29-2 Non-Neuromusculoskeletal Pediatric Conditions

This is especially noteworthy since there are millions of visits to chiropractors for these conditions. This issue of DC Tracts primarily deals with autism, colic, asthma, otitis media, and nocturnal enuresis.

The feature article makes note of various studies that have reported significant reduction of crying duration in colicky infants with various spinal and craniosacral interventions. With respect to asthma, the findings were that no significant changes were made with primary outcome studies (peak expiratory flow measured by spirometry), but most of the patients experienced relief of symptoms, such as coughing, difficulty breathing, etc. The studies on nocturnal enuresis were also significantly positive with regard to outcomes. Only the reports on treatment of otitis media were not as encouraging as far as patient outcomes. With regard to safety, Dr. Gleberzon says that “published cases of serious adverse effects in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are rare…no deaths associated with chiropractic care were found in the literature to date.”

Dr. Lisa Killinger comments on pertinent abstracts that relate to our topic. In her remarks, she makes a statement of important consideration, “A chiropractor seeing pediatric patients also must be familiar with, and respectful of, professional best practices related to pediatric care.” The abstracts cover advertising regarding alternative interventions for pediatric conditions, such as allergy and asthma, safety concerns in pediatric care, and the advice of some chiropractic physicians concerning immunization.

Dr. Brian Gleberzon’s audio lecture on autism measures up to the high quality of his previous lectures. He comments on the original misapplied diagnosis given to this problem: “Infantile Dementia.” The importance of this topic becomes more significant in light of the increasing incidence of autism and the lack of confirming evidence of any single primary cause. The appropriateness or effectiveness of chiropractic intervention in such cases has not been documented in any randomized clinical trials, but does show merit from best available evidence that has been gathered. At present he states that practice-based clinical trials have an advantage in pursuing answers to these concerns. To date, case reports have given some indication of benefit from chiropractic intervention in these cases. However, there is a downside because of outrageous and unfounded claims with regard to suspected causes and benefits of treatment for autism by some chiropractors.

Dr. Sharon Vallone’s lecture on dysfunctional feeding and airway obstruction in infants addresses the possible role of chiropractic care for these problems. She emphasizes the importance for the chiropractor to distinguish what problems motivated the parent to seek help, and also for the doctor to consider the various possible causative factors, such as birth injuries, tongue tie, neurologic dysfunction, genetic abnormalities, musculoskeletal problems, and a mother’s emotional/physical status that could affect breast feeding. She makes an obvious point, which still needs emphasis – determining the best therapeutic approach requires an accurate diagnosis. This would include evaluation of mouth, jaw, spine, and the sympathetic nerve system. In addition, she alerts chiropractic physicians treating feeding problems in infants to avail themselves of the services of a lactation consultant to help co-manage the problem. Awareness and inquiry about previously diagnosed congenital anomalies should also be a part of the initial consultation.

Respectfully,

Vincent P. Lucido, DC, DACBO
Editor-in-Chief