Background: Musculoskeletal (MSK) injuries are common though considered under-recognized at birth. There are no gold standard routines for examination of the musculoskeletal system in infants, and very little research that investigates clinical examination and MSK findings in infants under the age of six months.
Objectives: The objectives were to determine the prevalence of neck dysfunction, postural spine problems, and their possible association with parent reported behavioral problems such as suboptimal breastfeeding and supine sleeping in infants younger than six months of age. The aim of this study was to observe any associations between MSK problems of infancy and common behavioral and public health issues.
Methods: This is a cross sectional questionnaire based observational study in a clinical population. Mothers of infants presented to chiropractic clinics in Norway filled in a questionnaire on the first visit, and this was followed by a clinical examination and questionnaire completed by the Doctors of Chiropractic on the same day.
Results: In total, 90 infants enrolled in the study. A total of 56 infants (66%) had postural problems. Favorite side of cervical rotation (N=41; 75%) was the most common dysfunction in supine lying. Neck hyperextension was present in 21 infants (38%). The inability to rotate their head equally side to side was present in 49 children (54%). In total 22 (24%) of the infants did not have the ability to sleep or lie comfortably supine. Suboptimal breastfeeding was reported by 22 (25%) parents, and 10 (12%) of the mothers reported pain during feeding. TMJ imbalance was identified in 16 infants (19%). There were statistically significant associations between suboptimal breastfeeding and TMJ imbalance, suboptimal rooting/sucking reflexes, inability to turn head and neck equally and painful breastfeeding, respectively.
Conclusion: Parents reported several MSK problems in infants along with suboptimal breastfeeding and other ADLs, which were corroborated and specified by the clinical examination. More study is needed to determine a gold standard reference for infant musculoskeletal examinations
along with the importance in improving activities of daily living and public health through balance of the MSK system.
Author keywords: cervical spine dysfunction, musculoskeletal injuries, musculoskeletal problems, musculoskeletal examination, breastfeeding problems, supine sleep, infants, pediatrics, chiropractic
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