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	ask the experts jeanne ohm

Jeanne Ohm, DC
Family Chiropractor

• Stroller use
• Sleeping with arm under baby's neck
• Shoes
• Baby squished in a carrier
• Joint popping
• 11 month old baby not crawling
• Burning sensation
• Alignment after cesarean birth
• Orthodontic treatment and fainting
• Baby Bjorn
• Infant sleeping on parent's chest
• Natural development approach
• Problems with hearing
• Chiropractic care for ear infections, asthma and colic
• Kangaroo carriers and slings - effects on spine
• "Pigeon-toed"
• Infant sleep positions
• Colic
• Jaundice
• Erb's palsy
• Care of back in lifting and carrying children
• Flattened head
• Chiropractic and ear infections - preventing tubes
• Pregnancy and pubic bone pain
• Natural remedies for long plane ride
• Constipation due to breech (frank) position

I know that slings are preferred, but I was wondering if you could recommend a certain type of stroller for my baby if I were to use one?  I also do not know at what point a baby does not have to lie down flat.  Thanks in advance for your answers.

Yes, baby carriers (not necessarily slings) are best for reasons I have discussed previously on this post. I do understand, however, that there comes a time where occasional stroller use is convenient and sometime less stressful for the parents. In that case it is preferable to wait to when a baby is sitting on their own, for most strollers. At this time, they can be in a stroller that lets them do so. The alternate option, the infant "umbrella" strollers, cater to infants who cannot yet sit up—but they are often used by parents long beyond the age that they should be. In other words, older babies and toddlers having their spines forced into a "c" curve when they are old enough to sit up is counterproductive to their normal spinal development and may lead to postural abnormalities if used inappropriately.

Remember with all modes of carrying our children, diversity is best. Using one type continuously may lead to postural adaptations, affecting nerve system function and therefore any aspect of the child's well-being.

We cosleep with our five month old and I put my arm under her neck/upper back when we sleep because I feel more aware of her being in our bed that way and therefore it seems safer. She appears very comfortable and doesn't complain but is this bad for her spine? Thanks so much!

  Any repetitive positioning can have its effects on the developing spine. Let's first look at the positioning in relation to normal curvature development of you baby's spine. By placing your arm under your baby's upper back and neck, you are in essence molding the spine to adapt to the hard lump of your arm.

There are two postural considerations for you to be aware of. One is for the neck and one is for the upper back.

1. Whereas the cervical (neck) spine will eventually grow to have a curve in it in the same direction that your arm is making a curve now, it is important to note that the neck curve needs to develop on its own with activity from the baby when on its belly, creeping and crawling, not from being "formed" into the curve with posturing by your arm.

2. The upper back's normal curve should develop in the opposite direction than what you arm is pushing it into. Therefore, having your arm under this portion of the baby's spine is actually impairing normal postural development in this area. When one area of the spine is compromised, other postural formations of the spine will be compromised as well.

  With repetitive positioning it is also important to look at duration.  How long does your baby stay in this position? Do you find her moving and squirming away and you reposition her? What are her sleep positions during the day? Is she getting enough belly time? Is she crawling yet? These are questions a family chiropractor would personally address while doing an evaluation of your child.

  One last consideration: the restricted position you are placing yourself in: if it is night after night and all night long it will soon take its toll on your posture as well.

  The importance of postural development of the spine lies in the effect the structure of the spine has on nerve system function. Of course we know that the nerve system controls the development and function of all systems so its healthy function is imperative. This is the essence of chiropractic care—keeping the nerve system functioning for overall well-being.

Our daughter is one now and she is just beginning to walk. We are wondering if her first pair of shoes should be a sturdy hard-soled leather shoe or a natural soft-leather shoe? I had thought natural was better but her grandparents insist the first shoe is very important and should have lots of support. We appreciate any advice on this subject you can offer.

When my children were growing up, I remember those very hard soled, high tops you grandmother is referring to. Although they were the most popular option of that time, we went out of our way to find soft moccasin type shoes for our children. Keeping their feet free to move and breathe as they were created seemed more logical to us.

Since then, it has been found that shoes with stiff ankle support (high-tops) and those made from rigid materials are unnecessary and unhealthy. There is no evidence that they help babies walk.  Experts now agree that the feet, like hands, develop best when they are bare, not covered and confined. Walking barefoot helps build arches and strengthen ankles. Even walking on uneven ground, such as sand and grass, is good for an infants' feet since it makes the muscles work harder and actually strengthens and structurally develops the feet.

In addition to supporting the structural development of the feet by using soft, flexible shoes, there is evidence that the natural motion in the feet with soft or no shoes can positively affect overall neurological function and brain development. Except for the spine, the foot is the anatomical region which contains the most proprioceptive sensory receptors. These are distinctive nerve circuits which affect numerous aspects of brain and neurological development. Because of this magnitude of sensory input, natural, unrestricted movement of the feet is vital for overall neurological well-being.

In conclusion, the feet are designed to have maximum movement and flexibility in that movement.  Selecting shoes that allow for that movement will support the most healthy development of the feet AND of the baby's developing brain and nerve system. For more information, see this article. 

My baby is now six weeks old, and I've been wearing her in two different cloth carriers, a sling and a wrap that holds her either cradle style or upright. But in both of them she seems to be squished with her head pushed down in the sling and her body compressed when she is upright. Is it possible that I simply have her positioned incorrectly? Is this something I should be concerned about?

I am glad to hear you are alternating carriers, as that is usually the best for both you and the baby's posture. Without seeing your baby actually in the carrier it is difficult for me to assess if she is positioned correctly. For the carriers you have, do the manufacturers have a website that you can check to see instructions for proper wearing? Perhaps there is a better way for you to position the carrier and your baby until she is able to hold her head more steadily. Mothering magazine had a comprehensive article on baby wearing (including details and photos on proper positioning) in their Jan/Feb 07 issue. A copy of the article can be ordered on their site.

I live in rural Mexico where people are used to taking unquestioned directives from doctors whom I am not convinced are up to date with information and are not oriented at all to natural living. Since we adopted our now five month old daughter at age one month we have been distressed at how her joints pop and creak. This happens with the most gentle movement. She exhibits no pain and is bright and active. What we know of her early circumstances is that she was probably born before term to a teenage mother in extreme poverty and was not fed adequately. She was underweight when we received her. The only vitamins available here are Tri-vi-sol. I won't give her the iron solution because it is 45% sugar. Doctors here just laugh at me when I insist that I want information, not palliative statements to make me ignore this. We'd appreciate information. Thank you.

My suggestion is to bring your baby to a doctor of chiropractic or osteopathy for a complete exam. Regular pediatricians are not trained in the biomechanics of joints and may not be qualified to do a correct assessment of your baby. You can find a doctor of chiropractic here: http://www.icpa4kids.com/locator/results_list.php?country=Mexico&countrysearch=Go.

My son is 11 months old. He loves to roll and play whilesitting up, but he shows no interest in crawling. He doesn't get up on all fours or pull up to a sitting or standing position. We are doing an early intervention program and physical therapy. I'm just not seeing any results. Should I be worried about his development?

We now know that there are specific developmental movements that develop and strengthen the neural connections throughout the brain and throughout the central nervous system. A very important milestone for the developing child is crawling. In order for the two hemispheres of the brain to work together, the left and right brain hemispheres have to be interconnected. The communication pathway, known as the corpus callosum, is composed of specific bundled of nerve fibers. These nerve fibers are formed through specific movements, crawling being one of them.

Today, infants spend too much time on their backs. The back to sleep program, car carriers and others keep the infant limited to this position. As they get a bit older the modern usage of walkers and other similar types of sitting apparatuses limit the infants belly time. It is essential that we increase our babies' belly time, as this stimulates their ability to pass into the crawling stage at a reasonable time. This is why I also encourage the use of infant body carriers, where the parent is carrying the infant next to their body as opposed to in a hand held carrier. (The body carriers also allow the baby to reach important neurological developmental milestones.)

Many parents tell me that their babies "just do not want to be on their bellies" and they "fuss and cry in that position." I still encourage parents to take the time to put their babies in that position and get down on the floor with them to encourage their acceptance. Combined with baby carrying, the baby can become more comfortable and accepting of this new and vital position.

Sometimes, however they babies still complain. Very often there could be a spinal misalignment in the infant making it uncomfortable to be on their bellies. Spinal misalignments impair normal nerve system function and therefore development. Spinal muscles may be weakened because for the misalignment and making it difficult for an infant to crawl, so they avoid it.

Spinal misalignment may be caused by physical, emotional or chemical stress. I frequently point out how today's "normal birthing process" routinely includes all three of these stresses, and thus an infant's future nerve system may be affected since birth. If left uncorrected, normal nerve system function will be impaired in some way affecting numerous neurological functions.

Your family doctor of chiropractic can examine your infant to determine if a misalignment may be impeding your infant's normal developmental process. Rest assured the specific techniques a qualified doctor of chiropractic uses to adjust infants is very specific and gentle. Many babies sleep right through the adjustment. Our specialty is enhancing nerve system function by reducing any nerve system stress. Additionally, your family chiropractor can suggest exercises and movement activities you can do with your infant to support your child's restoration of neurological integrity. You can find a doctor of chiropractic who works with infants here: www.icpa4kids.org.

For the past five months I have been experiencing a burning sensation that covers my scalp and face. I've had an MRI of my neck and my head, which both came back normal. I'm convinced it is a result of my lifestyle. My children are four years old and 18 months old and I have been nursing and co-sleeping for over four years. Also, I have carried both children on my right hip and am feeling hip pain on that side, back and neck pain in addition to the burning sensation all over my scalp. Is this burning sensation something you've seen before? What are your recommendations for treatment?

Throughout our lives we have been subjected to physical, emotional and chemical stresses that may affect the alignment of our spinal bones which lead to sprain, strain and misalignment of our spinal vertebrae. Over a period of time, this spinal stress will cause postural distortions, muscle weakness, restricted spinal movement and eventually spinal nerve system stress.

While we are pregnant, our body goes through numerous changes and adaptations with our additional weight gain and postural changes. We produce a hormone called relaxin, which is perfect to allow our joints to open for delivery, but may contribute to existing instability in some joints adding to postural distortion and nerve system stress.

After we give birth, the hormone relaxin can remain in our system for up to nine months! As a mother of six, I know I put myself into adapted postures for sleeping, nursing and carrying our children. Combined with spinal misalignment and these compromised (and necessary) postures we can start experiencing the effects in the form of many symptoms.

You comment about your "lifestyle" and I can smile in remembrance: with six children very close in age, I spent 14 years of my life pregnant, nursing or both. Yes, we co-slept, sometimes with the entire family. Our "lifestyle" during those vital years compromised our spinal alignment and therefore affected optimal nerve system function. As both a mother and a doctor of family chiropractic since 1981, I can offer you some suggestions that I have experienced as helpful:

1. Carrying a baby on our hip as a primary mode will cause repetitive postural stress. I suggest using a baby wearing type of carrier—as a matter of fact, not just one type, but several—for postural variety for you and the baby. You can visit this link where I discuss this: http://www.icpa4kids.org/research/children/babywearing.htm
2. Co-sleeping is a natural and wonderful experience for the family. You can reinforce some of the many benefits here: http://www.icpa4kids.org/research/children/bonding.htm In our modern society many parents are choosing to re-adapt these normal and healthy sleeping practices. The problem is that frequently our beds are not big enough to accommodate the entire family and the parents, in an instinctual protective way compromise their sleeping positions for the children's safety and comfort. Ideally, we should have a large mattress on the floor that fits everyone comfortably and safely. This will take us out of the defense mode we may be in all night long preventing ourselves from feeling like we are rolling off the bed or encroaching on the baby's space. This alone will allow us to be more relaxed and comfortable. Switching sides of the bed can help us as the nursing mother from lying on the same side to nurse. Two small adaptations, two solutions to alleviate repetitive stress.
3. Visit your family chiropractor and have your spine checked. The symptoms you describe may very well be the result of nerve system stress and where as your lifestyle is "limited" at this point in time, you are accommodating the needs of your children in a very valuable way. Regular chiropractic adjustments can help your body adapt through this time easing postural stress, muscle strain and improving nerve system function. You can find a family chiropractor on our website here: www.icpa4kids.org

I have heard that even babies should see a chiropractor to ensure they are aligned, especially after birth. My son is seven weeks old and was born via cesarean. I don't know what you advocate in regards to infant chiropractic care or if you recommend it at all. Please advise.

I have been seeing infants in my practice for 23 years and all six of our children (even though they had natural home births) were checked immediately after birth.

This is because as a doctor of chiropractic who reads the literature on birth and has also witnessed numerous births, I can say that the birth process even under normal, natural circumstances can be traumatic to the infant's spine and cranium. This trauma may adversely affect the infant's nerve system function and therefore affect the infant's future health potential.

Most hospital births include unnecessary trauma. The routine procedures of medicalized birth (anesthesia, maternal positions, a fearful environment) all contribute to increases in complications and often result in invasive, traumatic births. As we are seeing in the US, the startling rise in c-section deliveries is a good indication that these routine procedures are not leading to safer more natural births but rather to the practice of more invasive, unnatural procedures.

A c-section delivery has as much if not more trauma than a vaginal birth. The pull force on the baby's head and neck during the c-section may be considerably greater than a regular vaginal birth because the uterine muscles of the mother are not assisting the delivery process. Most moms who have had a c-section describe a pulling and tugging sensation as the baby was being taken out of the belly. This pulling (which sometimes even lifts the mother from the table) is the amount of force that is pulling on the baby's fragile spine.

It is my suggestion for you as a mother to check out this website: www.icpa4kids.org to find a Doctor of Chiropractic in your area who cares for infants. Also, for future pregnancies, you may want to get under chiropractic care as well - it will help restore normal biomechanical function to your pelvis and facilitate a safer, easier birth in the future.

Finally, please check out the International Cesarean Awareness Network for guidance and support.

My 9 year old son is healthy and unvaccinated. We began orthodontic treatment 8 months ago because both parents have a narrow jaw and had 4 teeth removed to compensate for crowding. Our son now has upper and lower "spreaders" to force the palate and jaw to widen. During the first 3 months of treatment he fainted 3 times, the first time within days after starting treatment. Our D.O. said it was due to the changing pressures and alteration of cranial structures and gave him cranial osteopathic treatments. It's been 5 months since he last fainted. Now we have been moved to Germany and need to figure out what kind of supportive services he should get. Should we find a pediatric chiropractor? I'm having problems finding a qualified D.O. here. Thanks for any advice.

I would tend to agree with your Osteopath that the shifting of the cranial bones created "changing pressures and alterations of cranialstructures." My suggestion is to find a Doctor of Chiropractic in Germany who works with children (www.icpa4kids.org) and utilize his or her service (which may include cranial work). If the Doctor of Chiropractic does not do cranial work, they may know of a cranial practitioner who can work with your child as well.

My almost 6 month old son loves his Baby Bjorn. I carry him front facing and have used it since he was a few months old for about an hour a day. It is the most comfortable baby carrier for my own back, but I read recently that this position can cause his vertebrae to not align properly. Do you think having him in this carrier could be harmful?

Please read where I addressed the issue of carriers in this question.

The emphasis I have with all carriers is that they all are wonderful, yet all have potential postural considerations for both the mother and baby if used exclusively. My suggestion is to use a variety of carriers. This diversity offers the best biomechanics and reduces any potential for undue stress to one area. Please read Baby Wearing: Suggestions For Carrying Your Baby as well, as I discuss this in length along with many choices for carriers.

In conclusion, varying carrying positions and carriers for our babies and ourselves is optimal for both of our spinal and nerve system health.

We co-sleep with our infant. He is currently 3 months old and has slept on my chest since birth. Because he is sleeping on his stomach, I am wondering if this could cause any problems with his hips.

In regards to biomechanics of the spine, different positions are best for postural and neurological development. For example, babies who are constantly sleeping on their backs and in infant car seats are putting continued stress on the back of their heads causing a flattening to their skulls. Babies who continuously sleep on their stomachs with their legs spread may be overstressing their hip joints if they are flexed outward. Additionally, when people sleep on their stomachs (babies and adults) we see that their upper cervical spines are also regularly stressed because they have to turn their heads one way or the other to be on their bellies. In practice, we notice that "belly sleepers" (no matter what age) have a higher incidence of stress to their upper necks.

Additionally, it is important to note that the American Academy of Pediatrics has recorded that babies who sleep on their stomachs have a higher incidence of SIDS. The initiation of the "Back to Sleep Program" has reduced the incidence of SIDS significantly. Although they cannot seem to clarify why putting an infant on their back would reduce the incidence of SIDS, doctors of chiropractic realize that the stress to the upper neck in the belly position may be causing "noxious stimulation" to the spinal cord at the upper neck level and therefore affect breathing functions.

Our six children co-slept with us and because of our knowledge of spinal biomechanics, we laid them on their backs or sides next to us. We gave them plenty of belly time when they were awake to encourage additional neurological and postural development. As doctors of chiropractic, my husband and I recognized the importance of diversity in posture for optimal spinal development. In conclusion, varying positions for our babies is optimal for their spinal and nerve system health.

You may want to read a previous Mothering question I answered similar to this question here:
Infant sleep positions

These references may help you to understand some of the potential biomechanical causes of SIDS:

October is SIDS Awareness Month: Chiropractic Research May Present Preventative Treatment Options
Birth Trauma: A Modern Epidemic

and this article:
SIDS, Wives Tales, Ignorance, Prejudices & Slander

We are using a natural development approach with our 5 month old son. We are not sitting him up or allowing him to stand while we hold him until he gets to those milestones on his own. We were wondering if there were benefits for his spine and muscles from using the natural development approach?

I am supportive of lifestyles and approaches that encourage natural development for children. Having children stand and hang on parents hands before they are naturally pulling themselves up, can cause adverse effects on their child's spinal and pelvic alignment. We have seen this problem in children who use jolly jumpers and walkers. Undue stress to their musculoskeletal system before it is ready to support their body weight may lead to weakness and joint stress.

If you want to encourage natural muscle strength and development, prior to his or her natural standing you can perform some very simple and fun "exercises" with your baby. Giving your baby sufficient belly time helps to develop strong neck and upper back muscles. Lying your baby on his or her back and placing the soles of his/her feet on to your resisting palms encouraging a bicycle type motion is great motion for leg and lower back muscles without strain. Encouraging and playing crawling activities will strengthen his or her lower spine and also provide very important neurological development.

My 6 year old son is having problems with hearing which may be leading to behavioral problems. The ENT doctor has recommended myringotomy with tubes and an adenoidectomy. Are there any other options - herbs, homeopathy - that we could try?

There are numerous reasons why your child may have hearing problems and although you did not specify the diagnosis, it appears that these problems may be due to fluid build up and perhaps repeated ear infections.

That being the case, it is important to note that the standard from of treatment in this country is antibiotics. I encourage you to visit this link http://www.icpa4kids.org/research/children/earinfections.htm and explore the medical literature about the use of antibiotics for ear infections and that their repeated use actually lead to repeated ear infections. Further more, you will see that antibiotics for fluid build up is ineffective, although frequently prescribed.

As for ear surgery, here is a recent study concluding that ear surgery does not necessarily improve hearing outcome:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db= pubmed&dop t=Abstract&list_uids=15231974

Now I realize your child is older, and you are faced with this question. I always encourage parents to get a second and third medical opinion
before they follow recommendations for surgery. On this link you can read in the medical literature that the risks of ear surgery may outweigh the
benefits.

That aside, I will now offer you a link showing that children who had spinal subluxations which were corrected by Doctors of Chiropractic also
experienced relief of their symptoms of chronic ear infections/ fluid in their ears:http://www.icpa4kids.org/research/chiropractic/ear.htm

It is important to realize that chiropractic is not the treatment of ear infections or fluid build up, it restores normal function and allows the body to work more efficiently. Chiropractic for children is safe and gentle and it certainly makes sense to allow your child's body the option of maximum function before you treat a condition that may self resolve when normal function is established. You may look for a Doctor of Chiropractic in your area here: http://www.icpa4kids.org/find.htm

Will chiropractic care cure ear infections, asthma, or colic?

It's most important to understand that chiropractic is not a treatment for disease. It's purpose is to reduce spinal nerve stress, a serious and often painless condition most children (and adults) have in their bodies. Spinal nerve stress interferes with the proper functioning of the nervous system, can weaken internal organs and organ systems, lower resistance, reduce healing potential and set the stage for sickness and disorders of all kinds.

When a chiropractor frees the nervous system from spinal stress, the healing power of the body is unleashed: the immune system functions more efficiently, resistance to disease increases, and your child's body functions more efficiently. Your child can respond to internal and external environmental stresses such as germs, changes in temperature, humidity, toxins, pollen and all the other stresses he/she comes in contact with more efficiently.

So although children with diseases are often brought to the chiropractor, the chiropractor is not treating their diseases but is instead freeing them of spinal nerve stress, thus permitting their body's natural healing potential to function at its best.

What do you think about kangaroo carriers or slings? Do they have any effects on babies' spines?

The key with any positioning for the baby and its ramifications on the spine is moderation and diversity.

As for carriers, there are many types which place the baby in various positions. There is discussion that the ones which "spread the hips apart" are not recommended to keep the child in for long periods of time. We see with the back to sleep program initiated several years ago, babies craniums are becoming mishapen from frequently being on their backs. Babies bones are very soft and affected by the repetitive positions we put them in.

Chiropractors work with the spine to reduce interference to the nervous system, the key system to function and health in your baby. I will therefore discuss this question from a neurological point of view as well:

As for slings, for optimal neurological development, it may be advisable to alternate the side of the mother that the sling is on. This would enhance neurological development as does the nursing baby who turns his/her head from side to side with each nursing.

I do caution the overuse of those carriers which convert to car seat/ stroller. etc. They add to the "on the back time" and do not offer nearly as good neurological development opportunities as does a sling or carrier. A baby needs to be close to the mother's head and body to observe gestures, voice and security.

Another aspect of the carriers is that they also create undue stress on the mother's spine as she awkwardly tries to balance her weight when carrying them. This will then affect her nervous system function and her overall health.

With any carriers or sleeping positions we adopt, it is important to remember that diversity is best. Belly time on the floor for the baby is as important during waking time as on the back time during sleeping. Diversity with carriers offers the baby the best in neurological development without undue stress to the baby or mother's spine.

Should I be concerned that my otherwise very healthy and strong 6 year old daughter has suddenly started to walk "pigeon-toed" ? She is very tall for her age, and has always been whoppingly over the the percentile categories for height and weight {proportionaly}. We wonder if she is just growing really fast,and this possibly something that she will "grow out of", or if we need to have her checked out.

When a child starts to walk "pigeon toed" there may be reason to believe that her pelvis is out of alignment causing her feet to compensate when she walks.

Very often we are told that our children will "outgrow" symptoms. This approach does not really address the cause of the problem, but rather focuses on symptoms only as an indicator. Very often we see symptoms that children have "go away" when in reality, the body has compensated, changing symptoms. this does not mean that the cause has been addressed, or the reason for the symptom corrected.

Doctors of Chiropractic approach health from a perspective of getting to the cause, not merely removing symptoms.

A child whose pelvis is out of alignment causing adaptations in her gait could lead to further misalignment of her spine. Misalignments in our spine create stress to our nervous systems which in turn can affect any or all of our bodies functions.

Listen to what her body is telling you and have an evaluation by a Doctor of Chiropractic who works with children.

What is your recommendation about infant sleep position? We have a two month old (our third) who is having a really hard time staying asleep on her back. She seems to be happier on her tummy and seems to have no trouble lifting and turning her head when face down. I know about the medical establishment's recommendation about back sleeping to reduce the risk of SIDS but wondered if there was more to the story?

When our six children were young, it was still the recommendation to put children on their bellies to sleep. Being Doctors of Chiropractic, my husband and I chose not to. Basically, what we saw in our practice was that our patients who were stomach sleepers had chronic neck problems and even when they began chiropractic care, they did not hold their adjustments well. Biomechanically, it did not seem right to put our children on their stomachs either. We chose to have them sleep with us, primarily on their sides.

It is true that the AAP now recommends that children sleep on their backs to reduce the incidence of SIDS. Since the "back to sleep" program was initiated, the incidence of SIDS has gone down. What concerns me most is that the investigation stops there. There is no real investigation as to why putting children on their backs reduces the incidence of SIDS.

Again, from a biomechanical point of view, when a baby is placed on its belly for sleep and the head is in constant rotation to one side or the other, there is continuous irritation to the cervical spine--the area where the respiratory centers are. This irritation may affect that area of the spinal cord and therefore affect proper breathing function.

Finally, if you look at the amount of pulling and rotation done by the operator in most births (even those births which are considered "natural"), there is good evidence to believe that this pulling has caused irritation and even injury to the cervical spine. Couple that with putting the baby on its stomach, head rotated to one side or the other and you have further irritation to a possibly already injured area. From a biomechanical point of view, this spells SIDS.

I would suggest that you give serious recall as to how "gentle" your child's birth was, research the safe options and advice about cosleeping and make a choice that is right for your baby. Additionally, you may want your baby to be checked by a Doctor of Chiropractic who works with children so you can help reduce any spinal nerve stress that may have occurred during birth.

My 2 month old son has had "colic" (fussiness, gassy, on again, off again nursing) since he was about 1 week old. I have eliminated major allergens and other foods from my diet hoping that that would help, but to no avail. And now, for the past 3 weeks, he has been constipated. I have had cranial sacral therapy recommended to me. I am interested in what you think of that, and also if you have any other suggestions.

In our office (where I have seen quite a few infants) I have found the symptoms of colic to be related to spinal nerve stress. It is usually related to "torsion of the dura" the covering that protects the brain and spinal cord. Very gentle release moves and specific spinal adjustments (also very gentle) are usually effective in getting to the cause of the spinal nerve stress.

It is great that you are seeing a cranial sacral practitioner, however I would suggest a chiropractic exam as well. Perhaps you can find a Doctor of Chiropractic who does both. Many DCs who work with infants incorporate cranial work into their protocol.

My 10 week old still has signs of jaundice. My pediatrician had her levels tested and she was only at a 5. I know this is no reason to worry. The Dr. told me that it is probably breast milk jaundice and very rare but nothing to worry about. I guess my concern is why it is not going away. She is growing well, eating well, and seems extremely healthy. What would be the cause of this lingering jaundice, and other than breastfeeding and placing her in the sun, is there anything I can do to help it go away. Should I be concerned and look deeper?

"Breast-feeding jaundice" commonly occurs 2 to 4 days after birth. It develops in breast-fed babies who are not getting an adequate amount of breast milk or are not feeding often enough.

To prevent breast-feeding jaundice, the American Academy of Pediatrics recommends that mothers breast-feed at least 8 to 10 times every 24 hours. A baby is less likely to develop breast-feeding jaundice when fed frequently. Frequent feedings increase the amount of breast milk produced and ensure that the baby gets enough breast milk to get rid of the extra bilirubin. Supplementing breast milk with water or sugar water does not help lower the bilirubin levels in these babies.

Parents should report any symptoms of increasing bilirubin, including yellow skin and eyes becoming more pronounced and any changes in their babies' behavior, to their health professional. Breast-feeding jaundice should not be confused with breast milk jaundice, a less common condition. Breast milk jaundice is considered to be a common prolonging of the physiologic jaundice in newborns." - Web MD

It is always my suggeastion for parents (who have concerns or doubts about their practitioners advice) to obtain second and third opinions. Visit another pediatrician in your area for a second opinion.

As for the chiropractic relationship--chiropractic is not the tearment of a symptom or disorder--it is a gentle approach to reduce any nerve system stress that may be interfering with normal body function. Perhaps due to how your baby was in utero or how traumatic her birth was, there may be misalignment in her spinal or cranial bones that are interfering with her body's ability to functoion at its maximum potential. HAving your child's spine checked by a Doctor of Chiropractic who works with infants is always a good idea after birth.

My daughter was born with Erb's palsy, apparently a stretched nerve in her shoulder. She has recovered all functioning, but in an x-ray her bones don't line up at the shoulder joint. Her doctors are saying that she might need surgery at age 5 (she's 3 1/2 now). Could chiropractic do anything for her?

90% of the cases of Erb's Palsy are caused by birth trauma and birth trauma is a chiropractic issue. As the child is pulled from the mother during a difficult delivery stretching of the brachial pexus to the point of causing Erb's Palsy more than likely caused injury to the spinal cord as well. This is the area that the Doctor of Chiropractic works with--realigning spianl and cranial bones to reduce nerve stress from the spinal cord. The chiropractic adjustment and cranial work works to reduce any interference or residual stress to the nervous system and therefore maximize your child's overall function for health and well-being. Putting the issue of shoulder joint dysfunction aside, your child deserves to have his or her spine checked by a Doctor of Chiropractic to determine if there is additional spinal nerve stress as well.

As for the "bones not lining up at the shoulder joint" it is very hard for me to offer an evalustion without seeing the x-ray and personally taking your child's case history. Spinal x-rays and any compensations to the spine discovered in the xrays would reveal additional information to help me decide. As with all medical opinion, especially those leaning towards surgery, I would get several opinions.

Finally, having your child's spine checked and potentially worked on by a Doctor of Chiropractic who is accustomed to working with chidlrren and these types of injuries could only increase your child's ability to heal and function better. It seems you ahve a a good enough time period to have an evaluation and get some significant work done with your child that may very well change the Doctor's current prognosis.

I am trying to provide parents of young children with some suggestions of how to take care of their own backs given the physical stresses of caring for young ones. What would you recommend as basic strategies to help parents, especially in relation to all the carrying, lifting, and transferring of young children?

The carrying of young children can surely take its toll on parents. Some practical advice is to use our legs to lift with as opposed to bending over with our backs. It is important to bring our bodies to the level of the child before we lift do any lifting. Many injuries to the spine occur from stooping forward. Another critical factor to avid injury in lifting is to face the child/ car seat/ whatever straight on. Any twist or rotation in our spine while trying to lift increases our susceptibility for injury significantly.

Beyond lifting is the seemingly relentless (yet vital) need of the child to be carried. Although sometimes almost exhausting for the parent, I am a strong advocate of continued carrying of our children. (http://www.naturalchild.com/guest/laura_simeon.html)

Carrying our infants can be honored with the potential of minimal stress to the parents. The main advice here is to vary the positions we carry our infants in. Continuously propping a child on one hip will stress the parent's spine. Although it usually seems easier for the parent to carry on one side or the other-it is best to alternate sides and positions frequently.

There are numerous carriers designed to make life easier for us as parents and they all have their effects on both the parent's and the infant's spine.

Truly the most commons is the "car seat". This is being used more and more by parents as a carrier outside of the car. When the parent tries to walk carrying the baby in one of these, their whole spine becomes distorted. and the potential for injury is increased... Mothers who have just given birth and have relatively unstable joints in their pelvis from the birth process by are at even greater risk for injury. Additionally, the back to sleep program for infants has them spending far too much time on their backs and the car seat is just more time spent this way as well.

It is the author's recommendation that parents look at the pros and cons of each carrier and choose a few, rather than one select carrier for their children. Incorporating various carrying styles for the babies and alternating the stress load to the mother's spine are ideal ways to utilize these carriers to everyone's advantage. There are numerous carriers designed to hold the baby in various positions. Variety seems to offer both the mother and baby the greatest advantage in postural adaptations and therefore decreases the potential for injury. Front carriers, slings, wraps, back carriers all have their benefits and distribute the baby's weight differently for the parent. They also put the baby's spine in various positions as well. Prolonged, constant positions for the baby can cause cranial and spinal distortions. It is therefore my frequent advice to parents to have a variety of carriers to use for their babies and to share the carrying between them.

This particular website offers a comprehensive look at carriers and the various positions they put the child's spine in: http://www.beginnings.org/shop/007kiesdejuistedrager.htm

Finally, as a Doctor of Chiropractic I recommend parents and infants have their spines check on a regular basis. The stress of birth has its effects on mother, child (and father!) The continued normal repetitive stresses breastfeeding and carrying our children gives us further reasons why we should be concerned about our spine's alignment. Infants have their share of additional spinal stress in various carriers, frequent falls as well. Injury to the spine (however minor it may seem) can lead to spinal nerve stress affecting many functions of the body.

My 2 and 1/2 month old is starting to show signs of a flattend head on his left side. He prefers to sleep with his head angled a little to the left. Is this dangerous and what can I do to prevent any further flattening?

We are seeing this more and more in our practices because of the "Back to Sleep Program." This campaign launched in the 90's when it was discovered that putting a child to sleep on his/her back significantly decreased the chance of SIDS. Rather than putting babies on their stomachs (which has its own set of postural adaptations) parents are now advised to place their infants flat on their back for sleep time. Although I agree that a child on his/her back has a significantly less chance for SIDS, it is important for parents to offer the child alternate positions for both sleeping and when they are awake.

The reason why placing an infant on his/her stomach potentially increases the incidence of SIDS is because the stress/ pressure on the rotated/ turned neck when sleeping on their stomach is at the respiratory centers of the brain. Most births today include some sort of pulling to get the baby out, and this trauma to the baby's spine may lead to injury in this same area. Sleeping on the stomach may add further irritation to an already injured spine.

To respect this theory of injury, reduce the chances of SIDS and at the same time avoid too much time on the back, I suggest alternating a baby from side to side while sleeping (especially easy if co-sleeping). Too often babies are either lying asleep on their back or put in the carry type car seats for many hours during the day whether they are sleeping or awake. This is a good reason why parents should use body carriers as opposed to carting around the car seats as a carrier. I suggest using a variety of carriers to alternate positions of the baby.

It is also important to remember that when the baby is awake, it is best to allow the baby substantial "belly" time. Baby's need to be placed on their bellies when they are awake as opposed to being left in strollers and car seats. This will help reduce the amount of pressure on the back of their heads and teach them to lift their heads up strengthening their neck muscles.

The reason why your baby has a "flattened side" on one side is because he has a lateral deviation in his spine to that side to begin with. This would cause an undue amount of pressure while he is on his back on that particular side. We see this frequently in our office and our evaluations reveal that there is torsion to the baby's spinal cord. Torsion can be caused during a baby's development in utero where they stayed in one position for a long period of time. Another cause of torsion to an infant's spine is by the birth process where there was pulling and or rotation applied to the baby's neck when the baby was coming out. Doctors of Chiropractic who work with infants are qualified to recognize this distortion and have specific techniques to correct the cause of it. This torsion in the spine may lead to further health issues beyond a flattened back of the head. This undue stress to the baby's nervous system may affect any function of the baby. We have seen infants with this type of torsion have symptoms such as colic, restless sleeping, feeding difficulties, digestive problems, ear infections, and respiratory symptoms, etc. Only by reducing spinal nerve stress with the chiropractic adjustment can you get to the cause of his cranial distortion and offer greater potential for better overall function.

How can a chiropractor help a baby with ear infections to prevent having tubes put in?

It is important to realize that chiropractic is not the treatment of a condition, but the reduction of interference/ stress to the nerve system to enhance natural function. Doctors of Chiropractic evaluate areas of the spine and cranium which may be misaligned and putting pressure on to the nerve system. (The modern birth process is a primary cause of misalignment to the infant's spine and cranium.) This pressure affects nerve system function and therefore the function of all systems in the body. In 20 years of practice we have seen many children who once suffered from ear infections become symptom free with regular chiropractic care.

As parents it is important to make informed health care choices for our children. When a procedure is recommended for our children we can search the literature to discover the safety and efficacy of that procedure. At this link you can view excerpts from some medical studies that review tubal surgery: http://www.icpa4kids.org/research/children/earsurgery.htm

Additionally, this link will show you cases where children's symptoms of ear infections improved under chiropractic care: http://www.icpa4kids.org/research/chiropractic/ear.htm

Finally, this link explains in better detail about the relationship between chiropractic and body function. http://www.icpa4kids.com/children_chiropractic_function.htm< /p>

I am five months pregnant and have started feeling an aching pain in my pubic bone. It is worse while walking and standing on one leg, like when I am dressing. Could I be doing something to be stressing the joint? Would a chiropractic adjustment be something to consider for this type of discomfort?

I highly recommend that women have their spine and pelvis checked by a Doctor of Chiropractic in pregnancy. As the baby grows and the mother's pelvis compensates for that growth, any existing misalignment becomes further exacerbated. This causes mothers the frequent pain and discomfort felt in the pelvis (including the public bone area) and lower spine during pregnancy. We have had numerous patients experience relief from sacral pain, low back discomfort and pubic symphysis dysfunction. Also, creating a state of balance in the pelvis allows for a safer easier delivery for both the mother and child.

There is a great article written about pubic symphysis on this website as well: www.plus-size-pregnancy.org/pubicpain.htm#Tips%20for%20Coping%20with% 20Pubic%20Symphysis%20Pain

What kind of natural remedies can I use to help my 11 month old remain calm on a long plane ride?

I fly frequently and often hear upset infants on the plane. From the type of cry they have it is more discomfort than just restlessness. What it seems to me, is that their cries of discomfort rise from ear pain from the pressure changes in the cabin. It is a good idea to make sure your child's spine and cranium is in alignment prior to a flight to avoid any potentially greater pressure caused by their misalignment. Your Doctor of Chiropractic can check your infant's spine and cranium prior to a long trip and perhaps even teach you a technique called the "ear pull" which you could do on the flight to help drain clogged Eustachian tubes. Nursing an infant with excessive ear pressure may also help relieve the sensations of discomfort.

There are many reasons why a child gets restless on a long plane ride. You did not specify the length of time. I know for myself anything past 5 hours and I am squirming in my seat. Boredom and the opposition to be buckled in are two very natural causes of restlessness. While waiting in the terminal to go on to the plane, I have seen many mothers insist their children stay in their strollers. Rather than confining them for their last free minutes, I would suggest that parents let their children move freely about as they wait--there is too much constraint time in the near future. Letting a child work out their energies prior to the flight may be a bit tiring for the parent, but will be worth its weight in gold when the child takes a long nap on the flight.

For on the plane itself, mothers can prepare by having lots of snack foods and drinks for entertainment. Stay away from sugary snacks that would be boosting the restless energies. Preparing drinks made from sleepytime tea, chamomile teas are soothing alternatives to sweet fruit juices that are calming and soothing. Even natural sugars from fruits will cause bursts of energy.

When you are free to move about the cabin, let your child stretch his or her legs by taking multiple trips up and down the aisle. A change of scenery, looking at smiling faces of passengers, interaction may all help to entertain a child's exuberant need to be in motion physically and emotionally.

Our daughter, now 25 months old, suffers from constipation. For the past 6 months or so, we've been able to keep her more or less regular through a combination of homeopathic remedies and regular doses of lactulose. We are wondering now if the problem mightn't be related to the fact that she was determinedly breech (frank) and spent the last 12 weeks of pregnancy in that position, on the left side of her butt. She always favors the left side to sit on. In the past few months, she has begun to poo in the following position: sitting on the left side (again) of her butt, leaning back, propped on her left arm, sometimes holding her right foot in the air with her right hand (for counterbalance). Holding this position requires real abdominal strength (and work), and neither my husband nor I can imagine how someone could, as she seems to be able to do, move their bowels at the same time: the two muscular actions seem to be completely at odds. We have been told her lower back muscles are very tight, and we suspect her abdominal muscles are both strong and similarly tight. We've tried to get her to stand or squat, but she won't have anything to do with it (we don't know how we will ever get her onto a potty). Do you have any thoughts about this, or have you ever come across a child, particularly a breech baby, with a similar (to us inefficient) way of trying to poo? And do you have any suggestions, in the way of chiropractic/osteopathic/physiotherapeutic work which might help her, if in fact this is contributing to her problem?

Being in the breech position in utero is usually because there was torsion in the mother's uterus throughout pregnancy, creating a state called intrauterine constraint and prohibiting the infant from turning to the head down position for birth.

Intrauterine constraint restricts their movement and also the development of their skeletal structures. Imagine falling asleep with your head propped up to the side. When you wake up the next morning, your neck muscles are sore and stiff and your range of motion is limited. Imagine spending several months in that restricted position as your bones are developing. The bones will eventually form to the position they are forced into.

If she was on her left butt for 12 weeks, her whole spine became twisted to compensate that imbalanced posture. Try sitting on one butt and feel how it sends your whole spine off balance.

The spine houses the nerve system and if it is out of alignment, that will create stress on the nerve system. The muscles in her low back are tight compensating from this misalignment as well.

Her inability or difficulty moving her bowels may be multifactorial. Stress to her nerve system may be causing poor eliminating function. Her postural adaptations may have her organs positions compromised as well.

I would highly recommend that you find a Doctor of Chiropractic who works with children and does craniao sacral care as well.