When footage of a Melbourne chiropractor manipulating a four-day old baby’s spine went viral on social media earlier this year, the topic understandably gained a lot of negative attention. As a consequence, all manual therapists were given stern warnings about including non-musculoskeletal infantile complaints such as colic and ear infections in their advertising material.
Asides from scaring the pants out of every parent, however old or new, this video did no justice for the practitioners that do treat children and do treat them well. So for what conditions should a parent take their precious newborn to a manual therapist? And does all manual therapy for kids look like the ‘over-the-knee’ technique?
Thankfully it doesn’t.
Osteopaths are used to dealing with asymmetry. Asymmetric posture, asymmetric muscle tone and asymmetric joint function. In the infant, a well trained osteopath can detect asymmetric lie in utero (causing a misshapen head or foot) and asymmetric hip range of motion in the newborn (potentially indicating the presence or possible likelihood of dysplasia). As we expect the newborn spine to still have a preference for the rounded or C-shaped curve it develops in the womb, we can assess the spine for areas that may feel extended or arched – this may have occurred if the baby presented and was birthed posteriorly or if the mother had an extended ‘pushing stage’ during her labour. We can also assess the baby’s neck and jaw range of motion so that it has sufficient movement to turn and feed off both breasts. We can look and feel for tongue-tie.
So as osteopaths, what do we do once we find areas of asymmetry? I’ll impart a personal story to help you understand. Now nine weeks of age, I gave my little boy Louie his first osteopathic treatment on around day five of his life. He had been a bit windy and wiggly, so as a mum I pondered the possible reasons..was it the chocolate I ate, was it my milk flowing too fast, was it me taking him out in the windy weather? Not quite ready to part with the half-demolished block of chocolate in the pantry, I thought I’d see if I could lend a helping hand. As I held him looking up at me, with one hand under his head and one under his backside, I let what his body was telling me dictate the treatment. Post-birth some babies feel happier when slightly compressed, or when slightly flexed others feel more at ease in an arched position…I then take note of any preferences for bend or twist in the body. Now to the naked eye, it would look to an observer like I was doing nothing but holding my baby, these movements I was performing were micro in nature and directed towards the fascia of the body (the gladwrap like substance that encases our muscles and other soft tissues). I hold and wait and make further subtle adjustments with my hands to help his little body unwind. When he stretched his arms, let rip with a big poo and fell asleep he was telling me that his treatment was over.
A baby’s anatomy isn’t just a smaller version of an adults. Bones that are fused in the adult skeleton are separate entities in a newborn and can take months or even years to fuse. Certain conditions, whether musculoskeletal, cardiovascular or respiratory in origin are unique to babies. Therefore due care is required when taking a case history, performing a physical examination and applying any manual treatment. And at the heart of this matter, is the selection of our techniques when treating children. If a manual therapist chooses to open their doors to a wide age group then they should armour themselves with a wide array of effective techniques. A university lecturer once told my class ‘when all you’ve got is a hammer, everything starts to look like a nail’…so my advice to anybody considering taking their infant to a manual therapist is simple; do your research. Not only should the practitioner have a ‘special interest’ and ‘experience’ in treating infants but they should definitely have post-graduate training in the area. (Ideally, you would do the same when selecting your child’s GP and dentist too). And keep your children away from the hammer wielding manual therapists!