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Pregnancy & Children

CHIROPRACTIC CARE FOR PREGNANCY & NEWBORNS & CHILDREN!

Photography by: Léonel Bourque
LBphotos@hotmail.com

 

How can chiropractic add comfort?

Chiropractic care in pregnancy is an essential ingredient to your prenatal care choices. A large percent of all pregnant women experience back discomfort/pain during pregnancy. This is due to the rapid growth of the baby and interference to your body’s normal structural adaptations to that growth.

Pre-existing unnoticed imbalances in your spine and pelvis become overtaxed during these times. The added stresses lead to discomfort and difficulty while performing routine, daily activities.

Chiropractic care throughout pregnancy can relieve and even prevent the common discomforts experienced in pregnancy. Specific adjustments eliminate these stresses in your spine, restore balance to your pelvis and result in greater comfort and lifestyle improvements.

 

Comfort for your baby too

As your baby develops, your uterus enlarges to accommodate the rapid growth. As long as the pelvis is in a balanced state, the ligaments connected to the uterus maintain an equalized, supportive suspension for the uterus. If your pelvis is out of balance in any way, these ligaments become torqued and twisted, causing a condition known as constraint to your uterus.

This constraint limits the space of the developing baby. Any compromised position for the baby throughout pregnancy will affect his or her optimal development. Conditions such as torticollis occur because a baby’s space was cramped in the uterus.

If the woman’s uterus is constrained as birth approaches, the baby is prevented from getting into the best possible position for birth.

Even if the baby is in the desirable head down position, often constraint to the uterus affects the baby’s headroom moving into the ideal presentation for delivery. The head may be slightly tilted off to one side or even more traumatically, present in the posterior position.

Any baby position even slightly off during birth will slow down labor, and add pain to both the mother and baby. Many women have been told that their babies were too big, or labor “just slowed down” when it was really the baby’s presentation interfering with the normal process and progression. Avoidable interventions are implemented turning a natural process into an operative one.

Doctors of Chiropractic work specifically with your pelvis throughout pregnancy, restoring a state of balance and creating an environment for an easier, safer delivery.

 

Preparing for a safer birth

Dystocia is defined a difficult labor and is something every woman wants to avoid. In addition to the pain and exhaustion caused by long, difficult labors, dystocia leads to multiple, medical interventions, which may be physically and emotionally traumatic to both you and your baby.

Some of these interventions are the administering of pitocin, the use of epidurals, painful episiotomies, forceful pulling on the baby’s fragile spine, vacuum extraction, forceps and perhaps even c-sections. Each of these procedures carries a high risk of injury to you, your baby or both! However, all of these procedures used to hasten the delivery process can be avoided if delivery goes more smoothly to begin with.

When reviewing the obstetric texts, pelvic imbalance and its resulting effects on your uterus and your baby’s position cause the reported reasons for dystocia.

Chiropractic care throughout pregnancy restores balance to your pelvic muscles and ligaments and therefore leads to safer and easier deliveries for you and your baby. Additionally, the chiropractic adjustment removes interference to the nervous system allowing your uterus to function at its maximum potential. Many published studies have indicated that chiropractic care does in fact reduce labor time.

Give you and your baby the opportunity for a more comfortable pregnancy and a safer, easier birth!

At Chiroplus, we offer specific analysis and adjustments for your special needs in pregnancy. Both you and your baby’s continued safety and comfort is primary in our care.

 

Pregnancy matters

A recent USA Today article was titled fewer incisions at birth urged; Episiotomies rates “still way too high”! Author Mary Ellas reports, “Hundreds of thousands of U.S. women get an “unkind cut” each year: needless and even medically harmful incisions when they deliver babies”

Dr. Anne Waber, and OB/GYN at the University of Pittsburgh Medical School say, “The incisions are medically needed in less than 10% of births.” Incisions still occur in as many as 31% of all deliveries.

Women subjected to episiotomies are prone to more bleeding, experience a greater risk of infection and suffer increased pain. The more serious outcome is severe tissue tears leading to future bowel incontinence. As many as one in five serious tears can lead to bowel incontinence.

 

Dr. Jay Goldberg of Jefferson Medical College in Philadelphia describes the tears resulting from episiotomies, “It’s like starting a tear in a bed sheet when you do the first cut.”

 

-Text provided by Jen Drake D.C.

 

INTERNATIONAL CHIROPRACTIC PEDIATRIC ASSOCIATION

 

-January/February 1999 (Jeanne Ohm D.C.)

 

The epidural epidemic

Epidurals during birthing have become so routine, as mothers are being convinced that pain during labor is unnatural. Convinced that they should not endure pain during the birth process, mothers are set up to believe in a drug instead of their bodies’ own natural capabilities. Sixty four percent of certified nurse midwives reported concern over the increased number of their clients who desire epidural anesthesia, and a majority of certified nursemidwives surveyed (52%) reported a negative attitude toward the increased use of epidurals.

We started including questions about births years ago on our children’s case history and 9 times out of 10 mothers will check off that they had a “natural childbirth” and in the next question, they check off that they had an epidural. In other words, if they delivered vaginally, and their eyes were open, they are being led to believe that they delivered naturally.

What are not being provided to the parents are the increased complications, which are a result of epidural usage. The PDR cautions that “local anesthesia rapidly crosses the placenta…and when used for epidural blocks, anesthesia can cause varying degrees of maternal, fetal and neonatal toxicity.” It continues, “this toxicity can result in the following side effects: hypotension, urinary retention, fecal and urinary incontinence, paralysis of lower extremities, loss of feeling in the limbs headache, backache, septic meningitis, slowing of labor, increased need for forceps and vacuum deliveries, cranial nerve palsies, allergic reactions, respiratory depression, nausea, vomiting and seizures.” Many of these side effects result in multiple complications. For example, maternal hypotension causes bradycardia (decreased heart rate) in the fetus. This altered heart rate can lead to fetal distress and therefore an increase in operative deliveries. This had led doctors to warn that high concentration anesthetics and epinephrine should be avoided because they may influence labor and may lead to birth trauma.

 

8 THINGS TO KNOW ABOUT EPIDURALS

  1. Causes longer labors with slower progress.
  2. Can cause fevers in mothers during childbirth.
  3. Increase use of pitocin by as much as 3 ½ times, which causes slow and irregular contractions.
  4. Increase use of antibiotics in your baby by as much as 4 times.
  5. Increases use of forceps by as much as 4 ½ -20 times.
  6. Causes neonatal jaundice due to altered red blood cells.
  7. Increases the incidence of birth trauma due to the use of mechanically assisted deliveries.
  8. Causes adverse behavioral effects of the neonate.

 

In order to bring about a reversal in epidural usage, mothers must become educated not only on its potential side effects, but on their bodies own ability to give birth naturally. The overwhelming fear associated with birth has become a learned behavior in our culture. Fear causes additional muscular tension in the body, resulting in decreased blood supply to organs and therefore impaired uterine function. It is our privilege and obligation as Chiropractors to care for these women throughout their pregnancies, offering them encouragement and educating about choices for their upcoming experience, I have been told their pregnancies, offering them encouragement and educating about choices for their upcoming experience. I have been told by many chiropractors (and have heard it in our own practice) how women look forward to their visit with us because we treat the process of pregnancy with respect, and we enhance the mothers confidence in her own innate abilities.

 

INTERNATIONAL CHIROPRACTIC PEDIATRIC ASSOCIATION

 

-January/February 2000 (Jeanne Ohm D.C.)

 

Is the pit bull?

In one day’s time I received two calls asking about the relationship between the administration of pitocin and neurologically compromised infants at birth and my intuitive antennas went off. Pitocin is a synthetic version of oxytocin the naturally produced hormone in the laboring woman. It is preferably administered through IV. As with all drugs, it does not come without its side effects, the most common being increased blood pressure in both the mother and child. Even the American Academy of Pediatrics aggress that no drug has been tested as safe for the baby in utero.

Pitocin is used for either labor induction or labor enhancement (what an inappropriate use of that term!) The use of pitocin does not, however, duplicate the natural progression of labor. Pit induced labors have longer, harder and more painful uttering contractions. Additional reported risks of induction are:

For the mother: higher rate of complicated labors and deliveries, greater need for analgesics and anesthetics, postpartum hemorrhage and higher rate of placental rupture and separation life-threatening to both the mother and baby.

For the baby: induction causes fetal distress, a higher rate of jaundice, a greater chance of a prematurity, low APGAR scores at 5 minutes, permanent central nervous system or brain damage and fetal death.

In either induced or enhanced use of pitocin, the blood supply (and therefore the oxygen source) to the uterus is greatly reduced. With naturally paced contractions, there is a time interval between contractions allowing for the baby to be fully oxygenated before the next contraction. In induced or stimulated labor, the contractions are closer together and last for a longer time thus shortening the interval where the baby receives its oxygen supply. Reduced oxygen could have life-long consequences on the baby’s brain.

It is the belief (not necessarily the practice) in the medical profession that induction should occur when the risk of continuing pregnancy presents a threat to the life of the mother or baby. These situations include: some severe diabetics, kidney disease, severe preeclampsia, severe high blood pressure, kidney disease, and an overdue pregnancy where a danger to the fetus has been proven. If induction were carried out only when these conditions were present, at most, an estimate of 3% of births would be induced.

In reality though, due date paranoia remains the most common reason for induction and the consequent use of pitocin. Surprisingly, studies on the due date calculations revealed frightening evidence. Firstly, the due date varies significantly between first time pregnancies and subsequent pregnancies. Also, maternal race has been shown to be a determining factor in gestation time.

Another variable to the accuracy of the due date is the recent dependence of ultrasound as a reliable criterion for infant size and gestational age. First trimester measurements have an error bar of ± 5 days, increasing to ± days in the second trimester and are as high as ± days in the third trimester! Bigger fetuses are assumed to be older and in studies where the ovulation date was known 70% of women who were classified as postdates were incorrectly dated.

Furthermore, studies on induction have shown that 30% of fetuses testing normal developed fetal distress when labor was electively induced and the cesarean rate 15% verses 2% for spontaneous labor.

Using pitocin to enhance labor leads to an increase in epidurals, and therefore obstetric intervention during birth adding additional risks to both the mother and baby. And finally, a controlled randomized study showed that the use of pitocin to stimulate labor was not as productive for the progression of labor as allowing mothers to change positions during labor by walking, sitting or standing. Giving the mother back control of her body.

As more and more interventions are added to the birth process, the cause of birth trauma is proportionately rising. It is our job as chiropractors to continue to educate mothers about the choices they have in birth and help reduce the devastating effects birth trauma is having on their babies’ delicate nervous systems. It is a huge job ahead of us, yet I know chiropractors have the passion and the means to make it happen!

 

CHIROPRACTIC COMMUNICATIONS WORKING GROUP

 

-(CCA, OCA, CMCC, CCPA)

 

Chiropractic care and children

Children benefit from chiropractic care for the same problems for which adults are treated, which are predominantly musculo-skeletal disorders. For example, children have a fairly high incidence of back pain and other musculo-skeletal problems caused by participation in sports, sitting in desks at school, computer activities, and the frequent tumbles and falls active children experience.

Chiropractic care is widely recognized as one of the safest, drug-free, surgery-free therapies available for the treatment of spinal pain syndromes. Few other therapies can demonstrate a better safety record. Provincial governments across Canada recognize that the chiropractic profession’s scope of practice includes treating patients of all ages.

 

Are chiropractors trained to treat children?

Yes. Chiropractors have seven to nine years of university level education and training including 756 hours of training exclusively in adjustment techniques. Treatment for children is adapted to the age and smaller frame of the child and is delivered in a gentle manner to which children respond well.

 

What childhood conditions can chiropractors treat?

More than 44 studies have been conducted into the effectiveness of chiropractic treatment for neck and back pain alone and there is well-documented evidence of the prevalence of back pain in children. Young children can also benefit from a spinal check-up at key stages in the same way that they benefit from eye examinations and dental check-ups. For examples, starting to sit, crawl and walk are developmental points when a check-up will confirm that the spine is functioning properly or provide an early warning of any potential problems.

Chiropractors also consistently see evidence that spinal adjustment of infants and children has many positive effects for a variety of conditions, however; well-controlled research studies are required to better understand some of the benefits that are commonly seen in practice. As research unfolds, studies are confirming these benefits. For example, in recent years there have been two important studies investigating the effectiveness of chiropractic care for treating childhood colic and asthma.

In 1999, a research report published in the Journal of Manipulative and Physiological Therapeutics concluded “spinal manipulation is effective in relieving infantile colic. The study compared the effect of chiropractic treatment with a commonly prescribed medication used to relieve infantile colic. The results of this study are so compelling that the Danish Public Health Authority has given its public health nurses approval to refer infants with colic to chiropractors.

Another study published in the New England Journal of Medicine in 1998, looked at chiropractic care as complementary therapy for children with medically managed asthma. The study concluded that while chiropractic treatment did not affect lung function as measured by spirometry, there was a trend toward improvement in the patients’ quality of life based on a reduction in the amount of medication taken, as well as diminished severity of asthma attacks.

 

Do chiropractors support immunization?

The Canadian Chiropractic Association supports childhood immunization as an effective means of controlling communicable diseases. At the same time, the profession respects an inpidual’s right to choose.

 

Can chiropractic treatment replace medical care?

No. Depending on the patient’s condition, chiropractic care may be the primary treatment for the symptoms. In other situations, chiropractic care may be one aspect of treatment. Chiropractors frequently work in partnership with other health professionals where the skills of both apply to enhancing a patient’s well being.

As well, chiropractors will refer patients to other health professionals when appropriate. The profession has a very cooperative relationship with family physicians that are a major source of referral to chiropractors.

 

Do Canadian pediatricians support chiropractic care for children?

The chiropractic profession supports an integrative and collaborative approach to children’s health care and welcomes both jointly managed patient care and cooperative research into children’s health with the paediatric profession. The Canadian Paediatric Society’s position statement on chiropractic care encourages physicians to co-manage care when patients are also receiving treatment from a chiropractor.

 

References:

Battis and Drake center for chiropractic

MusculoSkeletal Pain in Primary Paediatric Care, Vol.102 No6, Dec 1998

Back Pain in School Children: Scandinavian Journal of Rehabilitative Medicine, 1994

The Epidemiology of low back pain in an Adolescent Population

The short term Effect of Spinal Manipulation in the treatment of infantile Colic: Journal of Manipulative and Physiological Therapeutics 1999

A comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma: The New England Journal of Medicine, Vol 339 No15, 1998

ICPA Newsletter March/April 1999

ICPA Newsletter January/February 2000

 

 

Childhood Earaches and Chiropractic

-Palmer Chiropractic University system news/2004

 

Recent reports on the Today show and in newspapers have reported on a new AMA (American Medical Association) study that indicated favorable results in treating childhood earaches with osteopathic care. As the chiropractic profession has known for years, spinal manipulation or adjustments have clearly had positive outcomes in dealing with this condition. Palmer’s professional journal Streams for The Fountainhead ran an explanation of chiropractic’s efficacy in its spring 2002 issue. They are presented here in support of the chiropractic viewpoint.

 

Otitis Media From Every Angle:

 

Why Look at Otitis Media Again?

The anguish of a child with an earache is not pleasant to see.

 

No one wants a child to suffer the pain of frequent recurring ear problems. Many chiropractors over decades of practice have seen excellent results gained through the adjustment of children suffering this common malady of youth. Another observation of chiropractors caring for children has been the fact that such problems often appear soon after infant vaccinations.

We asked two chiropractic authorities on otitis media to discuss the problem and its neurological/subluxation connection. Their insights shed new light on this common childhood condition.

Medicine has run the full gamut of the therapeutic approach for otitis media, from antibiotics to the placement of ear drainage tubes. Both procedures have distinct hazards. The overuse of antibiotics has produced so-called « super infections. » The destroying of bacteria through the antibiotic approach destroys the bad along with the good bacteria and has led to the need for the recolonization of bacteria through an alpha streptococci spray. Ear tubes also have their hazards such as perforated eardrums, scarring and resultant impaired hearing and chronic drainage from the ear.

 

Evidence continues to mount chiropractically and medically in regards to the efficacy of chiropractic care in the infections of childhood. As far back as 1987, when Gutman published « Blocked Atlantal Nerve Syndrome In Babies and Infants » (Manuelle Medizin, 1987), the enhancement of the body’s capability to ward off infection through the correction of chiropractic subluxations was becoming evident. For instance, Gutman citied, « early relapsing tonsillitis, interitis, conjunctivitis, colds and earache »-all responding to what he called « specific manipulation »-chiropractic adjustment of the upper cervical subluxations.

 

OTITIS MEDIA: The Neurological/Subluxation Connection By G.O. Schmiedel, D.C.

Otitis media, in the writer’s opinion, may be the consequence of lowered integrity of the tissues of the eardrum (tympanum and related nasopharyngeal structures, impediments to the normal drainage and equalization of air pressures between the eardrum and nasopharynx, or a combination of the two. The neurological implications involve structures, e.g., muscles involved in yawning and swallowing as well as the eardrum itself.

Sympathetic elements, especially vasomotor, that may be impaired, include the reticular formation, especially in the upper cervical region (upper neck), the lateral horn cells (intermedio lateral neurons) of cord levels T1-2 (upper back), the ganglionic neurons of the superior cervical ganglion, and their fiber pathways.

Vertebral subluxation of T1 or T2 may cause direct interference with the pre-ganglionic elements that synapse with post-ganglionic neurons of the superior cervical ganglion (which lies alongside C2-3 vertebrae in the upper neck).

The plexus about the internal carotid artery carries many post-ganglionic elements from the superior cervical ganglion. Some of these vasomotor elements are subsequently carried by the trigeminal for the blood vessels of the tensor veli palatini, and the vagus (very important nerve in the head) for the levator veli palatini, salpingo pharyngeus, and constrictor pharyngeus superioris muscles.

The auditory (Eustachian) tube is lined with mucous membrane which glands and blood vessels are supplied by the deep petrosal nerve. Fibers are carried subsequently by the greater petrosal of the facial to the auditory tube. Vasomotor and secretomotor fibers pass into the eardrum thru the carotid wall as carotico tympanic nerves. The vertebral arteries are also directly innervated by fibers from the superior cervical ganglion.

 

Sulbuxation of the occipito atlanto axial region (upper neck) may cause direct encroachment of the neural canal and its contents; including the lower medulla oblongata, upper medulla spinalis, and blood vessels, e.g., the anterior spinal artery. The vertebral arteries or their branches may also be compromised.

The compromised blood vessels may impair the function of most of the gray matter of the spinal cord (anterior spinal arteries) and the medulla oblongata including hypoglossal and ambiguus nuclei and the reticular formation (posterior cerebellar arteries).

The encroachment affecting the medulla oblongata may directly impair the nuclei hypoglossi and ambiguus that directly control muscles of deglutition; and the reticular formation that influences the nerve control for the blood vessels of the muscles of deglutition and the integrity of the tissues of the tympanum. The reticular formation also influences control of the mucous glands in the eardrum

Yawning or swallowing decidedly facilitates drainage of mucous produced by glands in mucous membranes that line the eardrum and equalize the pressures between the eardrum and nasopharynx via the auditory tube. The muscles most directly affecting the auditory tube are the tensor veli palatini, levator veli palatini, and constrictor pharyngeus superioris. Youngsters, especially infants, do not swallow as frequently as adults and weakness of the above muscles in particular may interfere with drainage of mucous and may result in unequal pressures of the eardrum. The mechanism and efficiency of swallowing may be affected by upper thoracic (T1 or 2) or upper cervical subluxation (especially C1, occiput).

The integrity of the tissues especially the mucous membranes of the eardrum may be affected by upper thoracic (T1 or 2) or upper cervical subluxation (especially C1, occiput).

A New Subluxation Model of Otitis Media

By Joan Fallon, D.C.

 

The chiropractic profession has long proposed subluxation models. Lantz, in his 1989 paper titled, « The Vertebral Subluxation Model », proposes a model for subluxation that has long been cited by the profession as the basis for explanation of subluxation. Gatterman has further defined the subluxation complex as « a theoretical model of motion segment dysfunction (subluxation) that incorporates the complex interaction of pathologic changes in nerve, ligaments, muscle, vascular and connective tissues ».

I would like to propose a model for subluxation as it relates to the pathogenesis of otitis media (OM), using the various components cited by all of my predecessors, and add to it the involvement of the cranial bones. I will call it the Vertebral-Cranial Subluxation Complex (VCSC) model. It is important to include the cranium when speaking about subluxation in the child, due to the fact that the cranium takes the larges portion of the external forces applied to the child’s body, which may contribute to the formation of the subluxation (VSC). From birth through childhood the cranium and cervical spine have the most involvement with external forces.

I will briefly discuss five parameters of subluxation as they relate to the pathogenesis of otitis media. While other parameters are a specific part of the VSC and the VCSC, these five play the most central role in the pathogenesis of OM. The parameters are: mechanical (spine), myologic (muscles), lymphatic, inflammatory and neurological (nerves).

 

Mechanical (spine)

Some of the mechanical manifestations of the VCSC have been previously discussed. With respect to the VCSC, it is important to examine such occurrences as birth malposition. Children born in malposition such as breech presentation, brow and occiput posterior, often have disruption of the normal vertebral motion segments of the cervical spine as well as those of the cranium. Children born with the aid of forceps and/or vacuum extraction often experience contusions of the scalp and facial bones, and alteration of the normal cranial juxtaposition may be involved. In children with craniofacial defects it is well documented that they have an increased incidence of otitis media (OM). Lewit, in his work describing cranial-cervical joint restriction in his study of 76 children with chronic tonsillitis, said that the most consistent finding among the children was a joint restriction at the C0-C1 junction of 98 percent.

Another aspect of mechanical change is represented in trauma to the cranium and spine. The child’s spine and cranium is significantly cartilaginous and therefore maintains a great ability to approximate its normal range of motion even with fixation and postural dyskinesia (decrease mobility). This would reduce the child’s exposure to the pain often associated with dyskinesia and it may also reduce the visualization of positional dyskinesia on X-ray examination. Any child who sustains repeated trauma to an area either from the birthing process or by some other means might likely have a hypermobile articulation.

 

Myologic (muscles)

The myologic (muscle) component of the VCSC plays a significant role in the pathogenesis of OM with respect to the dilatation mechanism of the cartilaginous Eustachian tube (ET). When one adds to this to the presence of muscle spasticity and altered reflex pathways due to increases in muscle spindle activity, the myologic effect is quite significant.

 

Lymphatic

The lymphatic component of the VCSC as it pertains to the pathogenesis of OM is generally assumed to be a secondary or tertiary component. While alterations in lymphatic flow are generally not thought to be a primary component of the VCSC, it can be a direct result of the formation of the VCSC. Lymphatic flows are directly dependent on the movement of the organism; restriction of muscle movement may result in lymphatic congestion. When the VCSC occurs at the C0-C1 articulation (upper neck), post-auricular, pre-auricular and suboccipital lymph swelling may be present. Lymphatic flow in the anterior and posterior cervical chain lymph nodes may be slowed. This lymph congestion may play a significant role in the Eustachian tube (ET) inability to drain middle ear fluids completely. Allopathic remedies for recurrent otitis media have revolved around the removal of lymph tissue, specifically the tonsils and adenoids. Dr. Peter Fysh outlined the fact that lymphatic effects may alter the course of phagocytic activity in the child precluding the continued impact on the immune system of the child.

 

Inflammation (swelling/edema)

OM may be the culmination of various etiologies including the VCSC, and central to many of these etiologies is an inflammatory process. The literature is replete with examples of chronic inflammation altering the structure and composition of connective tissue. Chronic inflammatory changes also may lead to fibrotic changes, which in the case of OM may preclude the drainage of the middle ear and Eustachian tube (ET). In neurologic inflammation it has been noted that changes in nerve transmission may occur, producing aberrant transmission.

The VCSC may result from localized trauma applied to a spinal or cranial area or from a visceromotor reflex set up by a condition elsewhere. The inflammation set up by the VCSC can be a reactive phase of an acute inflammatory process due to such etiologies as an allergic response. This allergic response may promote multiple succeeding bouts of OM or chronic serious OM.

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