Current Issue:  Vol. 20, Issue 1 ( 2021)

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, FICCP, Cheryl Hawk, DC, PhD and Joyce Miller, 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.


Is chiropractic care for children being sabotaged by its own research elite?

By Joyce Miller DC, Ph.D.

Children are a significant part of many chiropractor’s practices. There is even a scientific journal dedicated to their practice. According to the International research, 94% of chiropractors treat children who comprise from 5-32% of their practice. There were 103,469 chiropractors in the world in 2017. If the average chiropractor treats 110 patients per week, then 6-35 patients per week x 50 weeks of the year, the extrapolated number of children patients range from 30 million to 170 million/year world-wide, not insignificant numbers. In large outcome studies, parents report excellent clinical outcomes, and high rates of parent satisfaction. There is even some modest evidence of cost-effectiveness.

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Parent reports of chiropractic care for children: A preliminary report from 22,043 parents in Australia

By Dr Genevieve M Keating, Ph.D.

Editor’s Note: We found the following “Short Report” by Dr. Genevieve Keating sufficiently important to provide an abstract for clinicians ahead of full publication.

This short report is an extended abstract from a major study done in Victoria, Australia in 2020. This preliminary report is an introduction to the full report, which is in process. However, the information is so important for the profession that those on the front lines daily deserve an early warning. Watch for the full paper coming soon.

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A chiropractor’s dream: the Teen Summit and the Green Hub Project for Teens

By Tone Tellefsen Hughes, DC, BSc, FRCC

Inspired by a chiropractor and conceived initially as the Teen Summit, the Green Hub Project for Teens is a local community project that focuses on the improvement of teenagers’ (13-18 year olds) mental health. It resides in Milford, Surrey, UK, in a tranquil, walled garden, designed to support the wellbeing of teenagers’ mental health by providing a safe and welcoming environment in which they can engage in social and therapeutic horticulture. In partnership with the NHS (National Health Services), the Green Hub Project has been designed to provide a resource for local healthcare providers to refer emotionally challenged teenagers to enjoy nature while gardening alongside and interacting with skilled volunteers and others of their own age. The design of the project was to achieve positive, measurable goals and outcomes for teens’ mental wellbeing including encouraging self-acceptance, active lifestyles, positive social interaction, inclusion and respect for diversity, and the development and application of a range of learned life skills (teamwork, responsibility, planning and follow through, creativity, problem solving, affirming and supporting others and conflict resolution).

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The importance of therapeutic presence for the pediatric chiropractor: “getting into right relationship”

By Anne Matthews DC, Dip Biomech, FRCC

There are essential ethical elements required for a chiropractor to establish an authentic professional relationship in order to maintain the integrity of a healing relationship with their patients. Ethically, chiropractors also have an ongoing responsibility to do their own personal and professional development. Therapeutic presence is the capacity to hold a healing space for another person by developing trust and rapport and providing them with a safe energetic container influenced by one’s calm and centered state of being. The Polyvagal Theory provides a neurobiological narrative that focuses on the importance of ‘safety’ and the adaptive consequences of detecting risk on our physiological state, social behavior, psychological experience and health to achieve presence. To fulfill our biological imperative of connectedness, our personal, professional and ethical agenda needs to be directed toward making patients feel safe in the moment and getting into right-relationship. Recognizing and interpreting the mother/baby dyad’s adaptive behaviors provides an insight into their pre & perinatal imprints which reflect the child’s Baby Body Language patterns.

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Headaches in children: Part 1. The changing phenotypes of migraine headache in infants, children and adolescents

By Sue A. Weber DC, MSc, FEAC, FRCC

Headaches in children are common and the prevalence is increasing worldwide. The phenotype of migraine headache changes with continuing development of the nervous system. Children of all ages experience headaches but these are typically difficult to recognize and diagnose in the younger ages. Early intervention addressing the chemical, mechanical and psychological factors contributing to an individual’s headache is essential. This reduces the risk for central sensitization associated with chronicity and disability including reducing the risk for headache in adulthood.

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What role does the microbiome play in the immune function of the pregnant patient during the COVID-19 pandemic? Can probiotics help?

By Susanne Williams-Frey, DC, MSc

The COVID-19 pandemic has upended life and has left the world facing an uncertain future. It is thought that a global approach needs to be the focus before life can «return to normal». COVID-19, first identified as a geographically localized viral infection, rapidly spread to become a global pandemic. Eighteen months later, the prediction is that it will recur in waves due to its many mutations. This suggests its recurrence will be similar to the influenza virus. This is of particular concern for the more vulnerable population like pregnant women. In pregnancy the immune response is altered and many pharmaceuticals are contraindicated. Vaccination of pregnant women is still a subject of investigation with trials being carried out in many countries. But in the pregnant population many are vaccine hesitant because of unknown longterm effects for them and for their offspring. Ongoing strategies and alternative methods of preventing the disease need to be investigated. In COVID-19 patients, an alteration of the microbiome composition has been identified, which points towards a related decrease in the integrity of the immune system. Additionally, disease severity has been related to the amount of dysbiosis in the gut flora. Utilizing a therapeutic protocol of prebiotics and probiotics might be a viable alternative in preventing infection or decreasing the risk of severe outcomes when infected with COVID-19.

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Metarsus adductus in infants and toddlers: a literature review of clinical measurement tools

By Anna Papadopoulou, Mchiro, DACNB, MSc

: Metatarsus adductus (MA) is a common lower limb torsional abnormality that affects 1/1000 births and is one of the reasons for in-toeing in children. This condition has a good prognosis as it commonly spontaneously recovers around the school-age years, with 10-15% of cases persisting. At present there is a lack of agreement in terms of definition, standard approach of measurement and documentation criteria and robust evidence for the validity of intra- or inter-examiner reliability. This creates a barrier in monitoring and referring cases appropriately between clinicians as well as providing prognosis and reassuring parents. The aim of this study was to align the clinical needs of documentation and observation in these common clinical cases. Method: Literature search of the Cochrane library, Pubmed and ScienceDirect was undertaken. Keywords used: ‘MA’, ‘Intoeing’, ‘measurements/classification’, in English language, 1-3 years, excluding congenital abnormalities and neurological causes. Articles identified were screened for relevance and references were further assessed. Results: 173 articles were identified of which 18 fulfilled the requirements. Out of the 8 relevant articles, only 3 were fully compatible with the age in question. Techniques to measure metatarsus adductus included the heel bisector method, photocopies, ultrasound, footprints, dynamic foot pressure and radiographs. Radiographs are considered inappropriate for the toddler age group. Lack of robust evidence was an issue with identifying inter- and intra-rater reliability with both radiographic and non-radiographic findings, especially in relation to the pediatric population. Conclusion: Clinicians can use history and physical examination to rule out ‘red flag’ findings and other pathologies and monitor the progress using non radiographic methods. Given the lack of skeletal maturity, as well as the radiosensitivity in the toddler age group, x-rays should be avoided unless indicated for intervention.

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Plant-Based Beverages in the Diets of Infants and Young Children
Lisa M. Bodnar, PhD, RD, Elizabeth Y. Jimenez, PhD, RDN, LD, Susan S. Baker, MD, PhD
JAMA Pediatr. Published online February 22, 2021.
doi: 10.1001/jamapediatrics.2020.5840

Effect of Collaborative Care on Persistent Postconcussive Symptoms in Adolescents: A Randomized Clinical Trial
Carolyn A. McCarty, PhD, Douglas F. Zatzick, MD, Lyscha A. Marcynyszyn, PhD1, et al, Jin Wang, PhD, MS, Robert Hilt, MD, Thomas Jinguji, MD, Celeste Quitiquit, MD, Sara P. D. Chrisman, MD, MPH, Frederick P. Rivara, MD, MPH
JAMA Netw Open. 2021;4(2):e210207.

Complementary and Alternative Medicine Used by Children in Military Pediatric Clinics
Adam Huillet, Christine R Erdie-Lalena, Daniel C Norvell, Beth Ellen Davis
May 2011 Journal of alternative and complementary medicine (New York, N.Y.) 17(6):531-7 Follow journal
DOI: 10.1089/acm.2010.0339

Association Between Epidural Analgesia During Labor and Risk of Autism Spectrum Disorders in Offspring
Chunyuan Qiu, MD, MS, Jane C. Lin, MS, Jiaxiao M. Shi, PhD2, et al, Ting Chow, MPH, Vimal N. Desai, MD, Vu T. Nguyen, MD, Robert J. Riewerts, MD, R. Klara Feldman, MD, Scott Segal, MD, MHCM, Anny H. Xiang, PhD
JAMA Pediatr. 2020;174(12):1168-1175.

Pediatric Osteopathic Manipulative Medicine: A Scoping Review
Samantha DeMarsh, Anneliese Huntzinger, Alison Gehred, Joseph R. Stanek, Kathi J Kemper, Jennifer A. Belsky
January 2021 Pediatrics 147(2):e2020016162 Follow journal
DOI: 10.1542/peds.2020-016162

Association Between Disturbed Sleep and Depression in Children and Youths: A Systematic Review and Meta-analysis of Cohort Studies
Cecilia Marino, MD, PhD, Brendan Andrade, PhD, Susan C. Campisi, PhD3, et al, Marcus Wong, MScPH, Haoyu Zhao, MScPH, Xin Jing, HBSc, Madison Aitken, PhD, Sarah Bonato, MSc, John Haltigan, PhD, Wei Wang, PhD, Peter Szatmari, MD
JAMA Netw Open. 2021;4(3):e212373. March 22, 2021

Quantitative imaging of tongue kinematics during infant feeding and adult swallowing reveals highly conserved patterns
Catherine W. Genna, Yiela Saperstein, Scott A. Siegel, Andrew F. Laine, David Elad
Physiological Reports Volume 9, Issue 3 ee14685 First published: 06 February 2021

Association of the Timing of School Closings and Behavioral Changes With the Evolution of the Coronavirus Disease 2019 Pandemic in the US
Frederick J. Zimmerman, PhD, Nathaniel W. Anderson, BA
JAMA Pediatr. Published online February 22, 2021.

Harnessing the Web: How Chiropractic Education Survives and Thrives During the COVID-19 Pandemic: Chiropractic Educators Research Forum (CERF), December 5, 2020
Conference Proceedings: Chiropractic Educators Research Forum
J Chiropr Educ (2021) ABSTRACT | FEBRUARY 25 2021

Family-Centered Prevention Effects on the Association Between Racial Discrimination and Mental Health in Black Adolescents: Secondary Analysis of 2 Randomized Clinical Trials
Gene H. Brody, PhD, Tianyi Yu, PhD, Edith Chen, PhD, et al, Gregory E. Miller, PhD, Allen W. Barton, PhD, Steven M. Kogan, PhD
JAMA Netw Open. 2021;4(3):e211964. March 24, 2021

Shedding light on excessive crying in babies
Alexandra Adam-Darque, Lorena Freitas, Frédéric Grouiller, Julien Sauser, François Lazeyras, Dimitri Van De Ville, Philippe Pollien, Clara L Garcia-Rodenas, Gabriela Bergonzelli, Petra S Hüppi, Russia Ha-Vinh Leuchter
Pediatric Research 2020 Jul 6. Online ahead of print.
PMID: 32629458 DOI: 10.1038/s41390-020-1048-6

Preterm Birth and the Development of Visual Attention During the First 2 Years of Life: A Systematic Review and Meta-analysis
Or Burstein, MA, Zipi Zevin, BA, Ronny Geva, PhD
March 30, 2021. JAMA Netw Open. 2021;4(3):e213687.

Association of Race/Ethnicity and Social Disadvantage With Autism Prevalence in 7 Million School Children in England
Roman-Urrestarazu A, van Kessel R, Allison C, Matthews FE, Brayne C, Baron-Cohen S.
JAMA Pediatr. Published online March 29, 2021.

Relationship Between Neonatal Vitamin D at Birth and Risk of Autism Spectrum Disorders: the NBSIB Study
Wu, D.M., Wen, X., Han, X.R., Wang, S., Wang, Y.J., Shen, M., Fan, S.H., Zhuang, J., Li, M.Q., Hu, B., Sun, C.H., Bao, Y.X., Yan, J., Lu, J. and Zheng, Y.L.
(2018), J Bone Miner Res, 33: 458-466.

Maternal vitamin D status and infant outcomes in rural Vietnam: a prospective cohort study
Sarah Hanieh, Tran T Ha, Julie A Simpson, Tran T Thuy, Nguyen C Khuong, Dang D Thoang, Thach D Tran, Tran Tuan, Jane Fisher, Beverley-Ann Biggs
PLoS One. 2014 Jun 26;9(6):e99005. doi: 10.1371/journal.pone.0099005. eCollection 2014.
PMID: 24967813 PMCID: PMC4072587 DOI: 10.1371/journal.pone.0099005

Association Between Proton Pump Inhibitor Use and Risk of Asthma in Children
Yun-Han Wang, MSc, BPharm, Viktor Wintzell, MSc, Jonas F. Ludvigsson, MD, PhD, et al, Henrik Svanström, PhD, Björn Pasternak, MD, PhD
February 8, 2021. JAMA Pediatr. 2021;175(4):394-403.

Association of Child and Family Attributes With Outcomes in Children With Autism
Peter Szatmari, MD, Katherine Tombeau Cost, PhD, Eric Duku, PhD3, et al, Teresa Bennett, MD, PhD, Mayada Elsabbagh, PhD, Stelios Georgiades, PhD, Connor Kerns, PhD, Pat Mirenda, PhD, Isabel M. Smith, PhD, Wendy J. Ungar, PhD, Tracey Vaillancourt, PhD, Charlotte Waddell, MD, Anat Zaidman-Zait, PhD, Lonnie Zwaigenbaum, MD.
March 29, 2021 JAMA Netw Open. 2021;4(3):e212530.

Antenatal Vitamin D Status Is Not Associated with Standard Neurodevelopmental Assessments at Age 5 Years in a Well-Characterized Prospective Maternal-Infant Cohort
Elaine K McCarthy, Deirdre M Murray, Lucio Malvisi, Louise C Kenny, Jonathan O’B Hourihane, Alan D Irvine, Mairead E Kiely
J Nutr. 2018 Oct 1;148(10):1580-1586. PMID: 30169669
DOI: 10.1093/jn/nxy150

Maternal Plasma 25-Hydroxyvitamin D during Gestation Is Positively Associated with Neurocognitive Development in Offspring at Age 4–6 Years
Melissa M Melough, Laura E Murphy, J Carolyn Graff, Karen J Derefinko, Kaja Z LeWinn, Nicole R Bush, Daniel A Enquobahrie, Christine T Loftus, Mehmet Kocak, Sheela Sathyanarayana
The Journal of Nutrition, Volume 151, Issue 1, January 2021, Pages 132–139

Association Between Maternal Caffeine Consumption and Metabolism and Neonatal Anthropometry: A Secondary Analysis of the NICHD Fetal Growth Studies–Singletons
Jessica L. Gleason, PhD, MPH, Fasil Tekola-Ayele, PhD1, Rajeshwari Sundaram, PhD, et al, Stefanie N. Hinkle, PhD, Yassaman Vafai, PhD, Germaine M. Buck Louis, PhD, Nicole Gerlanc, PhD, Melissa Amyx, PhD, Alaina M. Bever, BS, Melissa M. Smarr, PhD, Morgan Robinson, BS, Kurunthachalam Kannan, PhD, Katherine L. Grantz, MD, MS
March 25, 2021. JAMA Netw Open. 2021;4(3):e213238.

The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature
Pierre Côté, Jan Hartvigsen, Iben Axén, Charlotte Leboeuf-Yde, Melissa Corso, Heather Shearer, Jessica Wong, Andrée-Anne Marchand, J. David Cassidy, Simon French, Gregory N. Kawchuk, Silvano Mior, Erik Poulsen, John Srbely, Carlo Ammendolia, Marc-André Blanchette, Jason W. Busse, André Bussières, Carolina Cancelliere, Henrik Wulff Christensen, Diana De Carvalho, Katie De Luca, Alister Du Rose, Andreas Eklund, Roger Engel, Guillaume Goncalves, Jeffrey Hebert, Cesar A. Hincapié, Maria Hondras, Amanda Kimpton, Henrik Hein Lauridsen, Stanley Innes, Anne-Laure Meyer, David Newell, Søren O’Neill, Isabelle Pagé, Steven Passmore, Stephen M.
Perle, Jeffrey Quon, Mana Rezai, Maja Stupar, Michael Swain, Andrew Vitiello, Kenneth Weber, Kenneth J. Young and Hainan Yu Côté et al.
Chiropractic & Manual Therapies (2021) 29:8

Distance Management of Spinal Disorders in the COVID-19 pandemic and beyond: Evidence-based Patient and Clinician Guides from the Global Spine Care Initiative
Haldeman S, Nordin M, Tavares P, Mullerpatan R, Kopansky-Giles D, Setlhare V, Chou R, Hurwitz E, Treanor C, Hartvigsen J, Schneider M, Gay R, Moss J, Haldeman J, Gryfe D, Wilke A, Brown R, Outerbridge G, Eberspaecher S, Carroll L, Engelbrecht R, Graham K, Cashion N, Ince S, Moon E
JMIR Public Health and Surveillance. 19/01/2021:25484 (forthcoming/in press)
DOI: 10.2196/25484 PMID: 33471778

Extrapolating Beyond the Data in a Systematic Review of Spinal Manipulation for Nonmusculoskeletal Disorders: A Fall From the Summit
Christine M. Goertz, DC, PhD, Eric L. Hurwitz, DC, PhD, Bernadette A. Murphy, DC, PhD, and Ian D. Coulter, PhD
J Manipulative Physiol Ther 2021;44;271-279)
PMID: 33879350 DOI: 10.1016/j.jmpt.2021.02.003

EDITORIAL: Gratitude for chiropractic’s canaries in the coal-mine
Phillip Ebrall, PhD.
Asia Pacific Chiropractic Journal · Editorial’s_canaries_in_the_coal-mine

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