June 2005

A child's first check‑up

by Dr. Ogi Ressel

Well, you've made it this far. You've made a mother realize the importance of a chiropractic check‑up for her child. Congratulations. Quite a feat! And I say this in all seriousness. Why? Listen up. When was the last time dad took the kids for a haircut, to the optometrist, the dentist, for new shoes, etc? Moms are the ones who make most of the health care decisions in the family.

Okay, now what?

The child is in your office with a very nervous mother. Her maternal instinct is in high gear, although on the surface she's really cool about it. Don't get me wrong, she thinks you're terrific, but don't forget for one second that this is her child you are about to see.

So, there are the usual initial forms to be filled out. You can't get away from these. When completing your intake forms, a mother should have the realization that you are well equipped to see children, that this is not new for you. This means that your clinical forms should speak of your expertise. They should ask about her pregnancy, labor, delivery, medical/chemical intervention, ultrasound, epidurals, forceps, C‑section, etc. These questions are very important for a DC. Many such procedures tend to lead to Traumatic Birth Syndrome (TBS), which often cause vertebral subluxations and will produce many negative health consequences for the child. It's your job to make a mom aware of this.

She should also be aware of in‑uterine constraint, a situation where a baby is trapped in a certain position in the uterus and is unable to free itself. This generally happens in the last trimester of pregnancy and is also the cause of subluxations. For instance, if the baby is in a transverse lie ‑‑ a horizontal position across the uterus ‑‑ it may be born with a c‑curve scoliotic configuration. This may necessitate a fairly rigorous schedule of care in order to reverse the neural patterning the baby has learned.

It's important that your forms also ask about the child's APGAR score, a numerical value assigned immediately after birth and at five minutes. The optimal score should be 10. Anything less usually indicates a degree of birth trauma, which is not a good thing. Since most mothers won't remember their baby's exact score, you may need to have the birth records faxed to you from the hospital/birth center.

It's also important to ask mom about the baby's' feeding habits (bottle‑fed vs. breast‑fed) and explain the benefits of breast‑feeding. La Leche League will help you with this. My favorite is to tell moms that breast‑fed babies are actually more intelligent. Works every time!

Pay attention to any difficulty a mother may have breast‑feeding, for instance the baby being fussy feeding on one side. This is a huge clue. It means that the baby is uncomfortable turning the head to one side, generally a side effect of a difficult delivery. This is very important as it indicates presence of subluxation.

These are some of the things that you want to chat with the mom about, even when the child isn't an infant. This is because the majority of health problems seen in adults have their origins in childhood (see last month's column, "Schedules of care for children," p.26).

I really enjoy this aspect of a child's visit. The emphasis isn't on symptoms but rather how his or her body is functioning. Remember, you're teaching your patients. Mom should be aware that this is NOT yet another medical examination. No, this is different. So, don't use techno babble moms can't understand.

Depending on the age of the child, you may want to approach your young munchkin from the perspective of playtime. You'll definitely be labelled as "uncool," however, if the child's more than 7 years of age (not a great way to make new friends!). It's best always to approach children with dignity, respect, warmth, and as their equal.

Have fun with kids. They're rarely as cerebrally constipated as adults. I usually ask a young five‑to‑seven year‑old girl, for example, how many boyfriends she has. You'll be amazed at the answers you get. And, this tends to lead to some discussion between the mom and her child, so you can sit back and enjoy the banter!

Make sure that mom and child understand what you mean by "subluxation." Illustrate by using the spinal model from Dr. Hamilton (www.thepinchednerve.com). It's the best subluxation model that exists for use with kids. It's bi‑color and very clearly illustrates the effects of the VS. Dr. Jeanne Ohm's "Power‑On" and "Power‑Off" analogy works well here. I ask children, "This is Power‑On and this is Power‑Off. Which is better?" You'll always get the correct answer! Even two year‑olds "get" this. What's most amazing though, is that moms do, too!

Here's where I ask the child, "I'm going to check you to see if your power is on. Would that be okay?" It's very important to ask children for their permission to examine them. Remember, respect and dignity are key.

(Dr. Ogi Ressel, author, researcher and an x‑ray and pediatric specialist, teaches The Practice Evolution Program, the "fastest‑growing coaching program on the planet." Visit online at www.practiceevolution.com and take the Practice Health Mini‑Checkup. Dr. Ressel may be contacted by e‑mail at drogi@practiceevolution.com or by calling 800‑353‑3082.)