Ruling revokes ban safeguarding babies from chiropractic procedure of spinal manipulation

The federal government may step in after the Chiropractic Board of Australia controversially lifted a ban on the spinal manipulation of children under the age of 12.

Health Minister Mark Butler is writing to the Chiropractic Board seeking clarity over the decision. Picture: NCA NewsWire / Martin Ollman

Health Minister Mark Butler has asked for an “urgent explanation” after the controversial lifting of a ban that prevented chiropractors from manipulating the spines of babies, as experts call for swift action.

Chiropractors are now able to perform spinal manipulation on children under the age of 12 following a decision by the Chiropractic Board of Australia, five years after a temporary ban on the practice was instated.

The practice sparked concern in 2018 when a video of a Melbourne chiropractor manipulating the back, hips, and collarbone of a two-week-old baby surfaced.

The chiropractor could be heard saying “he is going to squawk a bit” while the baby cried as an “activator” was used in the video that has since been deleted from social media.

The decision overturning the ban has deeply concerned industry experts, with Royal Australian College of General Practitioners chair of child and young person health Dr James Best saying he still gets a shiver down his spine when he sees the video.

“Frankly, that just looks dangerous to me, why on earth would you do that?” he said.

There is a much higher risk of injury for babies during spinal manipulation, Dr Best said, as the spinal column is very “malleable” and “manoeuvrable”.

“I’ve certainly spoken to orthopaedic surgeons and spinal surgeons about this topic and they are very concerned about any manipulation being done,” he said.

Spinal manipulation has been used to treat common childhood complaints such as colic, however RACGP chair of child and young person health Dr James Best said there was no evidence to suggest the practice could help those conditions.

Babies also can’t communicate when pain has been caused, Mr Best said.

“While there’s no great data to suggest harm, there’s no data to suggest that it’s safe either,” he said.

“Why would you do something that doesn’t have safety data? … I find it really disappointing and concerning.”

The practice has been used to treat common childhood complaints, including colic, torticollis and croup, however Mr Best said there’s no evidence to suggest spinal manipulation could help these conditions.

“There is no reason for something like that to be done,” he said.

Health Minister Mark Butler raised the issue with state and territory colleagues at Friday’s Health ministers meeting.

“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,” a spokesperson for Mr Butler said.

The Chiropractic Board of Australia’s decision to lift the ban was based on “contemporary evidence and information”, a spokesperson said, with a 2022 review by Cochrane Australia and a 2019 review by Safer Care Victoria (SCV) both finding it “difficult to draw conclusions about the safety and effectiveness of spinal manipulation in children, due to the paucity of research studies and reported information”.

As well as the independent review consultation by SCV, notification data from the Australian Health Practitioner Regulation Agency also didn’t identify “any reports of serious harm in children receiving chiropractic care in Australia”, according to the Chiropractic Board.

The health regulator has received 335 concern notifications about chiropractors since January 2021, five of which were relating to child patients.

Of those notifications, four resulted in no further action against the practitioners involved, while one young child’s case underwent regulatory action unrelated to the treatment provided.

A spokesperson for the Chiropractic Board said the updated guidelines highlight the need to ensure “parents or guardians fully understand their rights and the evidence before any treatment is provided to children”, however the RACGP has urged the board to reconsider the decision.

“The RACGP would like to see the Chiropractic Board of Australia reconsider their stance … I know that Health Minister Butler has said he’s writing about the situation, so it’s good to see some movement is happening in that direction,” Dr Best said.