ADJUSTING INFANTS
The recoil is used in adjusting a child the same as in adjusting an
adult. The young infant can be placed upon the knees of the mother
or nurse instead of being placed on an adjusting table. The ordinary
adjusting table will be too large for the real small infant. Care
must be used that the child is placed in the correct position for the
adjustment and that the neck and head are properly supported. Placing
the child on a pillow on the lap of an adult is not satisfactory
because the pillow is too soft and makes it more difficult to move
the vertebrae. If the child is adjusted on the mother’s lap care must
be exercised that the mother’s skirt is not drawn tightly for it is
best to leave the infant’s abdomen unsupported or at least not to
have too solid a support.
When the mother holds the babe on her lap there is a tendency for her
to raise her heel off the floor so as to make the knee supporting
the child’s head higher than the other. When the adjustment is given
the knee will not be sufficiently solid to support the child and the
vertebra will not move. For this reason the chiropractor must see
that the mother’s heels are both placed squarely on the floor. It is
a good plan after the contact has been taken and the chiropractor is
ready to give the adjustment to ask if both heels are on the floor.
Nine times out of ten one heel will be lifted and the toe will be
supporting the weight of the child.
In adjusting small infants in the dorsal and lumbar regions the side
of the thumb may be used for nail point. In getting the contact one
should palpate in the usual manner, find the vertebra that is to be
adjusted, remove all fingers except the pointer finger, turn the hand
so the finger is parallel with the child’s spine, then instead of
placing the pisiform bone of the nail hand, place the side of the
thumb in exactly the same manner as if it was nail point one. This
being done, remove the pointer finger. Then instead of placing the
hammer hand on the nail hand as in using the pisiform bone for nail
point, grasp the thumb that is being used for nail point between the
thumb and finger of the hammer hand and press the tissues tightly
to make the side of the nail thumb firm. The thrust is given with a
recoil just the same as in the usual manner.
It is best not to use too much force until it is determined just
the amount required to move the vertebra. One will be surprised,
however, at the amount of force required to move the vertebrae of a
very small infant. It should be remembered that the vertebrae must
move if we expect to get results. It must also be remembered that
the child is small and that it is necessary to adapt the amount of
force used to the size of the patient. It is not possible to injure a
child with a chiropractic adjustment, but it is possible to apply an
awkward force, supposed to be a corrective force, in such a way that
subluxations may be produced.
This method will be used only with the smallest infants. When the
child is a few months old the pisiform bone may be used in exactly
the same manner as with the adult. The only difference is that the
amount of force will be suited to the size of the patient. In case
a straight posterior subluxation and a double transverse adjustment
is given on a single vertebra the adjuster may use his two fingers,
the first and second, to get contact on the transverse processes. The
nail hand is then placed across the two fingers and the adjustment is
given with the recoil. It will require very little force to move a
vertebra of an infant on the transverse processes.
Care must be exercised that the neck is properly supported when an
adjustment in the cervical region is given. It is best to place the
child on an infant’s adjusting table whenever possible. When this
is impracticable the child may be placed on the lap of an adult the
same as for an adjustment in the other regions of the spine. If the
head is allowed to remain unsupported as is so often the case when
larger babies are adjusted in this manner, there is danger of moving
something that should not be moved when the adjustment is made.
Therefore that part of the neck directly beneath the vertebra to
be adjusted must be placed solidly on the mother’s knee. The same
technique is used with older patients in that the face is turned in
the direction of the laterality of the subluxation to be adjusted.
With the small infant it may be difficult or even impossible to
get nail point two in position to adjust, especially in the middle
cervical region. In this event the side of the first finger may be
used to an advantage. This will be used, however, only with the
smallest infants. In using nail point two it will be an advantage
to get the contact near the distal end of the fifth metacarpal bone
instead of at the center as in using nail point two on an adult. In
adjusting the atlas and axis it is very easy to get the contact with
nail point two in the usual manner.
The cervical vertebrae of the infant are very small and extreme care
must be exercised in adjusting. Sufficient force must be used to move
the vertebra.
The importance of proper attention to adjusting the segments of the
sacrum of the infant and small child can not be overestimated. During
childhood the child is subject to many falls and jars which are
likely to be centered upon the sacrum. These segments being separated
by cartilage are relatively easily subluxated. If they become
subluxated in youth incoördinations may develop, which in later life
will result in various degrees of discomfort or even defects which
will become permanent and for which nothing can be done. There are
many conditions in adult life which are without doubt the result of
pressure upon sacral nerve and this pressure can not be released
because of the inability to move the subluxated segments after they
become coalesced.
Many deformities and incoördinations in these zones could be averted
by proper attention to the segments of the sacrum during childhood.
When parents realize the importance of this they will take their
children to their chiropractor periodically to have the sacrum as
well as the rest of the spinal column palpated. Then the subluxations
that have been produced will be taken care of before they become
chronic and more difficult to correct.
A careful palpation of the segments of the sacrum should be made. The
most common subluxation is a rotation resulting in that segment being
more prominent on one side than on the other. When a segment is found
to be posterior on one side the adjuster should stand on the opposite
side and palpate in the usual manner finding the tubercle of the
segment subluxated, measuring to a point midway between the tubercle
and the ilium with the second finger of the palpating hand. This
finger should then be replaced with the second finger of the opposite
hand and the pisiform bone of the palpating hand should be used for
nail point. If the patient is a very small infant do not change nail
hands but use the thumb of the usual nail hand and adjust the same as
adjusting a dorsal or lumbar vertebra when using the thumb for nail
point.