CHAPTER IV
ADJUSTING INFANTS
CHAPTER IV
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.