Current Issue:  Vol. 15, Issue 2 (2016)

The Journal of Clinical Chiropractic Pediatrics (JCCP) is the official peer-reviewed journal of the ICA Council on Chiropractic Pediatrics. It is committed to publishing research, scientific and professional papers, literature reviews, case reports and clinical commentaries for chiropractors and other health care professionals interested in the treatment of the pregnant, postpartum and pediatric patient. Through the publication of these papers and the dissemination of this information, the JCCP seeks to encourage professional dialogue and awareness about chiropractic pediatric care to help enhance patient care and improve patient outcomes.

Editors: Sharon A. Vallone, DC., DICCP., Cheryl Hawk, DC, PhD.

We are hopeful that this venue will provide field clinicians interested in maternal health and pediatric chiropractic with current research, case reports and clinical commentary that they will find both useful and informative.  We invite you to submit your own research or scientific writing for consideration for publication in this journal.


Chiropractic research featured in the Journal of Evidence-Based Complementary and Alternative Medicine

By Cheryl Hawk, DC, PhD, CHES

The March 2016 issue of the Journal of Evidence-Based Complementary and Alternative Medicine is dedicated to chiropractic research—a first for this journal, and unusual for any medical journal. As guest editor of this issue, part of my responsibility was to encourage submissions, which were of course then rigorously peer-reviewed. Readers of the Journal of Clinical Chiropractic Pediatrics should be pleased to see that four of the seven articles included in this special issue were on the topic of chiropractic care for children. The abstracts of these articles are included in this issue of JCCP. They covered many aspects of chiropractic pediatrics: breastfeeding counseling in an interdisciplinary clinic which included chiropractic care and midwifery (Miller et al); a survey of obstetricians’ opinions on chiropractic (Weis et al); description of a reporting system for Doctors of Chiropractic (Pohlman et al); and description of a consensus-based set of core competencies for chiropractors treating children (Hewitt et al).

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The infant with dysfunctional feeding patterns – The chiropractic assessment

By Sharon Vallone, DC, FICCP and Faraneh Carnegie-Hargreaves, DC

The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life, followed by the introduction of complementary foods while breastfeeding for 2 years and beyond. Early and consistent breastfeeding support can often make the difference in a dyad’s ability to establish a functional breastfeeding relationship. While challenged dyads can sometimes accomplish competent breastfeeding given appropriate support, necessary interventions, and an opportunity to learn; timing is critical when a neonate has not been transferring adequate milk volume or is managing feeding in a passive or compensatory manner. Chiropractors should be most familiar with the diagnosis and treatment of musculoskeletal dysfunctions that could result in an inability to feed. They should also recognize and treat the compensatory changes that will develop in a healthy, neurotypical neonate who is challenged by an inability to feed efficiently in order to prevent the evolution of long term physiologic and postural ramifications.

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Infant presentations and outcomes at a chiropractic clinic in the UK: Parent report of treatment outcomes using the United Kingdom Infant Questionnaire (UKIQ)

By Pascal Nicolas-Schmid, Marte Amanda Hetlevik, Joyce Miller, DC, PhD

Objective: The purpose of this study was to pilot a new-validated infant treatment outcome measure and to describe basic characteristics and outcomes of infant chiropractic patients. The aim was to assess the performance of an outcome measure of infant care by chiropractic treatment through a before and after survey. This preliminary study may indicate usefulness of a newly validated measure of manual therapy care for common complaints of infancy. Methods: A validated parent report of outcomes (PROMS) was used. Mothers completed a questionnaire at entrance to a university-affiliated chiropractic teaching clinic and again at follow up when treatment was completed / infant discharged. Collection of demographic data including age, gender, condition at presentation, previous clinicians consulted and medications were included. Results: The study sample included 194 infant patients at intake and 102 at follow-up. Overall, 56% of patients (n=108) were aged between three days and 4 weeks and classified as neonate. In all, 96% of the infants were under 6 months of age. The most common presenting complaints were crying (n=65; 21%), feeding problems (n=62; 20%), discomfort in supine sleeping (n=58; 19%), check up after difficult birth (n=49; 16%), general sleeping problems (n=49; 16%) and head shape (n=25; 8%). A total 68% (n=120) had seen 1-4 clinicians, before presenting to the chiropractor and 60% (n=104) were taking from one to four medications. Prior to treatment the average score of the baby’s discomfort or pain was 4.3 (Pain scale 0-10). At the follow-up survey the average was 1.7, a 60% reduction and a statistically significant difference. The relative risk ratio for the parent report of improvement after attending treatment was 2.3 (95% confidence interval = 1.73-2.87). The mothers anxiety, depression and quality of life before and after treatment improved by a factor of 2.1 (95% confidence interval = 1.58-2.62). The narrow confidence intervals suggest that these findings might be applied to the general population. On follow-up, 97% of mothers reported a positive improvement of the baby’s condition and or behaviour since the beginning of care and satisfaction with the care provided. No adverse events were reported. Conclusion: The pilot study of this validated infant survey suggests it can be administered to mothers and that they are compliant in completion. Mothers report good success for chiropractic treatment for the infant’s problems along with satisfaction with the treatment.

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Special Needs Corner

Arnold-Chiari malformation
Elise Déry, DC

Bell’s palsy in infants, children and adolescents
Martine Cossette, DC

Selective Mutism
Josyane Maheux, DC

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Improvement of gastroesophageal reflux disease (GERD) in an infant following chiropractic care: a case report

By Edith Lacroix, DC

Objective: This case report discusses the evolution of an infant with gastroesophageal reflux disease (GERD) under chiropractic care. It is the hope of the author to encourage more research about the role of chiropractic as a safe alternative in the resolution of GERD in infants. Method: A literature search on Google Scholar and PubMed was done to find recent and relevant papers using the keywords infant, GERD, regurgitation and chiropractic. Clinical features: A 4-month-old female presented for chiropractic care for recurrent regurgitation after feeding. The infant was exclusively breastfed. She was averse to being carried and her complaints included frequent post prandial regurgitation, difficult eructation, interrupted sleep, choking and rumination, wheezing during sleep, fussiness, distended stomach and excessive intestinal gas. No medication was taken by the infant or the mother and lifestyle changes were made before consulting a chiropractor. Intervention and outcomes: The infant was treated with chiropractic manipulation using craniosacral therapy, myofascial therapy and Diversified adjusting technique. The treatment consisted of 17 visits over a 20-week period using a full spine protocol adapted for the pediatric patient based on size and gestational age. The original diagnosis of GERD improved to physiologic gastroesophageal reflux (GER) after 14 visits and then totally resolved at the 17th visit. Conclusion: Since current evidence fails to support traditional medicinal methods to treat GERD in infants, chiropractic care merits investigation as a safe alternative that might prove more efficient than medication and with fewer side effects. This case report constitutes an addition to the scientific literature regarding chiropractic care of infants suffering from GERD.

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Diagnosis and management of a complex milk protein intolerance with chiropractic care: a case report.

By Anne-Michèle Bérubé, DC

Objective: To discuss the chiropractic diagnosis and management of a non-neuromusculoskeletal condition such as neonatal milk intolerance. Presenting concerns: A six-day old girl presented with a gastrointestinal disorder, difficulty falling asleep, frequent crying periods and feeding abnormalities. Chiropractic spinal manipulation was the initial treatment. Intervention and outcomes: The patient received four treatments consisting of chiropractic spinal manipulation over a period of one month. After these treatments, she slept for longer periods of time, her stool was easier to pass, suckling improved but appetite remained variable. She required dietary changes in order to restore a normal feeding pattern and to gain weight. Conclusion: This case demonstrates the difficulty in differentiating gastrointestinal disorder in neonates. Chiropractic appears to be a supportive treatment to gastrointestinal disorder in facilitating neuromusculoskeletal function.

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Clinical presentation of neurologic manifestations secondary to Leigh disease: a chiropractic case report

By Annick Messier, DC

Objective: To raise awareness and assist in recognizing the signs of neurodegenerative disorders as they are presented in a chiropractic office for assessment. This report addresses the clinical presentation, neurologic examination and a discussion about the clinical detection of neurodegenerative disorders in children. Clinical Features: A case of Leigh disease in a 4-month-old boy. Chiropractic care was sought for gastroesophageal reflux and difficulty feeding. Physical examination revealed hypotonia, developmental delay and abnormal cranial nerve function. Intervention and Outcome: Due to neurologic presentation, an immediate referral for medical evaluation was done. The child was diagnosed with Leigh disease and passed away one month later. Discussion: Leigh syndrome is a heterogeneous and progressive neurodegenerative disorder of infancy and childhood caused by a mitochondrial dysfunction. Central hypotonia, developmental regression or arrest, and signs of brainstem or basal ganglia involvement (respiratory and ophthalmologic abnormalities, dysphagia, ataxia, dystonia and seizures) are a classical presentation. This inherited disease is fatal and rapid medical referral is required for patients presenting this condition. Conclusion: Chiropractors should obtain a precise case history and perform a complete physical and neurological examination to investigate for neurodevelopmental delay or regression. Neurologic abnormalities should be quickly referred for medical investigation to identify the underlying condition.

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Journal Abstracts

Barriers to implementing a reporting and learning patient safety system.
Pediatric Chiropractic Perspective

Katherine A. Pohlman, DC, DICCP, Linda Carroll, PhD., Lisa Hartling, BScPT, PhD, Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, Sunita Vohra, MD, FRCPC, FCAHS, MSc
Journal of Evidence-Based Complementary & Alternative Medicine, April 2016; vol. 21,2: pp. 105-109., first published on October 4, 2015

Attitudes toward chiropractic: A Survey of Canadian Obstetricians.

Carol Ann Weis, DC, MSc, Kent Stuber, BSc, DC, MSc, Jon Barrett, MD, FRCSC, FRCOG, Alexandra Greco, BSc, Alexander Kipershlak, BPHE, (Hons), Tierney Glenn, BScHK, Ryan Desjardins, MRT(R), Jennifer Nash, DC, Jason Busse, DC, PhD
Journal of Evidence-Based Complementary & Alternative Medicine, April 2016; vol. 21,2: pp. 92-104., first published on September 8, 2015

The use of chiropractic by special populations.

Cheryl Hawk, DC, PhD, CHES
Journal of Evidence-Based Complementary & Alternative Medicine, April 2016 vol. 21 no. 2 83-84
Full article available at:

Parent reports of exclusive breastfeeding after attending a combined midwifery and chiropractic feeding clinic in the United Kingdom.
A Cross-Sectional Service Evaluation.

Joyce Miller, BS, DC, PhD, Monica Christine Beharie, MChiro, Alison M. Taylor, R, Elisabeth Berg Simmenes, MChiro, Susan Way, PhD, RM
Journal of Evidence-Based Complementary & Alternative Medicine, April 2016 Vol. 21, No. 2, 85-91.

Core competencies of the certified pediatric doctor of chiropractic.
Results of a Delphi Consensus Process.

Elise Hewitt, DC, DICCP, FICC, Lise Hestbaek, DC, PhD, Katherine A. Pohlman, DC, MS, DICCP, PhD(c)
Journal of Evidence-Based Complementary & Alternative Medicine. January 5, 2016 2156587215622769

The influence of early infant-feeding practices on the intestinal microbiome and body composition in infants.

O’Sullivan A, Farver M, Smilowitz JT.
Nutr Metab Insights, 2015 Dec 16;8(Suppl 1):1-9. doi: 10.4137/NMI.S29530. eCollection 2015.

The effectiveness of lactation consultants and lactation counselors on breastfeeding outcomes.

Patel S, Patel S.
J Hum Lact. 2015 Dec 7. pii: 0890334415618668. [Epub ahead of print]

Hydrolysed formula and risk of allergic or autoimmune disease: systematic review and meta- analysis.

Robert J Boyle, senior lecturer in paediatric allergy, Despo Ierodiakonou, postdoctoral research fellow, Tasnia Khan, medical student, et al

Unsolved mysteries of the human mammary gland: defining and redefining the critical questions from the lactation consultant’s perspective.

Marasco LA.
J Mammary Gland Biol Neoplasia. 2014 Dec;19(3-4):271-88. doi: 10.1007/s10911-015-9330-7. Epub 2015 Jun 18.

Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED.

Roger Zemek, MD, Nick Barrowman, PhD, Stephen B. Freedman, MDCM, MSc, Jocelyn Gravel, MD, et al.
JAMA. 2016;315(10):1014-1025. doi:10.1001/jama.2016.1203.

Management of post-traumatic headaches in children and adolescents.

Joanne Kacperski, MD, Todd Arthur, MD
Headache 2016:56(1):36¬48.

Suicidality and aggression during antidepressant treatment.
Systematic Review and Meta-Analyses Based on Clinical Study Reports.

Tarang Sharma, Louise Schow Guski, Nanna Freund, Peter C Gøtzsche;
BMJ 2016; 352 doi: (Published 27 January 2016)
Cite this as: BMJ 2016;352:i65

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