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Chiropractic Journal of Australia : CJA September 2012
112 Chiropractic Journal of Australia Volume 42 Number 3 September 2012 continued with the patient’s mother choosing to not undergo a second dose of Depo-Provera injection. The infant’s pattern of breastfeeding and bowel function normalised. The authors theorised that the mother’s receipt of a Depo-Provera injection may have affected the child's health via the breastmilk. In the case presented in this discussion, and similar to previous publications on chiropractic care that address feeding diffculty, the failure to latch due to dysfunctions in the TMJ was commonly described. Wall and Glass32 reviewed the experiences of 11 mother-infant pairs who had breastfeeding problems related to the infants' mandibular asymmetry. Lower jaw asymmetry is an early identifable sign of torticollis, and a possible contributor to latch diffculties, nipple pain, and poor milk transfer. Paediatricians and lactation consultants should look for signs of lower jaw asymmetry combined with a preference for turning the head to one side in newborns who present with breastfeeding diffculties. By recognising these anatomic irregularities early in the course of breastfeeding, paediatric health care providers will be able to address breastfeeding problems promptly and proactively by direct care of referral to an appropriate practitioner within the paradigm of integrative medicine. In so doing, unnecessary hospital admissions (i.e., for dehydration symptoms) and further suffering on the part of the infant are avoided. Tow and Vallone33 commented that chiropractic care, when applied skillfully and in collaboration with the lactation consultant can support full competency in feeding and offer the infant the opportunity to reclaim his/her full human potential. As stated, we believe that the care provided as described in this case report may have contributed to improving the infant’s breastfeeding diffculties and possibly mitigate the causes of breastfeeding jaundice. Although a number of defnitions exist for integrative medicine,34 to date no consensus has emerged about what constitutes Integrative Health Care.35 Regardless, it has become increasingly clear among conventional and non- conventional practitioners as well as healthcare policy makers that patients are using “integrative health care” to improve their wellness and treat illness.13 In other words, at the heart of integrative medicine is the patient connecting CAM providers and biomedical physicians in an informal network that is often unacknowledged by the practitioners.36 Such was the situation in the case report presented. On a more formal level, we subscribe to the belief that a chiropractor has a role and precise function (as demonstrated in this case report) in an institutional integrative health care setting. Such a setting would involve a number of co- operating practitioners including chiropractors, naturopaths, acupuncturists and massage therapists, nurses and medical doctors. Garner and colleagues37 demonstrated the successful integration of chiropractic in a multidisciplinary healthcare team at two Community Health Centers in Ottawa, Ontario. Limitations The reader is cautioned on the generalisability of case reports. Lack of a control group, regression to the mean, the results of placebo, and the non-specifc effects of the clinical encounter (i.e., the demand characteristic and subjective validation) are competing explanations to cause and effect. With reference to the natural history, the inability to latch properly affects an infant's ability to breastfeed and maybe a contributing factor to jaundice. As stated, we hypothesised that chiropractic care mitigated the effects of jaundice in some measure. CONCLUSION This report presents the successful chiropractic care of an infant that directly addressed his inability to feed and indirectly, his non-breast feeding jaundice. We support research investigating the role of chiropractic care in similar patients within the milieu of an integrative care approach for infants and children. ACKNOWLEDGMENTS The authors would like to acknowledge and thank Fenisia Giglio (Masters in Education), for critically revising and editing the manuscript. REFERENCES 1. s Kemper KJ, Vohra S, Walls R; Task Force on Complementary and Al- ternative Medicine; Provisional Section on Complementary, Holistic, and Integrative Medicine. American Academy of Pediatrics. The use of complementary and alternative medicine in paediatrics. Pediatrics 2008;122(6):1374-86. 2. Pitetti R, Singh S, Hornak D, Garcia SE, Herr S. Complementary and alternative medicine use in children. Pediatr Emerg Care 2001;17 (3):165– 169. 3. Sawni-Sikand, Schubiner H, Thomas RL. Use of complementary/ alternative therapies among children in primary care pediatrics. Ambul Pediatr 2002;2 (2):99– 103. 4. Loman DG. The use of complementary and alternative health care practices among children. J Pediatr Health Care 2003;17 (2):58– 63. 5. Ottolini MC, Hamburger EK, Loprieato JO, et al. Complementary and alternative medicine use among children in the Washington, DC area. Ambul Pediatr 2001;1 (2):122– 125. 6. Ball SD, Kertesz D, Moyer-Mileur LJ. Dietary supplement use is prevalent among children with a chronic illness. J Am Diet Assoc 2005;105 (1):78– 84. 7. McCann LJ, Newell SJ. Survey of paediatric complementary and alternative medicine use in health and chronic illness. Arch Dis Child 2006;91 (2):173– 17. 8. Armishaw J, Grant CC. Use of complementary treatment by those hos- pitalised with acute illness. Arch Dis Child 1999;81 (2):133– 137). 9. Ohm J. Chiropractors and midwives: a look at the Webster Technique. Midwifery Today Int Midwife 2001 Summer;(58):42. 10. Fuhr AW, Green JR, Colloca CJ, Keller TS: Activator Methods Chi- ropractic Technique. Mosby-Year Book, Inc., 1997. 11. Meeker WC, Haldeman S. Chiropractic: a profession at the cross- roads of mainstream and alternative medicine. Ann Intern Med 2002;136(3):216-27. 12. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008;(12):1-23. 13. McHughes M, Timmermann BN. A review of the use of CAM therapy and the sources of accurate and reliable information. Journal of Man- aged Care Pharmacy 2005;11(8):695–703. 14. Alcantara J, Plaugher G, Lopes MA, Cichy DL. Spinal subluxation. In: Anrig C, Plaugher G, eds. Pediatric Chiropractic: Williams & Wilkins, 1998. JAUNDICE AND CHIROPRACTIC BERNARD · ALCANTARA
CJA June 2012
CJA December 2012