The Journal of Clinical Chiropractic Pediatrics (JCCP) published a review of studies in their November 2018 edition that shows that breastfeeding early in life reduces the possibility of childhood obesity. This paper reviewed previous studies on breastfeeding as it related to early obesity in children.
This study was conducted at AECC University College, Bournemouth, in the United Kingdom. The statistics of obesity in this study were from the European union, but similar, and in many cases worse statistics are true in the United States. The issues are therefore comparable on both continents and should be addressed equally on both sides of the ocean.
The study begins by noting that obesity in the European Union (EU) is increasing. Notably, England and Poland have demonstrated the steepest increases in obesity. It is estimated that each year 400,000 children across Europe are becoming overweight or obese. Evidence shows that overweight children generally become overweight adults. This then puts them at higher risks of all the health issues that arise from obesity as well as a higher risk of death from the issues related to obesity. It is estimated that in the EU around 2.8 million deaths per year result from obesity associated diseases.
The study authors point out that proper diet and exercise can correct obesity, but they concede that the implementation of this lifestyle is many times easier said than done. They also note that there is a correlation between the tendency to become an overweight child and breastfeeding early in live. They state, “Several high-quality studies indicate that breastfed children have a lower risk of childhood obesity.” Unfortunately, the researchers point out that England has one of the lowest rates of breast feeding in Europe.
The study recommendations for breastfeeding say, “It is extensively acknowledged that infants should be nourished with nothing other than breastmilk for the first six months of life and that breastfeeding should continue with the addition of complementary foods for up to and beyond two years of age.” The researchers sought to find out if lower rates of both exclusive breastfeeding and combination of breastfeeding and formula feeding could affect the increase rate of obesity in children.
Using a calculation known as the body mass index (BMI) as a common way to determine obesity, the researchers looked at a large number of studies to determine how many fit the criteria and could add insight into breastfeeding rates and the effect on obesity. In their review, they determined that 25 studies with 226,508 subjects met their criteria. Data from these studies was then analyzed to draw conclusions.
The results of the analysis of all these studies showed that babies who were breastfed for seven months or longer were 22% less likely to be obese compared to who had never been breastfed. When the researchers compared those children who had at sometime been breastfed to those that had never been breastfed, the results still showed a 15% reduction in obesity for those babies who had some breastfeeding as compared to those who had never been breastfed at all.
In their discussion the authors state that, “The answer to the research question is that breastfeeding appears to reduce the risk for childhood obesity, at least to some extent.” They continued in the study conclusion by saying, “Research suggests that early breastfeeding is protective against childhood obesity.”
On November 5, 2018, the Journal of Pediatric, Maternal & Family Health published the results of a case study documenting the successful vaginal birth of twins in a woman undergoing chiropractic care, who had previously had a cesarean birth.
When a woman has had a cesarean birth, the two options for subsequent births include a planned second cesarean birth, or a “VBAC”, which is a vaginal birth after caesarean. The authors of the study acknowledge that there are risks and benefits for both these directions. Cesarean births are more commonly recommended by medical professionals in this case but there are no clear evidence favoring one procedure over the other. In the case of twin births, cesareans are far more common.
Many women desire to have vaginal births after cesarean due to vaginal birth enhancing the health and well-being of the mother and baby, promotion of maternal infant connection and easing the transition to motherhood.
In this case, a 34-year-old woman presented herself for chiropractic care in her 16th week of a pregnancy of twin girls. Her primary complaint was that she was suffering with intermittent left sacroiliac pain, as well as left posterior hip and left buttock pain which had been present for the past three weeks. Overall, the woman rated her pain as a 6 out of 10, with 10 being the worst. Some activities made the pain more pronounced while rest seemed to improve her pain.
A chiropractic examination was performed and revealed postural imbalance as shown using bilateral weight scales. Additionally, visible postural abnormalities were noted in inspection including head tilt, a high shoulder and an increase in the mid back curvature. Spinal palpation noted multiple areas of restriction and positional concerns throughout the woman’s spine. From the examination, it was determined that subluxations were present in her spine.
The patient consented to a course of chiropractic care at the rate of 2 visits per week for an initial period of 8 weeks. This was followed by a weekly visit for the remainder of her pregnancy. After the third visit, the woman reported that she was not having any pain. She commented, “This is the first time in a long while that I haven’t felt the pain every day.” During the remainder of her care she reported only occasional discomfort which eventually disappeared altogether.
At 35 weeks and 5 days, the woman successfully delivered her twin girls vaginally. The babies were born 20 minutes apart and weighed 4 lbs., 13oz. and 4 lbs., 3oz. After being checked out in the neonatal intensive care they were returned to their mother who was told that her new daughters were healthy babies.
In a review of available literature on the subject, the study authors noted that there was not a lot of prior material available. “Despite the limited number of published cases in the care of patients with successful VBAC and/or twin pregnancies, we are of the opinion that literature does not truly reflect what occurs in chiropractic practice.” Submitting this case study for publication was partially to increase the database of cases of vaginal birth after cesarean, (VBAC). The authors concluded, “This case report provides supporting evidence on the benefits of chiropractic care for the pregnant woman with the desire for VBAC.”
The Journal of Pediatric, Maternal & Family Health published a case study on October 18, 2018, documenting the resolution of a breech pregnancy after chiropractic care. In a normal pregnancy, the baby’s head will be pointed downward prior to delivery. This is known as a cephalic or vertex position. A breech pregnancy is when the head is not pointed downward and either the buttocks or feet are downward instead.
The study begins by noting that, in the United States, there are approximately six million pregnancies yearly, of which about 875,000 will experience one or more complications. Breech pregnancy is one of the more common complications of pregnancy occurring in approximately 3-4% of pregnancies at full term.
Common medical practice for breech presentation is to schedule a cesarean delivery instead of allowing the baby to be born breech. The study notes that breech presentations will rarely spontaneously reposition to cephalic presentation beyond 34 weeks of pregnancy. Because of this, 80-100% of breech presentations are delivered by caesarean section. On occasion, a medical procedure known as an external cephalic version (ECV) is used to attempt to physically turn the baby by pushing from the exterior.
In this case, a 33-year-old woman who was 29 weeks pregnant with a breech pregnancy presented herself to the chiropractor for an evaluation and possible care. The breech presentation was confirmed by an ultra sound performed by her obstetrician. This was the woman’s first pregnancy.
A chiropractic examination was performed which consisted of static and motion palpation, postural analysis, a surface EMG study, thermographic heat readings along the woman’s spine and a Webster protocol analysis. The conclusion of the examination was that subluxations were present, and the Webster technique was indicated.
The Webster technique was developed by Dr. Larry Webster, a chiropractor whose practice specialized in pregnancy and pediatric cases. The International Chiropractic Pediatric Association defines the Webster technique as “…a specific chiropractic analysis and diversified adjustment. The goal of the adjustment is to reduce the effects of subluxation and/or sacroiliac (SI) joint dysfunction. In so doing neurobiomechanical function in the sacral/pelvic region is improved.” Specific chiropractic adjustments and the Webster technique were utilized in this woman’s case.
The study reports that, at the time of the woman’s ninth chiropractic visit, the fetus had turned to the normal cephalic vertex position as confirmed by a second ultrasound done by her obstetrician. The study further noted that the woman was able to have a normal vaginal delivery under the guidance and supervision of her midwife. There were no reported complications with the birthing process.
In the conclusion of this study the authors summed up this case by saying, “The patient presented with frank breech presentation. Utilizing Webster Technique during her pregnancy helped to reestablish normal sacral biomechanics of the female through sacral adjustments and trigger point therapy. After nine chiropractic adjustments, the fetus was confirmed to be in vertex position and the patient went on to have a natural vaginal birth with no complications. This single case study of one woman’s experience with Webster Technique will contribute to the current research available on Webster Technique.”
The Journal of Alternative and Complementary Medicine published a study on December 20, 2017, showing that pregnant women who were under chiropractic care experienced an improvement in their quality of life as measured by specific scientific tests.
The authors of the study begin by pointing out that, “During pregnancy, the expectant mother is faced with many physiologic and biomechanical changes that affect her emotional, physical, and mental well-being. Complementary and alternative medicine (CAM) is popular for women of childbearing age with prior use as the most significant independent associated factor for CAM use during pregnancy.”
Even though chiropractic is a separate and primary portal of entry form of non-medical care, it is often classified as complementary and alternative medicine (CAM) according to governmental authorities and the medical community at large. Other forms of healthcare are also included as CAM, including natural products or supplements, breathing exercises, meditation, acupuncture, massage, yoga, and homeopathy.
Pregnant women seek CAM procedures for a number of reasons including musculoskeletal problems, nausea, labor issues, lactating disorders, and delivery issues, to name a few. The authors note that, “Of the various practitioner-based CAM therapies, chiropractic has been shown to be popular among women before, during, and after their pregnancy.”
The study was conducted by reviewing information from a scientifically designed questionnaire given to patients of participating doctors of chiropractic. The criteria for patient participation was that the patient was at least 18 years of age, had agreed to informed consent to participate in the study, and the patient was pregnant during the course of the study.
The study results were determined from 343 participating pregnant women who met the criteria for this study. The average age of the women was 30.96 years. The educational level of the women showed a high level of education in the group with 31% having completed two years of college, 44% obtained a four year baccalaureate degree, and 20% had a master’s degree. On average, the women presented themselves for chiropractic care in their 25th week of their pregnancy, with the breakdown being that 13.1% were in their 1st trimester, 32.9% were in their 2nd trimester, and 53.9% were in their 3rd trimester of pregnancy.
When asked who was their primary provider for their pregnancy, 57% indicated that it was an OBGYN, 9% said it was a nurse midwife, 27% said a midwife, 3% said a medical doctor, and 3% said other. The results of the study showed a significant improvement in quality of life issues for the pregnant women for physical functioning, sleep disturbance, satisfaction with participation in social roles, pain interference, and fatigue.
In their discussion, the study authors gave an overview of the study when they stated, “The purpose of this study was to understand the characteristics and reasons why women seek chiropractic care and to test whether the changes in QoL (quality of life) observed after starting chiropractic care were greater than the changes they would expect based on chance alone.” In reporting the results of the survey, the authors concluded that the women were highly satisfied with their chiropractic care, and reported that their quality of life measures had statistically improved.