was no better than placebo.
Identifying postural distortions such as scoliosis, short leg syndrome, forward head posture, excessive foot pronation or other imbalances are an important part of paediatric assessment. “As the twig is bent, so grows the tree.”
In most cases these imbalances cause no obvious pain, though pain during growth spurts may be associated with these distortions.
ASSESSING YOUR CHILD’S POSTURE
From behind check that the following body landmarks line up evenly:
- Head alignment – it is most accurate to look at the bony points behind the ears, but sometimes the ears alone can give you a clue
- Shoulder alignment – are the tips of the shoulders even?
- Pelvic alignment – feel the bony tops at the waist (iliac crests) to see if they are even
- Knee alignment – do the knees appear ‘knocked’ together or ‘bowed’ apart?
- Feet – Do the arches roll in or sit too high? Is there uneven wear of the shoes.
From the side check that the following body landmarks line up vertically:
- The hole of the outer ear (external auditory meatus)
- Point of the shoulder
- Outer bony part of the hip (greater trochanter)