Efficacy of Chiropractic Manual Therapy on Infant Colic:
A Pragmatic Single-Blind, Randomized Controlled Trial
J Manipulative Physiol Ther. 2012 (Oct); 35 (8): 600–607
In this study, chiropractic manual therapy improved crying behavior in infants with colic (50% reduction). The findings showed that knowledge of treatment by the parent did not appear to contribute to the observed treatment effects in this study. Thus, it is unlikely that observed treatment effect is due to bias on the part of the reporting parent.
Chiropractic Care of Children from Birth to Adolescence
and Classification of Reported Conditions: An Internet
Cross-Sectional Survey of 956 European Chiropractors
J Manipulative Physiol Ther. 2012 (Jun); 35 (5): 372–380
Pediatric patients represent between 5% and 17% of general chiropractic practice and 39% of specialist pediatric chiropractic practice. In the absence of high levels of evidence, doctors of chiropractic have relied on clinical experience and education to provide care. Pediatric health conditions seen by chiropractors have been reviewed systematically. Several authors have traditionally reported conditions in 2 distinct categories of musculoskeletal and nonmusculoskeletal conditions. The rationale behind such a separation has not been investigated (to the author's knowledge). The safety of spinal manipulative therapy in pediatric care has been addressed in the literature with few safety incidents reported. Of the 956 (23.3%) participating chiropractors, 921 reported 19,821 pediatric patients per month. Children represented 8.1% of chiropractors' total patient load over the last year. A total of 557 (534 mild, 23 moderate, and 0 severe) negative (adverse) side effects were reported for an estimated incidence of 0.23%. On the given treatment statements, chiropractors reported varying agreement and disagreement rates based on patient age. The 8,309 answers on conditions were grouped into skeletal (57.0%), neurologic (23.7%), gastrointestinal (12.4%), infection (3.5%), genitourinary (1.5%), immune (1.4%), and miscellaneous conditions (0.5%). The number of treatment sessions delivered varied according to the condition and the patient age.
Neck and Back Pain in Children:
Prevalence and Progression Over Time
Musculoskelet Disord. 2011 (May 16); 12: 98 ~ FULL TEXT
The following article appears to be the first study to track and review the progression of back pain in the same group of children, over a prolonged period, to see how (or if) it is a contributor to those same complains in adulthood. Of particular interest is Table 2, because it breaks down and tracks complaints of either neck, mid back, or low back pain in the same group of children at 3 different time periods: ages 9, 13 and 15 years old.
Effect of Backpack Load Carriage on Cervical Posture
in Primary Schoolchildren
Work. 2012 (Jan 1); 41 (1): 99—108
Subjects demonstrated immediate and statistically significant changes in craniovertebral angle (CVA), indicating increased forward head positions upon donning the backpacks containing 15% and 20% body weight. Following the walking of 6 minutes, the CVA demonstrated further statistically significant changes for all backpack loads indicating increased forward head postures. For the 15 & 20% of body weight conditions, more than 50% of the subjects reported discomfort after walking, with the neck as the primary location of reported pain.
Is Chiropractic Pediatric Care Safe?
A Best Evidence Topic
Clinical Chiropractic 2011 (Sep); 14 (3): 97–105
The reviewed published chiropractic literature suggests a rate of 0.53% to 1% mild adverse events (AE) associated with chiropractic paediatric manipulative therapy (PMT). Put in terms of individual patients, between one in 100 to 200 patients presenting for chiropractic care; or in terms of patient visits, between one mild AE per 1310 visits to one per 1812 visits. For a comparison, Osteopathic PMT have a reported rate of 9%, and medical practitioners utilising PMT under the auspices of ‘chiropractic therapy’ have reported a rate of 6%. A reasonable caution to the parent/guardian is that one child per 100 to 200 attending may have a mild adverse events, with irritability or soreness lasting less than 24 hours, resolving without the need for additional care.
Attitudes and Views on Chiropractic:
A Survey of United States Midwives
Complement Ther Clin Pract. 2011 (Aug); 17 (3): 135–140
A total of 187 midwife respondents completed the (online) questionnaire resulting in a superficial response rate of 2.1%. Responders were certified nurse-midwives and had some form of training regarding chiropractic. The responders were aware that chiropractors worked with "birthing professionals" and attended to patients with both musculoskeletal and non-musculoskeletal disorders. The vast majority indicated a positive personal and professional clinical experience with chiropractic and that chiropractic was safe for pregnant patients and children. There is great awareness of and positive personal and professional experience with chiropractic on the part of midwives who participated in this survey.
The Pediatric Elbow:
A Review of Fractures
Dynamic Chiropractic ~ June 3, 2011 ~ FULL TEXT
The elbow fracture is one of the most common fractures in children. Assessing the elbow for fracture can be difficult because of the changing anatomy of the growing skeleton and the subtlety of some of these fractures. It's important to be aware of the radiographic signs of fracture in the elbow, along with knowing the appearance and fusion of the ossification centers in the pediatric patient, to avoid confusing an ossification center with a fracture fragment. Of course, alignment and radiographic positioning are also extremely important in making a diagnostic assessment.
Demographic Survey of Pediatric Patients
Presenting to a Chiropractic Teaching Clinic
Chiropractic & Manual Therapies 2010 (Dec 15); 18: 33 ~ FULL TEXT
This data review included 2,645 pediatric patients (0-15 years of age). Of these, 2,303 (87%) were under the age of five and 342 (13%) were between the ages of 5 and 15. The complaints of all children over five years were categorized as musculoskeletal. In all age groups, just over a third (34.7%) presented with musculoskeletal problems, 29.6% presented with excess crying (previously known as infant colic) and 15.7% with feeding disorders. All children had previously presented to at least one medical practitioner for the same condition and some had presented to multiple healthcare practitioners (Figure 3). The younger the child, the more common the referral with 83% of infants under 12 weeks of age being sent by a medical practitioner, 39% between 3 and 12 months of age and a 4-5% rate of referral in age groups over one year
Musculoskeletal Development and Sports Injuries in Pediatric Patients
Dynamic Chiropractic ~ October 21, 2010 ~ FULL TEXT
Physical activity is extremely important for everyone, but especially for children. A well-designed exercise program enhances the physical and intellectual development of a child. Competitive sports are often a child's first introduction to programmed exercise. In the past decade, there has been an increase in the number of children participating in team and solo sports. Younger children are allowed to participate in sports for enjoyment, health and personal development. However, this changes as competitive elements become more dominant and young athletes train harder and longer, and may practice a sport throughout the whole year. Consequently, sports-related injuries in children have significantly increased.
The Chiropractic Care of Children
J Altern Complement Med. 2010 (Jun); 16 (6): 621–626 ~ FULL TEXT
A majority of the responders were female with an average practice experience of 8 years. They attended an average of 133 patient visits per week, with 21% devoted to the care of children (<18 years of age). Practice income was derived primarily from out-of-pocket reimbursement with charges of an average of $127 and $42 for the first and subsequent visits, respectively. These visits were reimbursed to address common conditions of childhood (i.e., asthma, ear infections, etc.). Approach to patient care was spinal manipulative therapy (SMT) augmented with herbal remedies, exercises, rehabilitation, and so on. Wellness care also figured prominently as a motivator for chiropractic care. Fifty-eight percent (58%) indicated an established relationship with an osteopathic or medical physician. Eighty percent (80%) of the responders indicated referring patients to medical practitioners while only 29% indicated receiving a referral from a medical/osteopathic physician.
Low Breastfeeding Rates Incur Billions in Medical Costs
MedPage Today ~ April 05, 2010
A new study published today determined that if 90% of new mothers exclusively breastfed their infants for the first 6 months that it could save $13 billion each year, as well as the lives of 911 newborns. "Exclusive breastfeeding" means only breast milk -- no water, infant food, juice, formula, cow's milk, or sugar water for the first 6 months.
Best Practices Recommendations for Chiropractic Care for Infants,
Children, and Adolescents: Results of a Consensus Process
J Manipulative Physiol Ther. 2009 (Oct); 32 (8): 639–647
There has been much discussion about the role of chiropractic care in the evaluation, management, and treatment of pediatric patients. To date, no specific guidelines have been adopted that address this issue from an evidence based perspective. Previous systematic reviews of the chiropractic literature concluded that there is not yet a substantial body of high quality evidence from which to develop standard clinical guidelines. The purpose of this project was to develop recommendations on "best practices" related primarily to the evaluation and spinal manipulation aspects of pediatric chiropractic care; nonmanipulative therapies were not addressed in detail.
A Description of Children and Adolescents in Danish Chiropractic Practice:
Results from a Nationwide Survey
J Manipulative Physiol Ther. 2009 (Oct); 32 (8): 607–615
For the older children, musculoskeletal problems were the most dominant complaint, ranging from 33% among the preschool children to 75% among the teenagers. These complaints were often chronic and about a third of the children older than 2 years had experienced symptoms for more than 1 year before seeing the chiropractor. Among the older children and the adolescents, musculoskeletal complaints were most common and mostly of a chronic nature. The large number of pediatric patients in chiropractic practices and the paucity of evidence of treatment effectiveness indicate the need for further research in these age groups.
Contribution of Chiropractic Therapy to Resolving Suboptimal
Breastfeeding: A Case Series of 114 Infants
J Manipulative Physiol Ther 2009 (Oct); 32 (8): 670–674
Cooperative multidisciplinary care to support breastfeeding was demonstrated in this population. Chiropractic treatment may be a useful adjunct to routine care given by other professionals in cases of diagnosed breastfeeding problems with a biomechanical component.
The Safety and Effectiveness of Pediatric Chiropractic: A Survey
of Chiropractors and Parents in a Practice-based Research Network
Explore (NY) 2009 (Sep); 5 (5): 290–295
The indicated primary reason for chiropractic care of children was "wellness care." With respect to condition-based presentations, musculoskeletal conditions were the most common, in addition to nonmusculoskeletal conditions of childhood. The most common techniques used were diversified technique, Gonstead technique, Thompson technique, and activator methods. Treatment-associated complications were not indicated by the chiropractic and parent responders. Chiropractor responders indicated three adverse events per 5,438 office visits from the treatment of 577 children. The parent responders indicated two adverse events from 1,735 office visits involving the care of 239 children.
A Poorly Understood Abnormality of the Adolescent Spine
Dynamic Chiropractic ~ August 26, 2009 ~ FULL TEXT
Scheuermann's disease (SD) - osteochondritis of vertebral epiphyseal plates or adolescent kyphosis - was first described in 1921 by Holger Werfel Scheuermann, a Danish surgeon, as an osteochondrosis with cause unknown involving the spine and frequently causing lower thoracic kyphosis. The term juvenile kyphosis has sometimes been used to designate this condition. Although many theories have been proposed, the cause of SD is still unknown. Currently under investigation are the roles of juvenile osteoporosis, hereditary factors, biomechanical factors, and a variety of other causes, but to date no specific etiology has been determined, except that there is a disruption in the normal development of the vertebral end plate.
Doctors Likely to Encounter Children With Musculoskeletal
Complaints Have Low Confidence in Their Clinical Skills
The Journal of Pediatrics 2009 (Feb); 154 (2): 267–271
Questionnaires, filled out by a broad spectrum of medical providers in England [Primary Care (n = 75), Pediatrics (n = 39), Emergency (n = 39), Orthopedics (n = 40), and experienced doctors in Primary Care (n = 93), and Pediatrics (n = 60).], revealed that 74% of them scored their personal confidence in pediatric musculoskeletal clinical assessment as "no" to "low".
Adverse Effects of Spinal Manipulative Therapy in Children
Younger Than 3 Years: A Retrospective Study
in a Chiropractic Teaching Clinic
J Manipulative Physiol Ther 2008 (Jul); 31 (6): 419–423
This study shows that for the population studied, chiropractic manipulation produced very few adverse effects and was a safe form of therapy in the treatment of patients in this age group.
Development, Testing, and Findings of a Pediatric-Focused
Trigger Tool to Identify Medication-Related Harm
in US Children's Hospitals
Pediatrics 2008 (Apr); 121 (4): e927–935 ~ FULL TEXT
Adverse drug event rates in hospitalized children are substantially higher than previously described. Most adverse drug events resulted in temporary harm, and 22% were classified as preventable. Only 3.7% were identified by using traditional voluntary reporting methods. Our pediatric-focused trigger tool is effective at identifying adverse drug events in inpatient pediatric populations. [Editorial Commentary: These findings (that only 3.7% of adverse events find their way into hospital error reports) is very alarming, and suggests that previous reports have only documented the tip of the iceberg.]
Pediatric Drug Prescriptions
Dynamic Chiropractic ~ March 11, 2008 ~ FULL TEXT
The majority of drugs given to children have never been tested specifically for them. Physicians are prescribing drugs based on a “best guess” as to the dosage, efficacy and even safety. The FDA understands that giving medications to children for which there is only adult data available could be harmful, considering that children have dosing concerns and side-effect risks that differ from adults. The latest legislation has made some headway in the battle against the lack of proper labeling; yet, it still fails to completely overcome the absence of research, particularly in the older medications.
Antibiotic Use In Infants Linked To Asthma
The Science Advisory Board ~ June 13, 2007
New research indicates that children who receive antibiotics before their first birthday are significantly more likely to develop asthma by age 7. The study, published in the June issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), reports that children receiving antibiotics in the first year of life were at greater risk for developing asthma by age 7 than those not receiving antibiotics. The risk for asthma doubled in children receiving antibiotics for nonrespiratory infections, as well as in children who received multiple antibiotic courses and who did not live with a dog during the first year.
Neck and Shoulder Pains in Relation to Physical Activity
and Sedentary Activities in Adolescence
Spine 2007 (Apr 20); 32 (9): 1038–1044
Almost half of the girls and one third of the boys reported mild neck or occipital pain, or shoulder pain, and 3% of girls and 2% of boys reported severe neck or occipital pain, or shoulder pain during the past 6 months. High-level physical activity associated with an increased prevalence of both severe neck or occipital pain and severe shoulder pain in girls, but not in boys. Prolonged sitting was associated with a high prevalence of neck or occipital pain and shoulder pain in girls, and neck or occipital pain in boys. Of various sedentary activities, television watching and reading books associated with neck or occipital pain in girls, whereas playing or working with a computer associated with neck or occipital pain in boys. In girls, television watching also associated with mild shoulder pain.
ICPA and FCER Responds to Pediatrics Article ~ February 2007
It’s a battle that the chiropractic profession is familiar with—a “scientific” article appears in a medical journal decrying the risks of chiropractic cervical manipulation, and newspapers and television news programs spread the conclusions without either comparison to risks associated with common medical treatments or rebuttal from within chiropractic. The latest front in this battle is over the chiropractic treatment of the pediatric population. Published in the January 1, 2007 issue of Pediatrics, the Journal of the American Academy of Pediatrics, the article
“Adverse Events Associated With Pediatric Spinal Manipulation: A Systematic Review,” has quickly reached the airwaves of the popular media.
Full Breast-feeding May Lower Hospitalizations
for Infections During First Year of Life
Medscape Medical News ~ July 14, 2006
“On the basis of the present data, we conclude that full breastfeeding would lower the risk for hospital admission as a result of infections among infants who are younger than 1 year within an industrialized country,” the authors write.
“The results are consistent with early studies and add to the body of evidence confirming the hypothesis that full breastfeeding lowers the risk for hospitalization as a result of infectious diseases during the first year of life in a developed country.”
Is Comorbidity in Adolescence a Predictor for Adult Low Back Pain?
A Prospective Study of a Young Population
BMC Musculoskelet Disord 2006 (Mar 16); 7: 29 ~ FULL TEXT
Your chiropractic care may be working out “kinks” in your lower back that have been around a lot longer than you realize. This new study of 10,000 Danish residents shows a link between adolescent and adult low back pain (LBP). Researchers studied twins born between 1972 and 1982 by sending out questionnaires in 1994 and again in 2002. The outcomes showed that a high percentage of those who had LBP in 1994 still suffered from LBP in 2002. They also found that those with persistent LBP were 4.5 times more likely than the average person to have future LBP episodes!
The Course of Low Back Pain from Adolescence to Adulthood:
Eight-year Follow-up of 9600 Twins
Spine 2006 (Feb 15); 31 (4): 468–472
High prevalence rates of low back pain among children and adolescents have been demonstrated in several studies, and it has been theorized that low back pain in childhood may have important consequences for future low back pain. Almost 10,000 Danish twins born between 1972 and 1982 were surveyed by means of postal questionnaires in 1994 and again in 2002. The questionnaires dealt with various aspects of general health, including the prevalence of low back pain, classified according to number of days affected (0, 1-7, 8-30, >30). Low back pain in adolescence was found to be a significant risk factor for low back pain in adulthood with odds ratios as high as four. We also demonstrated a dose-response association: the more days with low back pain at baseline, the higher the risk of future low back pain.
Chronic Daily Headache in Adolescents:
Prevalence, Impact, and Medication Overuse
Neurology 2006 (Jan 24); 66 (2): 193–197
Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype;
Although this article does not discuss care options for chronic tension-type headache, conservative chiropractic care is the natural choice.
Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy:
A Retrospective Case Series
J Midwifery Womens Health 2006 (Jan); 51 (1): e7-10
Sixteen of 17 (94.1%) cases demonstrated clinically important improvement. The average time to initial clinically important pain relief was 4.5 (range 0-13) days after initial presentation, and the average number of visits undergone up to that point was 1.8 (range 1-5). No adverse effects were reported in any of the 17 cases. The results suggest that chiropractic treatment was safe in these cases and support the hypothesis that it may be effective for reducing pain intensity.
Self-reported Nonmusculoskeletal Responses to Chiropractic Intervention:
A Multination Survey
J Manipulative Physiol Ther 2005 (Jun); 28 (5): 294–302
Positive reactions were reported by 2% to 10% of all patients and by 3% to 27% of those who reported to have such problems. Most common were improved breathing (27%), digestion (26%), and circulation (21%).
Manual Therapy in Children: Proposals for an Etiologic Model
J Manipulative Physiol Ther 2005 (Mar); 28 (3): e1–e15 ~ FULL TEXT
Manual therapy in children (MTC) is receiving greater attention. Several monographs and reviews deal with this subject (1-4). Although these publications cover the field from the viewpoint of a classic pediatric approach, discussing which diagnoses of pediatric medicine might be successfully treated by MTC, they do not furnish an independent concept for the functional disorders that we see in these children. This article proposes such a framework through a model: the kinematic imbalances due to suboccipital strain (KISS) concept. This concept groups the symptoms and signs associated with functional disorders of the cervical spine into an entity linked to easily recognizable clinical situations. By using this concept as a term in the communication with other caregivers of infants and children, we may be able to improve the contact between pediatricians and specialists of MTC, thus facilitating the identification of those cases where the use of MTC will be most useful.
Adolescent Idiopathic Scoliosis
Dr. Diane Benizzi DiMarco
Due to the close association of spinal maturity with lateral spinal curve progression, adolescent idiopathic scoliosis represents a sensitive topic for those treating females who have entered menarche or will be soon. A lateral bending of the spine, adolescent idiopathic scoliosis can present with a lateral and rotary deformity. Spinal curvatures can be the result of varied factors including; muscle diseases or spasms, neurological disease, diseases of the CNS or PNS, congenital vertebral deformities, leg length inequalities, tumors, pain, injury and degenerative spinal arthrosis. The most common cause of scoliosis, adolescent idiopathic scoliosis, accounts for approximately 80% of all diagnosed scoliosis cases. (1) Females are affected at a rate of 9:1. Idiopathic scoliosis, juvenile and adolescent affect females ages three to ten years of age and ten years to skeletal maturity, respectively. (2,3)
Drug Research and Children
FDA Consumer Magazine ~ January—February 2003
Most drugs prescribed for children have not been tested in children. Only 20 percent to 30 percent of drugs approved by the Food and Drug Administration are labeled for pediatric use. So by necessity, doctors have routinely given drugs to children "off label," which means the drug hasn't been studied in children in adequate, well-controlled clinical trials approved by the agency.
Evaluation of Chiropractic Management of Pediatric Patients
with Low Back Pain: A Prospective Cohort Study
J Manipulative Physiol Ther 2003 (Jan); 26 (1): 1—8 ~ FULL TEXT
Fifteen chiropractors provided data on 54 consecutive pediatric patients with LBP. The average age of the patients was 13.1 years, 57% were male, 61% were acute, with 47% attributing onset to a traumatic event (most commonly sports-related); 24% reported an episode duration of greater than 3 months. Almost 90% of cases presented with uncomplicated mechanical LBP, most frequently diagnosed as lumbar facet dysfunction or subluxation.
Reported Adverse Drug Events in Infants and Children
Under 2 Years of Age
PEDIATRICS 2002 (Nov); 110 (5): E53—E53
Less than 1% of the nearly 2,000 drugs identified in the study were associated with over half of all serious or fatal side-effects. Deaths linked to side-effects were far more likely in the first few months after birth (41% in the first month). In a full quarter of cases, drugs were administered to the mother, not the infant, and then passed to the child through the womb or through breastfeeding. Included in the list of the drugs most likely to cause dangerous side-effects in children were ibuprofen and acetaminophen (drugs more commonly known by such brand names as Advil and Tylenol).
Back, Neck, and Shoulder Pain in Finnish Adolescents:
National Cross Sectional Surveys
British Medical Journal 2002 (Oct 5); 325 (7367): 743–745 ~ FULL TEXT
To study changes in the prevalence of pain in the back or neck in adolescents between the years 1985 and 2001, the authors compared biennial nationwide postal surveys, between 1985-2001, and annual classroom surveys, from 1996-2001.
They found that pain in the neck, shoulder, and lower back is becoming more common in Finnish adolescents. This pain suggests a new disease burden of degenerative musculoskeletal disorders for future adults. Prevalence of pain in the back and neck was greater in the 1990s than in the 1980s and increased steadily from 1993 to 1997. Pain of the neck and shoulder and pain of the lower back was much more common in 1999 than in 1991 and in 2001 than in 1999. Pain was more common among girls and older groups: pain of the neck and shoulder affected 24% of girls and 12% of boys in 14 year olds, 38% of girls and 16% of boys in 16 year olds, and 43% of girls and 19% of boys in 18 year olds; pain in the lower back affected 8% of girls and 7% of boys in 14 year olds, 14% of girls and 11% of boys in 16 year olds, and 17% of boys and 13% of girls in 18 year olds.
The Importance of Prenatal Exposures
on the Development of Allergic Disease
Am J Respir Crit Care Med 2002 (Sep 15); 166 (6): 827—832 ~ FULL TEXT
This study of British children suggests that women who have an infection or take antibiotics during pregnancy are more likely to have a child with an allergy-related condition such as asthma, hay fever or eczema. Researchers at the University of Nottingham evaluated the medical records of nearly 25,000 British children and their mothers. The study found that
children exposed to antibiotics in the womb had a higher risk of developing asthma, hay fever and eczema than did children whose mothers did not take the medication during pregnancy.
Chiropractic Spinal Manipulation for Cervicogenic Headache
in an 8-Year-Old
J Neuromusculoskeletal System 2002 (Fall); 10 (3): 98—103
A case of cervicogenic headache (CEH) in an 8-year-old boy that improved after chiropractic spinal manipulation is reported. An 8-year-old boy presented with a complaint of daily headache. The duration of symptoms was over 3 years. The patient met the diagnostic criteria for CEH. Awkward head position reproduced head pain, as did palpation of the upper cervical region. Decreased range of motion of the neck was evident, as well as abnormal tenderness and primarily of the right upper cervical region, and ancillary myofascial release. A significant decrease in headache frequency as reported by the patient and parent was seen after the first treatment. After four treatments the headache frequency decreased to approximately one per month.
The Webster Technique:
A Chiropractic Technique with Obstetric Implications
J Manipulative Physiol Ther 2002 (Jul); 26 (6): E1—9 ~ FULL TEXT
Intrauterine constraint is defined as any force external to the developing fetus that obstructs the normal movement of the fetus. Intrauterine constraint has been casually related to a number of structural defects of the peripheral and craniofacial skeleton of the fetus. 1-10
Taylor 11 and others 12,13 have described how the forces of intrauterine constraint adversely affect the spine during the prenatal and perinatal periods. Moreover, intrauterine constraint can prevent the developing fetus from attaining a head-down vertex position and achieving a vaginal birth, thereby necessitating a cesarean section delivery.
Dramatic Rise in Childhood Obesity
JAMA 2001 (Dec 12): 286 (22): 2845—2848
The authors of a recent study in the JAMA determined obesity trends in over 8,000 children, ages 4 to 12, between 1986 and 1998. The prevalence of overweight children increased over 120% among Hispanic and African-American children and over 50% among Caucasian children in the 12-year study. Nearly one-quarter of Hispanic/African-American children and roughly one-eighth of Caucasian children were considered overweight in 1998.
To Treat or Not to Treat Otitis Media: That's Just One of the Questions
J Am Board Fam Pract 2001 (Nov); 14 (6): 474—476
Recent evidence has thrown into question the use of antibiotics and the length of treatment, if prescribed. The growing worldwide development of multidrug-resistant bacteria, the uncertainty of diagnosis, and that up to one third of cases of AOM are viral in origin 12 have made popular a wait-and-see approach to the initial prescription of antibiotics, especially in many European countries. In several randomized clinical trials, antibiotics provided only a small benefit. 13-15 In a meta-analysis of more than 2000 children with AOM, ear pain resolved spontaneously without antibiotics in two thirds by 24 hours and in 80% by day 7.
Ritalin: This Children's Drug Is More Potent Than Cocaine
The London Observer September 9, 2001
Using brain imaging, scientists have found that, in pill form, Ritalin - taken by thousands of British children and four million in the United States - occupies more of the neural transporters responsible for the “high” experienced by addicts than smoked or injected cocaine. The research may alarm parents whose children have been prescribed Ritalin as a solution to Attention Deficit Hyperactive Disorder.
Chronic Pediatric Asthma and Chiropractic Spinal Manipulation:
A Prospective Clinical Series and Randomized Clinical Pilot Study
J Manipulative Physiol Ther 2001 (July); 24 (6): 369—377
After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment. You can review many other articles on chiropractic and Asthma in the Research Section.
Antibiotics/Antimicrobials Ineffective for Treatment of Children
With Acute Sinusitis
PEDIATRICS 2001 (Apr); 107 (4): 619–625
This randomized trial found that neither amoxicillin nor amoxicillin-clavulanate offered any clinical benefit compared with placebo for children with clinically diagnosed acute sinusitis.
Epilepsy and Seizure Disorders: A Review of Literature
Relative to Chiropractic Care of Children
J Manipulative Physiol Ther 2001 (Mar); 24 (3): 199—205
Chiropractic care may represent a nonpharmaceutical health care approach for pediatric epileptic patients. Current anecdotal evidence suggests that correction of upper cervical vertebral subluxation complex might be most beneficial. It is suggested that chiropractic care be further investigated regarding its role in the overall health care management of pediatric epileptic patients.
The Risk of Carcinogenesis From Radiographs to
Pediatric Orthopaedic Patients
J Pediatr Orthop 2000 (Mar); 20 (2): 251—254
The use of serial radiographs during the treatment of idiopathic scoliosis, hip dysplasia, and leg-length discrepancy appears relatively safe. The increased risk of carcinogenesis or hereditary defects in these patients is minimal.
The Short–Term Effect of Spinal Manipulation in the Treatment of
Infantile Colic: A Randomized Controlled Clinical Trial
with a Blinded Observer
J Manipulative Physiol Ther 1999 (Oct); 22 (8): 517–522
By trial days 4 to 7, hours of crying were reduced by 1 hour in the dimethicone group compared with 2.4 hours in the manipulation group (P = .04). On days 8 through 11, crying was reduced by 1 hour for the dimethicone group, whereas crying in the manipulation group was reduced by 2.7 hours (P = .004). From trial day 5 onward the manipulation group did significantly better that the dimethicone group. The authors then conclude: Spinal manipulation is effective in relieving infantile colic. You may also enjoy FCER's review of this article.
Back Pain in Children Who Present to the Emergency Department
Clin Pediatr 1999 (Jul); 38 (7): 401—406
When present, pediatric back pain is most often musculoskeletal, associated with an acute infectious illness or a traumatic event. Although the etiology is rarely serious, back pain often affects the daily activities of symptomatic children.
Nonspecific Back Pain in Children:
A Search for Associated Factors in 14-year-old Schoolchildren
Rev Rhum Engl Ed 1999 (Jul); 66 (7–9): 381—388
The findings from this cross-sectional study indicate a need for a longitudinal prospective study designed to identify etiologic and prognostic factors of back pain in adolescents, with the goal of devising preventive strategies likely to reduce the risk of low back pain in adulthood.
Pediatric Drug Studies: Protecting Pint-Sized Patients
FDA Consumer Magazine ~ May—June 1999
Of the nine-item laundry list of medicines Goldberg's 6-year-old daughter Abby was taking for her severe asthma, not a single one was tested or approved in the United States for children under 12. "I feel as though I am testing drugs on my own child, every day, and it isn't helping anyone," Goldberg said... Because of their immature organs and different metabolic and immune systems, children react unlike adults to many drugs. Treating children with adult drugs, then, can carry the risk of unforeseen adverse reactions.
Prolonged Low-Back Pain in Young Athletes:
A Prospective Case Series Study of Findings and Prognosis
Eur Spine J 1999; 8 (6): 480—484
We investigated the prognosis of low-back pain and the association of clinical symptoms and anatomic findings among young athletes. Consecutive patients, aged between 12 and 18 years, who had low-back pain that had interfered with their training for at least 4 weeks were included in the case series.
Why the Back of the Child?
Eur Spine J 1999; 8 (6): 426—428
An international congress about "the back of children and teenagers and the prevention of backache" was held in March 1999 in Grenoble (France). Beside specific low back pain following progressive and growth diseases, special attention was paid to non-specific low back pain (LBP).
One-Third Of Children In Road Traffic Accidents Develop Stress Disorder
LONDON, ENGLAND –– Dec. 11, 1998 –– In a study of 119
children involved in road traffic accidents during 1997 Dr. Paul Stallard and colleagues from the Royal United Hospital in Bath reveal that one-third were found to be suffering from
post-traumatic stress disorder. Published in this week's issue of the British Medical Journal,
the study found that young people displayed symptoms including sleep disturbance and nightmares, separation anxiety, difficulties in concentration, intrusive thoughts, difficulties in talking to parents and friends, mood disturbance, deterioration in academic performance, specific fears and accident related play.
Research Perspectives in Asthma: A Rationale for the Therapeutic Application of Magnesium, Pyridoxine, Coleus forskholii and Ginkgo biloba in the Treatment of Adult and Pediatric Asthma
The Internist 1998 (Sep); 5 (3): 14—16
Thanks to the American Chiropratic Association's Council On Family Practice for their permission to reprint this article exclusively at Chiro.Org! You can review many other articles on Chiropractic and Asthma in the Research Section.
Acquired Verbal Aphasia in a 7-Year-Old Female: Case Report
Journal of Clinical Chiropractic Pediatrics 1998 (Apr); 1 (2)
A case report is presented of a seven-year-old female patient with acquired verbal aphasia. Despite appropriate referral to specialists in pediatrics, audiology and speech and language pathology, the patients verbal difficulties failed to respond to conventional therapies. Chiropractic evaluation disclosed disclosed biomechanical abnormalities in the spinal and pelvic region and cranium, which had previously gone unrecognized. The patient's speech difficulties improved following the commencement of chiropractic care. Follow-up evaluations over a period of 18 months demonstrated that speech improvements had been maintained. It is impossible to generalize the results of a single case to the population of patients with aphasia. Hoewver, this case study raises important issues regarding the role of chiropractic care in the multidisciplinary management of patients with acquired aphasia.
Back Pain Risk Continues After Pregnancy
Obstetrics & Gynecology 1998 (Feb); 91 (2): 182–186
Women with severe low back pain during pregnancy are at high risk for back pain for more than 10 years after the pregnancy –– and the problem is likely to recur in a subsequent pregnancy, according to a new study in the journal Obstetrics & Gynecology. More seriously, (19%) of the women with previous low back pain stated they had refrained from another pregnancy because of their fear of the recurrence of their low back pain.
Therapeutic Misadventures With Acetaminophen:
Hepatoxicity After Multiple Doses in Children
J Pediatr 1998 (Jan); 132 (1): 22—27
Twenty-four of 43 patients (53%) died, with an additional three surviving after orthotopic liver transplantation. Parents should be advised about the potential hepatotoxicity of acetaminophen when given to ill children in doses exceeding weight-based recommendations.
Relation of Infant Diet to Childhood Health:
A Seven Year Follow Up.
British Medical Journal 1998 (Jan 3); 316 (7124): 21—25
The probability of respiratory illness occurring at any time during childhood is significantly reduced if the child is fed exclusively breast milk for 15 weeks and no solid foods are introduced during this time. Breast feeding and the late introduction of solids may have a beneficial effect on childhood health and subsequent adult disease.
The Role of the Chiropractic Adjustment in the Care
and Treatment of 332 Children with Otitis Media
Journal of Clinical Chiropractic Pediatrics 1997 (Oct); 2 (2)
To our knowledge this is the first time that tympanography has been used as an objectifying tool with respect to the efficacy of the chiropractic adjustment in the treatment of children with otitis media. In addition, the role of the occipital adjustment needs to be examined. This study begins the process of examining the role of the vertebral cranial subluxation complex in the pathogenesis of otitis media, and the efficacy of the chiropractic adjustment in its resolution.
You can review
many other articles on chiropractic and Otitis Media in the Research Section.
Are Antibiotics Indicated as Initial Treatment for Children
With Acute Otitis Media? A Meta-Analysis
British Medical Journal 1997 (May 24); 314 (7093): 1526–1529 ~ FULL TEXT
Early use of antibiotics provides only modest benefit for acute otitis media: to prevent one child from experiencing pain by 2-7 days after presentation, 17 children must be treated with antibiotics early.
Cervicogenic Hearing Loss
HNO 1994 (Oct); 42 (10): 604—613
Findings in 62 patients suffering from vertebragenic hearing disorders are reported before and after chiropractic management. Results indicate that these hearing disorders are reversible, as demonstrated by audiometry and OAE. The therapy of choice is chiropractic manipulation of the upper cervical spine. The commoness of vertebragenic hearing disorders emphasizes their clinical and forensic importance.
You can review many other articles on chiropractic and Hearing Loss in the Research Section.
Musculoskeletal Injuries in Child Athletes
British Medical Journal 1994 ( Jun 11); 308: 1556—1559
The growing skeletons of children may be injured more easily than the mature skeletons of adults because the bones are more porous and the long bones are further weakened by the epiphysical plates at their proximal and distal ends.
Endometriosis and the Anterior Coccyx: Observations on 5 Cases
Research Forum 1985 (Summer); 1 (4): 120–122 ~ FULL TEXT
This case review involves five women presenting with medically-diagnosed endometriosis. All five women had been advised that they were surgical candidates. Relief of symptoms is effected by adjusting the anteriorally displaced coccyx. The author suggests a relationship between the displaced coccyx and endometriosis and counsels upon the recognition of same.
“Joint Pain in Children”
A Seven Article Series By Deborah Pate, DC, DACBR
Joint pain is a common complaint in children but seldom a symptom of serious joint disease. How can you determine if a child with knee pain has just a strain/sprain or a more serious joint disease, such as Lyme disease, rheumatic fever, or juvenile rheumatoid arthritis? I'd like to review the more common joint disorders affecting children.
Chiropractic Advice for Moms-to-Be
American Chiropractic Association
During pregnancy, a woman's center of gravity almost immediately begins to shift forward to the front of her pelvis, according to Dr. Jerome McAndrews, spokesperson for the American Chiropractic Association (ACA). Although a woman's sacrum - or posterior section of her pelvis - has more depth than a man's to enable her to carry a baby, the displaced weight still increases the stress on her joints. "As the baby grows in size," Dr. McAndrews explains, "the woman's weight is projected even farther forward, and the curvature of her lower back is increased, placing extra stress on her spinal disks in that area. As a result, the spine in the upper back area must compensate - and the normal curvature of her upper spine increases as well."
Spinal Manipulation May Benefit Asthma Patients
Foundation for Chiropractic Education and Research (FCER)
Patients afflicted with asthma may benefit from spinal manipulation in terms of symptoms, immunological capacity, and endocrine effects, an audience was told on October 5 at the 9th International Conference on Spinal Manipulation in Toronto. The investigative team, headed by Ray Hayek, Ph.D., has been conducting a trial at 16 treatment centers in Australia involving 420 patients with an average age of 46 in an effort to find out what effects spinal manipulation has on symptoms, depression and anxiety, general health status, and the levels of immunity as reflected by the concentrations of both an immunoglobulin (IgA) and an immunosuppressant (cortisol).
The Safety of Chiropractic for Children: A Researcher’s Perspective
A survey study examining the practice characteristics and pediatric care of chiropractors 1 in the Boston area estimated that approximately 420,000 pediatric chiropractic visits were made in the Boston metropolitan area alone for 1998. If extrapolated for the rest of the United States and Canada, the number of chiropractic visits to children in one year would be enormous numbering in several million visits. Given this high utilization rate of pediatric chiropractic services in the United States and Canada, statistics should indicate a great number of morbidity and mortality. On the contrary, there exists little evidence of harm to children from chiropractic.
Often when a woman becomes pregnant, or is trying to get pregnant, she develops a new perspective on her health. For most this means a new or renewed interest in nutrition and healthy food choices. Some women are afraid their diet is insufficient and worry it might affect their baby. Others simply want to do everything in their power to have an easy pregnancy and a normal infant. All are valid concerns. They are also opportunities for you to discuss the reasons to supplement, even for those already eating healthfully.
The National Institute of Health (NIH) Takes a Closer Look
at Pollution and Children's Health
The National Institute of Environmental Health Sciences (NIEHS) convened the three-day meeting, which will look at indoor and outdoor pollutants' role in asthma, brain and reproductive system disorders, behavioral problems like autism and attention deficit hyperactivity disorder and cancer. Children are especially vulnerable to pollutants because they breathe in more air and take in more food and liquid, proportional to their size, than adults, said Phil Lee, a senior scholar at the University of California, San Francisco, and former assistant secretary at the Department of Health and Human Services. More information like this may be found in our Environmental Toxins Page
Why Should Children Have Chiropractic Care?
More and more parents are seeking chiropractic care for their children. Many spinal problems seen in adults began as early as birth. Even so called 'natural' birthing methods can stress an infant's spine and developing nerve system. The resulting irritation to the nerve system caused by spinal and cranial misalignment can be the cause of many newborn health complaints. Colic, breathing problems, nursing difficulties, sleep disturbances, allergic reactions and chronic infections can often be traced to nerve system stress.
Children and Scoliosis
Scoliosis is defined as “any lateral deviation of the spine from the mid-sagittal plane.” While there are many causes for scoliosis, children and adolescents with scoliosis who present to chiropractors usually fall into three categories.
Otitis Media and the Sanctity of Medical Guidelines
Within recent times, however, we need only consider otitis media as an example of the extreme volatility of medical guidelines. A complete reversal appears to have taken place within just the past six years! Traditionally, the initial recommended intervention in the United States has been tympanostomy with the option to use antibiotics,4 despite that in the United Kingdom, the Scandinavian countries and the Netherlands, physicians have embarked upon a policy of watchful waiting with no deleterious consequences from their reluctance to use antibiotics.5
Top Child Health Agencies Urge Testing to Protect Early Brain
Development From Toxins: One Out of Six Affected
One out of six children are suffering from behavioral disorder according to the Learning Disabilities Association and the National Institute of Environmental Health Sciences (NIEHS–NIU). Both are calling for research testing to recognize, reduce and eliminate the
environmental toxins scientifically linked to learning disabilities.
The Risk of Injury for Children Exposed to Whiplash Trauma
Arthur C. Croft, DC, MS, FACO
Less than two percent of the literature about whiplash is devoted to children. When I wrote the first edition of my textbook in 1988,  I cited an older German study placing the risk for children at approximately one-sixth the risk of adults. By the time the second edition was published in 1995, a Swedish study had since been published putting the risk proportion in children closer to two-thirds that of adults. 
Even Small Amounts of Tylenol May Be Dangerous for
Infants and Small Children
In a paper published in Contemporary Pediatrics, Dr. James E. Heubi states that in infants and small children, studies have indicated that the toxic dose is less than twice the recommended dose. Studies have also shown that it is very easy to mistakenly give children too much acetaminophen and, as a result, endanger their lives and health.
Child Acetaminophen Deaths Reported
At least 24 children in the United States have died and three have required liver transplants after receiving accidental overdoses of acetaminophen -- the most widely used medication for relief of pain and fever in children and infants, according to a report in the Journal of Pediatrics.
Protecting Your Child From Computer-related Repetitive Stress
Whether it's typing a school report or surfing the Internet, your child may be spending lots of hours at the computer. By learning about the causes and prevention of repetitive stress injuries now, you can protect your child from future injury.
Children and the Caffeine Culture
Here is a two-part article on the increasing caffeine consumption by children and youths in the U.S. that appeared in the San Mateo County Times on October 26 and 28, 1998, and probably in other ANG Newspapers in the San Francisco Bay Area. It was written by Dr. Ron Eisenberg and Dr. Virgil Williams, staff physicians at Highland General Hospital in Oakland, California, who apparently write other medical related columns for the newspaper group.
Research: New Challenges for Chiropractic
Review the article and controversy associated with this New England Journal of Medicine article on chiropractic and asthma. We also have the press releases and responses from the Research and Academic Community.
Children Not Eating Enough Fruit and Vegetables
Of 168 US preschoolers who participated in a week-long nutrition study, none ate the five recommended daily servings of fruits and vegetables, report researchers in the Journal of the American College of Nutrition.
Janet Zand, L.Ac., OMD
Excerpted from Smart Medicine for a Healthier Child by Avery Publishing Group
The Post-Antibiotic Age
What exactly was this Germ Theory? Very simply, the Germ Theory stated that there were separate diseases and that each disease was caused by a particular microorganism. It was the job of science, then, to find the right drug or vaccine that would selectively kill off the offending bug without killing the patient. That would be great, but nature is rarely so black and white about things, ever notice that? For one thing, bacteria and viruses tend to be "environment-specific." That's why some people get colds and others don't. That's why some survived the Bubonic Plague.
American Academy of Pediatrics (AAP) Addresses Parents
Religious Objections to Medical Care
This is a pretty scary statement. Who gets to decide about the health care choices for your child? Parents sometimes deny their children the benefits of medical care because of religious beliefs. In some jurisdictions, exemptions to child abuse and neglect laws restrict government action to protect children or seek legal redress when the alleged abuse or neglect has occurred in the name of religion. The American Academy of Pediatrics (AAP) believes that all children deserve effective medical treatment that is likely to prevent substantial harm or suffering or death. In addition, the AAP advocates that all legal interventions apply equally whenever children are endangered or harmed, without exemptions based on parental religious beliefs. To these ends, the AAP calls for the repeal of religious exemption laws and supports additional efforts to educate the public about the medical needs of children.