At Thrive we pride ourselves on staying up to date with the most current research on chiropractic care for babies and children. 

We want to make sure we have all the available information to offer your child the best and safest chiropractic care possible.

Here is a summary of the literature and if you wish to read these articles in full, we’ve included links.

Chiropractic spinal manipulation of children under 12: Independent review

There is no record of any serious adverse events with babies or children under 12 in Australia. 

The public survey was overwhelmingly positive:

• Almost 22,000 members of the public who had taken their children to see a chiro responded, more than any other survey of its kind by quite a long way

• 99.7% expressed satisfaction with the service they had received

• 98% said they felt it had benefited their children

Read the full independent review into chiropractic spinal manipulation of children under 12 in Australia.

Chiropractic care for children infographic.

How does manual therapy compare with other common treatments for infantile colic, positional plagiocephaly and congenital muscular torticollis?

Method

Systematic review of systematic reviews and guidelines on the effectiveness of treatments for infantile colic, positional plagiocephaly and congenital muscular torticollis.

We extracted data of the included reviews, assessed their quality and compared treatment outcomes.

Results

There was mixed quality evidence to show that manual therapies were beneficial for reducing crying time for colic, improving symmetry in positional plagiocephaly and range of movement in congenital muscular torticollis.

• Infantile colic: Low to moderate evidence for reducing crying time. Low risk.

• Positional plagiocephaly:

  • Manual therapy: moderate to high evidence compared to repositioning.

  • Re-positioning therapy (with or without pillow): moderate to high evidence compared to usual care.

  • Helmet therapy: low favourable evidence

Adverse Events Due to Chiropractic and Other Manual Therapies for Infants and Children: A Review of the Literature

Objective

The purpose of this study was to review the literature for cases of adverse events in infants and children treated by chiropractors or other manual therapists, identifying treatment type and if a preexisting pathology was present.

Method

English language, peer-reviewed journals and non-peer-reviewed case reports discussing adverse events (ranging from minor to serious) were systematically searched from inception of the relevant searchable bibliographic databases through March 2014. Articles not referring to infants or children were excluded.

Results

Thirty-one articles met the selection criteria. A total of 12 articles reporting 15 serious adverse events were found. Three deaths occurred under the care of various providers (1 physical therapist, 1 unknown practitioner, and 1 craniosacral therapist) and 12 serious injuries were reported (7 chiropractors/doctors of chiropractic, 1 medical practitioner, 1 osteopath, 2 physical therapists, and 1 unknown practitioner). High-velocity, extension, and rotational spinal manipulation was reported in most cases, with 1 case involving forcibly applied craniosacral dural tension and another involving use of an adjusting instrument. Underlying pre existing pathology was identified in a majority of the cases.

Conclusion

Published cases of serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are rare. The 3 deaths that have been reported were associated with various manual therapists; however, no deaths associated with chiropractic care were found in the literature to date. Because underlying pre existing pathology was associated in a majority of reported cases, performing a thorough history and examination to exclude anatomical or neurologic anomalies before applying any manual therapy may further reduce adverse events across all manual therapy professions.

Best Practices for Chiropractic Care of Children: A Consensus Update

Objective

Chiropractic care is the most common complementary and integrative medicine practice used by children in the United States, and it is used frequently by children internationally as well. The purpose of this project was to update the 2009 recommendations on best practices for chiropractic care of children.

Methods

A formal consensus process was completed based on the existing recommendations and informed by the results of a systematic review of relevant literature from January 2009 through March 2015. The primary search question for the systematic review was, “What is the effectiveness of chiropractic care, including spinal manipulation, for conditions experienced by children (<18 years of age)?” A secondary search question was, “What are the adverse events associated with chiropractic care including spinal manipulation among children (<18 years of age)?” The consensus process was conducted electronically, by e-mail, using a multidisciplinary Delphi panel of 29 experts from 5 countries and using the RAND Corporation/University of California, Los Angeles, consensus methodology.

Results

Only 2 statements from the previous set of recommendations did not reach 80% consensus on the first round, and revised versions of both were agreed upon in a second round.

Conclusions

All of the seed statements in this best practices document achieved a high level of consensus and thus represent a general framework for what constitutes an evidence-based and reasonable approach to the chiropractic management of infants, children, and adolescents.

A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children

Objective

A literature review of tensile strength of adults and pediatric human spine specimens was performed to gather information about biomechanical forces and spinal differences of adults and children and to synthesize these findings into a scaling model to guide safety and clinical decisions for spinal manipulative therapy (SMT) for children and infants.

Methods

The literature search was performed using PubMed from inception to November 2012 with no filters or language restrictions. The search included terms related to pediatric spine biomechanics and tensile strength. Studies included those in which human tensile strengths necessary to create anatomical damage in the cervical, thoracic, or lumbar spine of pediatric human subjects were recorded. The pediatric population was defined as human subjects from birth to 18 years old. Biomechanical findings were used to propose a scaling model based on specimen age and differences in tensile strengths. A model of care was proposed using the scaling model and the existing literature on pediatric technique adaptations.

Results

Nine experimental studies were selected, 5 in the pediatric population (46 specimens) and 4 in the adult population (47 specimens). Mean tensile strengths were estimated, and ratios were used to describe differences between 4 age groups. The preliminary model of care proposed includes maximum loading forces by age group. From these studies, a model showed a nonlinear increase in the cervical spine tensile strengths based on specimen age.

Conclusions

The literature showed that tensile strength differences have been observed between pediatric and adult specimens. A preliminary model of care including pediatric SMT technique adaptation based on patient age is proposed, which may possibly contribute to further knowledge of safety and clinical implications for SMT for children and infants.

Forces of Commonly Used Chiropractic Techniques for Children: A Review of the Literature

Objective

The purpose of this study is to review the available literature that describes forces of the most commonly used chiropractic techniques for children.

Methods

Review of the English-language literature using search terms Chiropract* and technique, protocol, or approach in databases PubMed, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, and Index to Chiropractic Literature and direct contact with authors of articles and book chapters.

Results

Eleven articles that discussed the 7 most commonly used pediatric chiropractic techniques and the forces applied were identified. Chiropractic techniques reviewed described forces that were modified based on the age of the patient. Force data for mechanically assisted devices were varied, with the minimum force settings for some devices outside the age-specific safe range recommended in the literature when not modified in some way.

Conclusion

This review found that technique selection and application by chiropractors treating infants and young children are typically modified in force and speed to suit the age and development of the child.

Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analyses

Objective

To conduct a systematic review and meta- analyses to assess the effect of manual therapy interventions for healthy but unsettled, distressed and excessively crying infants and to provide information to help clinicians and parents inform decisions about care.

Methods

We reviewed published peer-reviewed primary research articles in the last 26 years from nine databases (Medline Ovid, Embase, Web of Science, Physiotherapy Evidence Database, Osteopathic Medicine Digital Repository , Cochrane (all databases), Index of Chiropractic Literature, Open Access Theses and Dissertations and Cumulative Index to Nursing and Allied Health Literature). Our inclusion criteria were: manual therapy (by regulated or registered professionals) of unsettled, distressed and excessively crying infants who were otherwise healthy and treated in a primary care setting. Outcomes of interest were: crying, feeding, sleep, parent–child relations, parent experience/satisfaction and parent-reported global change.

Results

Nineteen studies were selected for full review: seven randomised controlled trials, seven case series, three cohort studies, one service evaluation study and one qualitative study. We found moderate strength evidence for the effectiveness of manual therapy on: reduction in crying time (favourable: −1.27 hours per day (95% CI −2.19 to –0.36)), sleep (inconclusive), parent–child relations (inconclusive) and global improvement (no effect). The risk of reported adverse events was low: seven non-serious events per 1000 infants exposed to manual therapy (n=1308) and 110 per 1000 in those not exposed.

Conclusion

We found moderate favourable evidence for the reduc- tion in crying time in infants receiving manual therapy care (around 1hour per day), but this may change with further research evidence. We still do not know if this result is meaningful to parents or if the reduction is due to the manual therapy component of care or other aspects of care. For other outcomes, the strength of evidence was low and inconclusive. Manual therapy appears relatively safe.

Can a paediatric chiropractor help your child?