Stephanie Claydon remembers her newborn’s first visit to a chiropractor like one of those tearjerker videos where babies get fitted with glasses for the first time. She’d brought her two-week-old son, Samuel, in for treatment after noticing he could only turn his head to one side.“The chiropractor used her thumbs and index fingers to touch pressure points along his spine and neck,” Claydon recalls. “As soon as she was done, his eyes opened so big, and he looked around as if to say, ‘Wow, there’s a whole other world on this side of my head!’”
She hadn’t gone there without trepidation, though. The Toronto mother of two says she’s always been a bit iffy on chiropractic care for herself, so she was cautious when making an appointment for her son after a few friends recommended it. “I get a lot of massages, but getting my spine adjusted—just the idea of all that cracking—it made me nervous to bring him.” But she was quickly reassured by the chiropractor’s approach. “She walked me through everything,” says Claydon. “She put her thumb on me to say, ‘This is as hard I’m pushing,’ and it was like somebody just touched your arm. There was no cracking his neck or anything like that.” The results after a single visit left her amazed: Her son could turn his head to both sides, and the stiffness never came back.
Her feelings of uneasiness returned, however, a few days after the appointment. “I saw an article about chiropractic care and children,” Claydon says. “It said something along the lines of, it could do more harm than good,” she states. She was suddenly worried she’d exposed her newborn to something dangerous. “I was like, ‘What have I done, exactly?’”
About 4.5 million Canadians include a chiropractor in their lineup of healthcare providers each year, visiting one of approximately 9,000 licensed chiropractors, according to the Canadian Chiropractic Association (CCA). Stats on how many Canadian children are treated by chiropractors aren’t available, but a recent study in Ontario found that children younger than 15 made up 5.5 percent of the patients of 42 chiropractors who were surveyed.
Chiropractic care, in general, has a history of being a controversial topic (just try bringing it up at a family dinner). But a recent video ignited concern over very young babies being treated by chiropractors. It came out of Melbourne, Australia, in February 2019, and shows a chiropractor adjusting a newborn’s spine by hanging him upside-down and using a spring-loaded device on the infant’s neck, despite the baby’s obvious distress.
A month later, the Chiropractic Board of Australia temporarily banned spinal manipulative therapy (SMT) for kids under two while it awaits the outcome of an independent research review of the practice (the results have yet to be released).
In light of Australia’s review, the College of Chiropractors of British Columbia (CCBC), which regulates and licenses B.C. chiropractors to protect the health and safety of British Columbians, announced in July 2019 that it would also be conducting a review of SMT in children under the age of 10. The results, released in September, concluded that “the treatment of children with SMT does not present a significant risk to the public.”
A reassuring outcome for many parents. But with moms in playgroups and on social media extolling the benefits of chiropractic care to treat everything from colic and bedwetting to autism, here’s what you need to know about the safety of chiropractic care for kids.
How chiropractors treat kids
Ask Dr. Dina: Is chiropractic care safe for kids? Chiropractors use an array of therapies to treat their patients. One of the most common treatments is spinal manipulative therapy, in which precise, hands-on adjustments are made to the vertebrae of the spine. These adjustments target the joints of the spine, aiming to create more room for the joint to move around. SMT is the most common culprit for the cracking sounds that make some people skittish about chiropractic care. But that audible pop is simply the sound of a joint releasing an air bubble, like when you crack your knuckles. Chiropractors also use other therapies, including soft tissue therapy, like massage, and at-home exercises, to treat the spine or any other part of the musculoskeletal system that is causing their patients trouble, like knees or wrists.
“Chiropractic treatment is much broader than SMT, particularly when treating kids,” says Debbie Wright, a chiropractor who’s been practising in Courtenay, B.C., for more than 17 years. With children and infants, mainly assessment and advice are offered, and then hands-on treatment if required, which “is modified for smaller frames and frequently involves gentle touch and spinal massage, stretching and exercises”—therapies that are unlikely to lead to that unnerving popping sound.
Parents who bring their kids to a chiropractor are most often looking for help with an injury, says Wright, “after, say, a collision at soccer or a fall off the playground equipment.” Lauren Moses-Brettler, a Toronto mother of three boys—one of whom spends a lot of time on sports fields—is a fan of chiropractic care. “My eldest was having a lot of leg and knee pains that were brushed off as growing pains by his paediatrician. He plays a lot of baseball, and he’s so tall—plus there’s a history of knee disease in my family. We thought it was worth also having him seen by a chiropractor,” she says. “He’s been going semi-regularly for a few years. The chiropractor does some stretches and a few actual adjustments to his knees and legs. It’s all very gentle and he’s always happy to go. It’s not a miracle cure but it definitely lessens his discomfort.”
With infants, says Wright, torticollis (the medical name for the tight neck muscle Claydon’s son was most likely suffering from) is a common reason parents will bring their baby to a chiropractor, since it can lead to issues with nursing (a sore neck can make it hard for a baby to comfortably get into a good position for breastfeeding). Parents of older children might also be seeking help with scoliosis or kyphosis (both abnormalities of the spine). But in no way, says Wright, is hanging a baby upside down part of routine treatment.“These techniques are not typical, nor were they part of my education,” she says. “It is not something I would do.”
Still, some parents are bringing their kids to chiropractors for ailments that aren’t obviously connected to the spine or to movement—things like colic, asthma, ear infections, autism and ADHD. These conditions are not within the scope of a chiropractor’s practice, says Wright. “Our clinical expertise is in the assessment, diagnosis and treatment of the spine, muscles and nervous system,” she says. “So if a parent is looking for care for a childhood condition that’s not in that area of expertise, I’m going to refer them back to their doctor or another healthcare provider.”
What can a chiropractor treat?
While the B.C. College concluded that spinal manipulation does not pose significant risk for kids under 10, it very clearly outlined in an October 2018 policy that its chiropractors “must not represent to the public that chiropractic has any beneficial effect on childhood diseases, disorders or conditions such as: ADHD (or ADD), autism spectrum disorders including Asperger syndrome, cerebral palsy, Down syndrome, fetal alcohol syndrome, or developmental and speech disorders.” Other provincial regulatory bodies across the country do not specifically state on their websites whether their members can claim to treat any of these or other childhood conditions.
But if you’re a parent struggling with a child with ADHD or a baby with colic, for example, you might be ready to try just about anything that might help—and it wouldn’t be hard to find a chiropractor willing to try. A 2014 study looked at the websites of 80 chiropractors across Canada and found that 37.5 percent offered treatment for ADHD, while 45 percent claimed they could help with colic.
“Colic is the bane of many parents,” says Wright. “But the current evidence suggests that chiropractic has no benefit to colic beyond a placebo. There is limited evidence that taking a colicky infant to a chiropractor may result in fewer reported hours of colic, according to some parents. But’s it’s not strong. More research is needed.”
Marc Halligan*, a B.C. chiropractor who estimates that about 15 percent of his clients are children (and who asked that his real name be withheld), says finding research to back up chiropractic care can be challenging because studies are most often performed on adults. What’s more, he notes that those in the medical profession often prescribe pharmaceuticals to kids for things like reflux, or ADHD, and it’s accepted. “Yet the idea of a chiropractor doing something gentle, safe and effective to try to help a child worries them—that’s a double standard,” he says.
“I’ve seen many things respond well to chiropractic care,” he says. “Colic, ear infections, reflux, sleep issues, bedwetting—often we’ll see an improvement, even though it’s not a treatment for those things.” Halligan feels it’s crucial to be clear with parents that “we’re not replacing medicine. This is not a diagnosis or treatment of any medical condition, but we can check your child’s spine and nervous system for imbalances.” If imbalances are detected and corrected, he says, a child’s body “will have a better ability to adapt and heal itself.”
What causes a spine and its nerves to be out of balance? Some chiropractors blame it on a “vertebral subluxation complex,” or subluxation for short—a misalignment of your spine that impinges on your nerves and affects your overall health. In chiropractic and medical circles, however, subluxation has become a trigger word. Some say it flat-out does not exist (and the dearth of evidence sides with them), while some feel strongly that it does (but concur that more research would be helpful).
It’s a nitpicky divide that’s been shaped by decades of history, complicated by health-insurance providers and what they’ll cover, and sensationalized by the media, often in response to a few outliers like that doctor in Melbourne. To stay away from that grey area, some chiropractors steer clear of the term altogether and restrict themselves to offering pain relief for musculoskeletal conditions like whiplash or low-back pain, or torticollis and sports injuries in children and infants.
The Canadian Paediatric Society (CPS) has a position statement on its website, updated in February 2018, that digs into the nitty-gritty of the available research. On colic, for example, it mentions one study that compared drug therapy with spinal manipulation, where SMT came out the winner. But it then goes on to explain how the study does not meet the rigorous standards of medical research. “Some chiropractors,” it acknowledges, “do not believe that controlled clinical trials are the best way to validate their methods.” Generally, the CPS says that reports of paediatric complications from chiropractic treatment are few.
So how does a busy parent, who can barely keep a pair of socks matched, wade through all that noise? As with any medical professional, start by checking credentials. Chiropractors in Canada must complete an undergrad, attend a certified chiropractic college for four years (there are only two accredited schools in Canada), and pass licensing exams. Wright suggests getting a recommendation from a friend or family member, “then go in and have a chat before you book an appointment.” Be skeptical of any treatment that is touted as a cure, or sounds too good to be true. It’s also a smart idea to talk to your doctor or paediatrician before bringing your child to a chiropractor. They may suggest a different health professional who will work with your child to treat the condition you’re concerned about.
Claydon, Samuel’s mom, advises making sure you understand and are comfortable with any treatment before it begins. “I had a good experience. I did my research and found someone who had a lot of experience treating babies. I never felt like my child was in danger of being hurt.”