Babies are not miniature adults!
My patients know that I have many nicknames for their babies and small children. From the time I meet them while they are still in utero, the fun begins. Nugget, Munchkin, Tiny Human, Teacup-Human, Smush, Moose, Monkey…the list goes on and on. And those are just the actual dictionary-recognized words that I use. Any number letters (with or without vowels) can combine in an attempt to express my inherent love for these little dudes and dudettes. One term that you will not hear me use when talking about babies or kids, though, is “miniature adults”. Because that could really not be farther from the truth.
We don’t just use a shrink-ray on an adult to make a child. Their anatomy is not just a smaller version of an adult’s, but in some cases is markedly different in the way it comes together. For example, as we discussed (or, rather, as I pontificated and you read) in my post on constipation, the very number of bones that a child has is different from that of an adult. In regards to constipation, the sacrum has not yet fused into one bone, but rather remains in 8 separate segments. Areas in children that are made of cartilage, in adults ossify (in people-terms: become bone). All of this, of course, affects how a chiropractor would adjust a baby versus an adult. The points that are contacted, the force that is used, all must be changed to avoid harm and maximize effect. But these variations in anatomy also explain why children are more susceptible to certain ailments than their fully-grown counterparts. The most common of these is, of course, the ear infection.
Ear infections (acute otitis media or otitis media with effusion, though different, often get lumped together here) affect somewhere between two-thirds and three-quarters of children under age three. Of these, about one-third will have multiple episodes. In addition to ear pain, symptoms may include fever, irritability, and a decrease in normal sleeping and eating habits. Long term issues associated with ear infections include the potential for hearing loss and the spread of the infection to various nearby structures. Understandably, this leads to a lot of doctors visits every year.
Ear infections can be caused by bacterial or viral infection, but fluid build up without infection can occur due to a blockage of the normal draining mechanism of the middle ear – the eustachian tube. The typical approach to management has been a course of antibiotics. But, as many parents know, this often proves ineffective, resulting in another, stronger antibiotic prescription that may or may not be successful in eliminating the issue. Remember, if the problem is not coming from a bacteria, antibiotics will not eliminate it! In the meantime, a child subjected to antibiotics, especially when they are not fully warranted, builds up an antibiotic resistance. This increasingly common issue dictates the need for even stronger medicines when a true bacterial infection comes along and contributes to the development of “super-bugs” we’re hearing so much about lately. Throw in the fact that antibiotics naturally are indiscriminate in the bacteria they take and will wipe out the positive flora of the digestive tract just as quickly, and you can see why parents and doctors alike are growing increasingly hesitant to jump on the prescription bandwagon right away when it comes to an ear infection. Even more upsetting for parents is the prospect of tubes. This requires putting their child under anesthesia and, although it allows for drainage of the middle ear, it does not address the actual issue: why is little Munchkin getting ear infections in the first place?
Let’s go back to the Eustachian tubes for a minute. In most adults, this tube is oriented in a downward-sloping direction and runs from the ear to drain into the back of the throat (pleasant thought, I know). This angle accounts for the decreased prevalence of ear infections in adults. In babies, however, this tube is relatively flat. Fluid in the ears is less likely to roll downhill because there’s not much of a hill in the first place. It’s also got a much shorter distance to travel in little Smush. Further, consider how a baby does most of it’s eating – or, more accurately, drinking: flat on his or her back. We just discussed how the throat and ear are connected via the Eustachian tube…and if it can go one way, it can go the other just as easily in the case of a baby. All of this puts Nugget at an increased risk for developing an ear infection.
But let’s take this one step further. Consider the position of the top vertebra of the spine. Its spot at the top of the neck means it can wreak a lot of havoc on some very important structures. Chiropractic theory proposes that rotation of the atlas vertebra can put pressure/alter muscle and ligament tone around the Eustachian tube. This may very well be the root cause of why this little tube isn’t draining in the first place.
What does correcting this issue with Chiropractic look like for Monkey? Well…not much, if we’re being honest. Which is a good thing, I promise! Given the fact that infants and children are so “squishy” (that’s the scientific term, I believe) and they don’t have years of stress causing poor muscle patterns to become engrained, we don’t need a lot of force to correct for a misalignment, or subluxation. My mentor and pediatrics professor explained it as only taking about the amount of pressure it would require to hold a coin pressed to your cheek. That should set even the most nervous parent at a little more ease, I hope. With proper analysis and this gentle force in the necessary direction will get the job done without causing mom, dad, or Moose any increased stress.
So, it seems we may have a fantastic alternative for the concerns that doctors and parents are expressing concerning drugs and surgery for their kiddos. Alternative suggestions while “riding out” an ear infection include warm compresses over the ear and lavender or tea tree oil behind it, but none of these actually address the basic issue at hand. And while many are suggesting this period of “watchful waiting” already, I would suggest parents take it one step further and let your chiropractor assess as to whether a misaligned atlas might be playing a role in your child’s ear infection. If it is, a gentle adjustment might save you all of the time, energy, and money that goes along with traditional management. Even if it doesn’t completely resolve the problem (but it usually does), your child still stands to benefit from a fully-functioning nervous system throughout the rest of the recovery period. So what does Tiny Human (or Sleepy Parent) have to lose?
If you have a little munchkin tugging on their ear and you’d like to give us a try, go here to book an appointment!
