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Baby spinal manipulation sees Minister request ‘urgent explanation’
Mark Butler will write to the Chiropractic Board after it quietly re-introduced the practice last November following a four-year ban.
Chiropractic manipulation of infants’ spines was banned for four years but returned via a members’ only update.
Federal Health and Aged Care Minister Mark Butler is seeking clarification in the wake of revelations that recently released Chiropractic Board of Australia (CBA) guidelines permit spinal manipulation for babies under two years of age.
A spokesperson for the Minister told Nine Newspapers he is also set to raise the issue with state and territory counterparts at a meeting on Friday.
‘The Health Minister is writing to the Chiropractic Board seeking an urgent explanation on its decision to allow a resumption of spinal manipulation of infants under two, in spite of two reviews concluding there was no evidence to support that practice,’ the spokesperson said.
The practice was shut down by an interim CBA ban in 2019 after the Council of Australian Governments (COAG) Health Council responded to community concerns about spinal manipulation on children and agreed to investigate the practice to see if there was a public safety risk.
The outrage came in response to a video of a two-week-old infant being held upside down by a Melbourne-based chiropractor, who then used a spring-loaded device on the child’s spine.
The CBA put out a statement in November last year to its members to clarify the ‘range of treatment modalities’ in caring for children and included mobilisation, soft tissue therapy and manipulation.
Dr James Best, Chair of RACGP Specific Interests Child and Young Person’s Health, told newsGP CBA’s decision to add manipulation back into its guidelines is ‘very concerning’.
‘There is no safety data on spinal manipulation and children,’ he said.
‘There is good reason to be concerned that there may be safety issues given the anatomy and softness of children’s spines, them being more flexible and particularly more prone to damage by manipulation.’
Safer Care Victoria and Cochrane Australia released a report and a review, respectively, that found a lack of evidence on the efficacy and safety of the practice.
The major finding in the Safer Care Victoria report was that ‘the evidence base for spinal manipulation in children is very poor’.
The treatment has often been touted as a solution to childhood conditions such as colic, back/neck pain, headache, asthma, ear infections or torticollis, but Dr Best says ‘there is no evidence at all’ that it helps.
‘Why would you be doing something that is potentially dangerous when there are current indications there is no evidence of benefit?’ he asked.
The treatment often involves moving spinal joints outside the normal range of motion using high-velocity thrusts.
Dr Best said the risks in treatment could include damage to ‘the tissues or the spinal column’ as well as damage to ‘soft tissues, blood vessels and muscles’.
In response to questions from newsGP, an AHPRA spokesperson said the CBA is a ‘risk-based regulator’ committed to ensuring patient safety ‘while recognising the rights of parents to make choices about the healthcare their children receive’.
‘The Board has carefully looked at the evidence and yes, there isn’t currently sufficient evidence of effective care but also there isn’t evidence of harm,’ they said.
‘The updated guidance includes increased focus on informed consent, where parents are empowered to make a decision about their children’s healthcare with the knowledge and understanding of known risks and benefits involved.
‘The updated guidance also clearly states that practitioners must practice within the scope of their education and training.’
In 2016 the RACGP told members not to refer patients to chiropractors following the release of a similar video showing another Melbourne chiropractor cracking the back of a four-day-old baby.
Then-president Dr Frank Jones called on the Federal Government and private health insurers to stop compensating policy holders for the questionable treatments, which he described as ‘cruel’.
A baby’s neck was also broken by a chiropractor in 2013, which again led to calls from doctors to ban the treatment.
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