Prevalence of Musculoskeletal dysfunction in Infants Presenting for Chiropractic Care in Norway: A Cross-sectional Study

Cathrin Alvestad Slettebø 2015


Background: Musculoskeletal injuries are common though considered under-recognized at birth. Little is understood about whether such birth traumas could affect activities of daily living of the newborn, but it is known to affect at least breastfeeding and excessive crying. There are no gold standard routines for examination of the musculoskeletal system in infants, and even very little research that investigates clinical examination and MSK findings in infants under the age of six months.

Objectives: To determine the prevalence of neck dysfunction, postural spine problems, and their possible association with parent reported behavioural problems such as suboptimal breastfeeding in infants younger than six months of age. The aim of this study is to observe any associations between MSK problems of infancy and common behavioural and public health issues such as breastfeeding and supine sleep.


Methods:  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 chiropractor on the same day. Eleven chiropractors enrolled or graduated from a Masters program in musculoskeletal health of paediatrics participated in this data collection. There were no interventions and the study was observational in nature.

Results:  In total, 90 infants enrolled in the study.  A total of 56 infants (66%) had postural problems. Favourite side (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 of full cervical rotation 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.