Children and Chiropractic Care:
Birth to 18 Years
Conditions cared for and side effects
A report on the scientific literature
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Chiropractic has been successfully caring for children for various conditions for over a century. The main issues are what conditions are cared for by chiropractors, what is the reported success rate and what is the incidence of side effects. Over time, research has started to catch up on what individual chiropractors have been realizing in their private practices and this article will outline the current state of the literature.
Marchand (2012) reported that an extensive European study was performed revealing that 8.1% of chiropractic practices were children between the ages of 0-18 (this is lower than the 17.1% of pediatric case loads of American Chiropractors.) This was based upon 921 doctors of chiropractic participating and reporting 19,821 pediatric visits, thereby certifying a valid cross-section of patients to conclude results.
The pediatric related conditions that were reported to be cared for by chiropractors were the following:
Miller and Benfield (2008) conducted a study of children younger than 3 years old to determine the adverse effects of chiropractic care in that age group, arguably the most susceptible to injury based upon the fragility of that age group. The study was based upon 5,242 chiropractic adjustments and if the results were extrapolated to the wider infant/toddler population that receives chiropractic treatment, the adverse reaction rate is expected to be 1 out of every 1300 chiropractic adjustments. There was less than 1% of patients experiencing negative side effects and all of these adverse reactions to care were mild in nature; transient and required no medical care with serious complications. The typical reaction was transient crying.
The “Practical Application” reported by Miller and Benfield was that chiropractic adjustments were safe for young children and adolescents.
Marchand (2012) also reported the negative side effects of chiropractic care in children to be less then 1% (0.23%,) which is consistent with what Miller and Benfield reported 4 years prior in an independent study. However, Marchand went further to categorize the negative side effects into mild, moderate and severe. In a 1 year study of 237,857 pediatric patients, there was a reported 534 mild side effects (0.2%) and 23 (0.009%) had moderate side effects with 0 (zero) reporting any severe side effects.
To render perspective on the safety of chiropractic care and children Le, Nguyen, Law and Hodding (2006) reported "The incidence of adverse drug reactions among hospitalized children in the United States has not been well studied. Because clinical trials involving neonates, infants, children, and adolescents are limited, the safety and tolerability of many pharmacologic agents are not well established. Often the pharmacologic actions of drugs in neonates, infants, and children are not similar to those identified for adults; therefore, information obtained from research with adults cannot be applied directly. On the basis of a meta-analysis of 17 prospective studies conducted in the United States and Europe, the incidence of adverse drug reactions among hospitalized children was 9.5%, with severe reactions accounting for 12% of the total (pg. 557.)
The above study indicates that side effects need more researched in many sects of health care, but comparatively speaking, chiropractic is a much safer choice than most alternative options.
Over time, research will continue to render more outcome statistics on the efficacy of chiropractic care. However based upon the current statistical conclusions, chiropractic is being utilized to help an array of maladies worldwide in the pediatric population with minimal to no side effects.
Children/Pediatric Utilization of Chiropractic Care
A report on the scientific literature
Mark Studin DC, FASBE(C), DAAPM, DAAMLP
83% of children under 3 years old were referred by their medical practitioners
Children have been under chiropractic care for almost 100 years according to my 30 years of rendering chiropractic care to children and the 2 generations of my instructors and mentors that taught me how to care for children. While there is a growing body of evidence of the efficacy of chiropractic care and childhood maladies, the amount of children under care and being referred to chiropractors by pediatricians and other medical doctors is growing.
In December, 2008, the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health, released findings on Americans and the use of complementary and alternative medicine (CAM). "The findings are from the 2007 National Health Interview Survey (NHIS), an annual in-person survey of Americans regarding their health- and illness-related experiences. The CAM section gathered information on 23,393 adults aged 18 years or older and 9,417 children aged 17 years and under" (National Center for Complementary and Alternative Medicine, 2008, http://nccam.nih.gov/news/camstats/ 2007/camsurvey_fs1.htm). They found that 11.8% of children in the United States have undergone CAM therapies, indicating that children aren’t obtaining the desired outcomes and their parents are looking for solutions.
CAM is a term applied to any healing discipline that does not fall into the category of traditional medicine or any health care that traditional medicine must govern over, such as nursing or physical therapy, rendering those as secondary health care providers and not allowing them to care for patients unless under the supervision of a medical doctor. Chiropractic is considered part of CAM simply because doctors of chiropractic are not medical doctors or secondary providers requiring supervision by a medical doctor.
Miller reported in 2010 on 2,645 children that were treated in the outpatient clinic of the Anglo-European College of Chiropractic from 2006-2010 for various maladies. Of these children, 87% were under the age of 5 and 13% were between 5 and 13. 34% were seen for musculoskeletal problems such as neck pain and postural issues, 30% were treated for infant colic/excessive crying, 16% for feeding disorders and the balance for various other issues. Every child had been seen by at least one medical practitioner and some by many medical providers. Of the 2,645 children referred to the chiroprctic clinic, 83% were referred by thier medical physicians.
According to Jandial, Myers, Wise, and Foster in 2009, 21% of all medical practitioners, including pediatricians, had no confidence in treating musculoskeletal issues and only 53% had "some" confidence in treating musculoskeletal issues in children. Considering the "self-rated" format of this study, there are no interpretation issues of the results. Miller (2010) also reported in the study that 83% of the children under 3 years of age were referred by medical practitioners, underscoring the need for this type of care and the efficacy of the care for children. In a limited study, Alcantara and Davis (2010) reported improvement with chiropractic treatment in children with attention deficit hyperactivity disorder (ADHD) as well as various other limited and case studies. While significantly more research is required for children and chiropractic care, the growing body of recognition by the medical and chiropractic communities and the public gives evidence to the results of chiropractic care in the pediatric population.
1. National Center for Complementary and Alternative Medicine. (2008, December). The use of complementary and alternative medicine in the United States. Retrieved from http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm
2. Miller, J. (2010). Demographic survey of pediatric patients presenting to a chiropractic teaching clinic, Chiropractic & Osteopathy,18(33), Retrieved from http://www.chiroandosteo.com/content/pdf/1746-1340-18-33.pdf
3. Jandial, S., Myers, A., Wise, E., & Foster, H. E. (2009). Doctors likely to encounter children with musculoskeletal complaints have low confidence in their clinical skills. Journal of Pediatrics, 154(2), 267-271.
4. Alcantara, J., & Davis, J. (2010). The chiropractic care of children with attention-deficit/hyperactivity disorder: A retrospective case series. Explore, 6(3), 173-182.