Chiropractic Care Practices and Children

By dralexbello | children care

Dec 05
Chiropractic Care Practices and Children

The act of childbirth can be an extremely traumatic event –for both mother and child. The child is especially vulnerable to the forces placed on his/her spine. All forms of childbirth – c-section, vaginal birth, scheduled Cesarean or unscheduled Cesarean can stress a developing spine. The stress on the upper cervical spine is particularly susceptible. This is the area where the head and neck meet and is also known as the cranio-cervical junction. This junction houses the lower portion of the brainstem, which protrudes outside of the protective encasement of the skull. Irritation to this area can cause countless issues like colic, poor apatite, inexplicable crying and structural issues.

Awkward sleeping positions, crawling and the inevitable falls while learning to walk places stress on a child’s spine. During this period of growth, your child’s spine should be examined by a chiropractor for any structural shifts. If these structural shifts are not fixed or reduced and proper spinal motion is not restored more spinal problems will occur later in life. I typically give the analogy of the baby tree that was blown over slightly by wind and then grows into a crooked tree. This can set the stage for structural issues in the middle and lower back, ‘growing pains,’ and a weakened immune system response.

The chiropractor typically alters his/her techniques to fit a child’s size, weight and unique situation. In our office, we use an extremely gentle form of upper cervical chiropractic called Blair Upper Cervical, which means there is no twisting, cracking or popping of the neck. Parents often report that their children seem healthier than other kids their age.

Health Begins Before Birth

Babies can benefit from chiropractic care before they are born, by having a mother who receives prenatal chiropractic checkups. A healthy diet, proper exercise, key supplements, stress management, and a chiropractic lifestyle help prepare for a happy, healthy baby.

Cervical Spondylosis Treatment

Interesting Studies

The following studies are provided by the International Chiropractic Pediatric Association: www.icpa4kids.com

Birth trauma remains an under publicized and, therefore, an undertreated problem. There is a need for further documentation and especially more studies directed toward prevention. In the meantime, manual treatment of birth trauma injuries to the neuromusculoskeletal system could be beneficial to many patients not now receiving such treatment, and it is well within the means of current practice in chiropractic and manual medicine. (1)

“Spinal cord and brainstem injuries often occur during the process of birth but frequently escape diagnosis. Respiratory depression in the neonate is a cardinal signal of many injuries. In infants, there may be lasting neurologic defects reflecting the primary injury” (2)

The cause of clavicle fracture is the violent hurry of delivery, the drawing of the head before the birth of shoulders. (3)

This study suggests that the approach to the childbirth conducting should be changed so that the percentage of clavicle fractures can be reduced or noticed in time by the help of more frequent and systematic clinical examinations. (4)

Confirming clinical observation, average peak forces for some difficult and many shoulder dystocia deliveries exceed the force necessary to induce clavicle fracture at birth. (5)

There exists a positive relationship between cranial motion restrictions and learning disabled children, as well as children with a history of an obstetrically complicated delivery. (6)

Trauma to the cervical spine and head can cause such problems as headaches, vestibular troubles, auditory problems, visual disturbances, pharyngolaryngeal disturbances, vasomotor and secretion problems and psychic disturbances. Manipulation of the neck achieves excellent results with many of these conditions. (7)

Even after vaginal births, 4.6% of term neonates suffer unexplained brain bleeds and up to 10% suffer neonatal encephalopathy. These pathologies may possibly be avoided by decreasing distortion of fetal skulls, from pelvic misalignment, at delivery. Any late second stage labor position that denies posterior sacral rotation (the popular semi-recumbent position places the laboring woman squarely on her sacral apex) denies the mother and fetus crucial sagittal pelvic outlet diameter and jams the sacral tip up to 4 cm into the pelvic outlet. (8)

High cervical spinal cord injury in neonates is a specific complication of forceps rotation. (9)

Assisted breech or forceps deliveries can cause severe spinal cord injury seen in stillbirth and crib death (SIDS) autopsies. (10)

The neonatal mortality rate attributable to the use of the forceps was 34.9 per 1000. The incidence of delayed onset of respiration (17.4%), birth trauma (15.1%), and abnormal neurological behavior–namely, apathy or irritability or both–(23.3%) significantly exceeded those in a matched group of babies born spontaneously. Babies on whom forceps were used had a significantly greater incidence of abnormal neurological behavior. (11)

Among 44,292 infants born between October 1, 1982, and July 31, 1987, there were 92 recorded cases of congenital seventh nerve palsy. Of these ’81 were acquired’ for an incidence of 1.8 per 1,000. Seventy-four of the 81 (91%) were associated with forceps delivery. (12)

Recognized causative factors are traction on the infant’s trunk during the breech delivery, rotational stresses applied to the spinal axis, traction on the cord via the brachial plexus in shoulder dystocia, and hyperextension of the fetal head in breech delivery or transverse presentation. Recognition of these factors is the basis for prevention of this terrible accident. (13)

Case histories of over 135 babies with K.I.S.S. syndrome (Kinematic Imbalance due to Suboccipital Strain) reveal a significantly high portion of these babies suffered birthing injuries due to prolonged labor and use of extraction devices. (14)

The vacuum extractor exerts considerable traction force. A fetal skull fracture can result, and its true incidence may be higher than expected, considering that few neonates with normal neurologic behavior undergo skull x-ray. 6.&7. Scalp trauma occurred in 21% of our newborns delivered by vacuum extraction and was more common after longer vacuum applications, longer second stages, and paramedian cup placement. (15)

Delivery by vacuum extraction increases the incidence of perinatal injuries and consequently the incidence of neurological deficits in children. (16)

The incidence of Erb’s palsy in our population is similar to that of other reported studies and has remained unchanged over the past 30 years, even as our cesarean rate has risen from 5% to 20%. (17)

Erb’s palsy is the most common obstetric brachial plexus injury followed by total plexus palsy. (18)

When birth weight was controlled for in the analysis, mid-forceps vacuum, and low-forceps remained significantly associated with the Erb’s palsy. These data demonstrate a high risk for serious birth injury associated with instrumental midpelvic delivery. (19)

Seventy-five percent of cases of Erb-Duchenne palsy (Erb’s palsy) improved markedly, and far quicker than in the three-week waiting period before chiropractic treatment. (20)

Mild cases with C5-C6 root injury (Erb’s palsy) have a good outcome and may be treated conservatively. (21)

A 5-wk-old infant boy suffered from Erb-Duchenne palsy. The patient received specific chiropractic adjustments to the mid-cervical. The Erb’s palsy resolved with only a mild residual “waiters tip” deformity within 2 months. In this case, the chiropractic adjustment is suggested as an effective treatment for Erb’s palsy. (22)

1. Gottlieb MS; Neglected spinal cord, brain stem and musculoskeletal injuries stemming from birth trauma. J Manipulative Physiol Ther 1993; 16(8):537-43 / Medline ID: 94087093
2. Towbin, A; Latent spinal cord and brain stem injury in newborn infants. Develop Med Child Neurol 1969; 11:54-68 / Medline ID: 69208820
3. Jojart G; Zubek L; T�th G. Clavicle fracture in the newborn. Orv Hetil, 132(48):2655-7 1991 / Medline ID: 92100483
4. Jelic A; Marin L; Pracny M; Jelic N. Fractures of the clavicle in neonates. Lijec Vjesn 1992; 114(1-4):32-5 / Medline ID: 94118739
5. Allen RH; Bankoski BR; Nagey DA. Simulating birth to investigate clinician-applied loads on newborns. Med Eng Phys 1995; 17(5):380-4 / Medline ID:95400556
6.  Upledger JE, The relationship of craniosacral examination findings in grade school children with developmental problems., J Am Osteopath Assoc 1978; 77(10):760-76 / Medline ID: 78193624
7. Maigne, R., Orthopedic Medicine, A New Approach to Vertebral Manipulations. Charles C. Thomas, 1976
8. Gastaldo TD; Labor Posture. Birth 1992; 19(4):230 / Medline ID: 93112208
9. Menticoglou SM; Perlman M; Manning FA; High cervical spinal cord injury in neonates delivered with forceps: report of 15 cases. Obstet Gynecol 1995; 86(4 Pt 1):589-94 / Medline ID: 95405789
10. Towbin, A; Latent spinal cord and brain stem injury in newborn infants. Develop Med Child Neurol 1969; 11:54-68 / Medline ID: 69208820
11. Chiswick ML; James DK. Kielland’s forceps: association with neonatal morbidity and mortality. Br Med J 1979; 1(6155):7-9 / Medline ID: 79104560
12. Falco NA; Eriksson E. Facial nerve palsy in the newborn: incidence and outcome. Plast Reconstr Surg 1990; 85(1):1-4 / Medline ID: 90083438
13. Byers RK; Spinal-cord injuries during birth. Dev Med Child Neurol 1975; (1):103-10 / Medline ID: 75131672

14. Biedermann H; Kinematic Imbalance Due to Suboccipital Strain in Newborns. Manuelle Medizin 1992; 6:151-6
15. Teng FY; Sayre JW; Vacuum extraction: does duration predict scalp injury? Obstet Gynecol 1997; 89(2):281-5 / Medline ID: 97167347
16. Papaefthymiou G; Oberbauer R; Pendl G. Craniocerebral birth trauma caused by vacuum extraction: a case of growing skull fracture as a perinatal complication. Childs Nerv Syst 1996; 12(2):117-20 / Medline ID: 96270942
17. Graham EM; Forouzan I; Morgan MA. A retrospective analysis of Erb’s palsy cases and their relation to birth weight and trauma at delivery. J Matern Fetal Med 1997; 6(1):1-5 / Medline ID: 97181216
18. al-Qattan MM; Clarke HM; Curtis CG. Klumpke’s birth palsy. Does it really exist? J Hand Surg �Br� 1995; 20(1):19-23 / Medline ID: 95279850
19. McFarland LV; Raskin M; Daling JR; Benedetti TJ. Erb/Duchenne’s palsy: a consequence of fetal macrosomia and method of delivery. Obstet Gynecol 1986; 68(6):784-8 / Medline ID: 87066010
20. Biedermann H; Kinematic Imbalance Due to Suboccipital Strain in Newborns. Manuelle Medizin 1992; 6:151-6
21. Lindell-Iwan HL; Partanen VS; Makkonen ML; Obstetric brachial plexus palsy. J Pediatr Orthop B 1996; 5(3):210-5 / Medline ID: 97019833
22. Harris SL; Wood KW; Resolution of infantile Erb’s palsy utilizing chiropractic treatment. J Manipulative Physiol Ther 1993, 16(6):415-8 / Medline ID: 94014831

Follow

About the Author

Dr. Alexander Bello is a Southern California native and graduated from UCLA in 2003. He then went on to graduate from the Southern California University of Health Sciences with a Doctorate of Chiropractic from the Los Angeles College of Chiropractic.