Despite headlines, the benefits of pediatric chiropractic care are long-lasting
Approximately 1.9 million children in America have been treated with chiropractic or osteopathic manipulation according to the National Center for Complementary and Integrative Health. That makes this health and wellness remedy the most sought-out form of complementary and alternative medicine when compared to other options such as yoga, meditation, and massage therapy.
However, treating this demographic takes a few special skills as “children are not mini adults,” says Jack M. Bourla, D.C., A.C.P. In addition to treating patients at his private practice — Providence Chiropractic Center in Redwood City, Calif. — Bourla also serves as Chairman of the Board for the International Federation of Chiropractors and Organizations (IFCO), an organization that strives to reinforce the safety and effectiveness of pediatric chiropractic on a global level.
Bourla adds that “failure to understand the nuances and developmental milestones of babies, infants, toddlers and children can be detrimental to the child and its development.” So, what does he recommend DCs do when it comes to treating pediatric patients?
Tip #1: Get proper training
“Providing chiropractic care to kids is a privilege that needs to be taken very seriously,” says Bourla.
The International Chiropractic Association offers a Diplomate in Clinical Chiropractic Pediatrics, which is a board-certified program specializing in pediatrics and pregnancy. The International Chiropractic Pediatric Association is another organization that Bourda indicates serves as a valuable resource in areas related to chiropractic safety for pediatric patients.
There are also several private educators that Bourla says serve as great resources for DCs interested in learning more about pediatric chiropractic. This includes Dr. Martin Rosen, Dr. Amy Spoelstra, and Dr. Steve Tullius. “Each of these educators has specialized in the proper care of children,” says Bourla, “whether they are typical kids or kids with special needs, including those with neurodevelopmental disorders.”
Tip #2: Obtain a detailed history
A second best-practice tip provided by Bourla is to always obtain a detailed history for your pediatric patients. “Taking a thorough health history — albeit brief, yet powerful in kids — is key to understanding the needs of that patient and offering the most appropriate care,” Bourla says.
This includes asking about the mother’s gestation, labor, delivery, and nursing habits since this type of information “can give important clues as to the types of stress or challenges that child may be facing” says Bourla.
A few of the questions he recommends asking include whether there was distress, a long labor, or use of medications during delivery. “Knowing more is way better than knowing less,” he says.
Bourla also stresses that, when obtaining this thorough history, it’s also important to remember that, while children undergo certain milestones as part of their development, each child develops as it will. Therefore, he or she may not follow the exact timeline, yet still develop “normally.”
Tip #3: Accommodate
“You can’t just one day say ‘I see kids’ and not make necessary arrangements for them,” says Bourla. Instead, the environment you create impacts how these minor patients feel about being in your office, a factor that Bourla says “can play a huge role in how they respond to your chiropractic care.”
If your goal is to create a more child-friendly environment, some questions to ask yourself include:
- Does my office have a dedicated area for kids to just hang out and play?
- Does this area make them feel comfortable and safe?
- Does it give them the opportunity to learn and explore?
- Can the child rest if he or she so chooses?
- Does it offer the child the ability to eat or nurse when hungry?
- Is there a space where parents can change the child’s diaper?
- Are the sounds and smells in this area pleasant?
When treating this demographic, Bourla stresses that it is also important to use adjusting tables that are appropriate for their smaller frames.
Tip #4: Understand, then mirror
Bourla’s fourth tip for working with children can be broken into two parts, and the first part is to seek to understand the child as much as possible.
“A good pediatric chiropractor will recognize that understanding the individual child and her personality (maybe just that day) is paramount to almost anything else that occurs in that encounter,” says Bourla. This involves learning how to read children based on the behaviors they display.
The National Center on Parent, Family and Community Engagement states that these behaviors can be influenced by the developmental stage the child is in, or his or her individual differences related to temperament, health, and more. Certain behaviors may also appear as a result of the individuals in the child’s life, previous experiences, and even culture.
Once you’ve identified and sought to understand the child, Bourla says that the second part of the process is to mirror what you see. As an example, “If you have a child that is reserved, tentative, and withdrawn,” says Bourla, “you can’t be Bozo the Clown and shriek in a high-pitched voice in an attempt to bring them to your desired level of behavior. Rather, you need to mirror them and then gently proceed with your analysis and chiropractic care of that child.”
Tip #5: Use appropriate force
The final tip offered by Bourla involves using appropriate force. “Children do not need forceful thrusts,” says Bourla. “[They] still possess ossification centers which fuse at varying time during their development. Ligaments are more lax in children and they need less force that aging individuals.”
Perhaps most importantly is to know when not to do the adjustment at all.
“Never force an adjustment on an unwilling child,” says Bourla. In cases such as these, no adjustment whatsoever is better than risking harm to the child — whether physically or emotionally — when he or she doesn’t want the care.
