Why Infants Get Referred to Chiropractors: A 1,049-Baby Danish Snapshot
Overgaard and colleagues pulled the curtain back on what actually walks through the door of a Danish chiropractic clinic when the patient is under one year old. The complaint pattern is more mechanical than most parents (and most pediatricians) would guess, and the referral pathway runs through public-health visitors more often than through the family doctor.
Infant chiropractic referral patterns describe how babies under one year arrive at a chiropractic clinic, who sends them, and what the parents are asking about. In this Danish study of 1,049 infants, the most common reason was abnormal range of motion in the neck or spine (48 percent). About half of the babies were referred by another healthcare professional, most often a public-health visitor (44 percent of all referrals).
Key Points
- Nationwide cross-sectional survey of Danish chiropractic clinics, covering 1,049 infants aged 0 to 12 months seen between November 2018 and October 2019.
- The most common primary complaint was abnormal range of motion in the neck or spine, at 48 percent. Crying or infantile colic came second at 17 percent. Feeding problems and disturbed sleep tied at 5 percent each.
- Most complaints had been present for somewhere between one week and three months before parents sought care. This is not a same-day visit pattern. Parents tried other things first.
- Secondary complaints showed up in 58 percent of cases. Babies rarely came in with one isolated issue. Range of motion, sleep, and feeding clustered together more often than not.
- Healthcare-professional referrals accounted for 51 percent of visits. The single largest source was the Danish public-health visitor system at 44 percent of those referrals, not the family physician.
- Denmark integrates chiropractors into the standard healthcare pathway in a way the United States does not. The complaint mix probably translates. The referral mix definitely does not.
What the Researchers Did
The team behind this paper sat at the Spine Centre of Southern Denmark, the University of Southern Denmark, the Chiropractic Knowledge Hub, and Macquarie University in Sydney. They invited every chiropractic clinic in the Danish Chiropractors' Association, all 238 of them, to take part in a national electronic survey. Clinicians pulled retrospective data from their own medical records, capturing every infant visit between November 2018 and October 2019.
The questionnaire asked four straightforward things. What is the baby's primary complaint? Is there a secondary complaint, and if so what is it? How long has the symptom been present before this visit? Was the family referred by another healthcare professional, and if so by whom? Demographic data filled out the rest.
By the time the data window closed in early 2020, 1,049 completed infant questionnaires were in. That is a meaningful national sample for a country of roughly 5.9 million people. The Danish Agency for Patient Safety classified the work as quality assurance, which under Health Act paragraph 42d removed the written-consent requirement. The University of Southern Denmark approved the protocol.
What They Found
The headline finding is the complaint mix. Abnormal range of motion in the cervical or upper-thoracic spine accounted for 48 percent of primary complaints. In plain terms, parents were noticing that the baby preferred to look one direction, struggled to turn the head fully, or held the neck in a fixed posture. Crying or infantile colic followed at 17 percent. Feeding problems and disturbed sleep each came in at 5 percent. The remaining 25 percent split across a long tail of less common reasons.
The duration data is just as telling. Most of these complaints had been present somewhere between one week and three months before the family showed up at the chiropractic clinic. Parents were not bringing newborns in on day three. They were bringing in babies whose problems had persisted long enough to outlast the early reassurance of "this will probably resolve on its own."
Secondary complaints showed up in 58 percent of cases. The most common secondary patterns were abnormal range of motion (41 percent), disturbed sleep (22 percent), and feeding problems (21 percent). The clinical takeaway here is that infant presentations cluster. A baby who is hard to console at night is often also a baby who turns the head one way more easily than the other. Parents may report only the loudest symptom. The clinician has to look for the rest.
The referral pathway data is where the Danish context becomes impossible to ignore. Fifty-one percent of infants were referred by another healthcare professional. Of those referrals, 44 percent came from the Danish healthcare-visitor system, a publicly funded program in which trained nurses visit every newborn at home in the early months of life. General practitioners and other providers made up the rest of the referral pool. In other words, the system is built so that the people who already see the baby at home in the first weeks of life have a clear pathway to a chiropractor when something looks off.
Clinical Perspective: What I See in My Practice
The complaint mix in this Danish dataset matches what I see in my Tulsa practice when parents bring in an infant. I do treat infants. I am not a board-certified pediatric chiropractor and I do not hold the Webster certification. I want that on the record up front because parents deserve to know what credentials a clinician carries before any hands go on a baby. With that boundary stated, the work I do with infants is gentle, low-force, and focused on restoring symmetric movement of the cervical spine and pelvis using sustained light pressure rather than the higher-velocity adjustments used on adults.
The most common reason I see infants is the same thing this study found. A parent notices that the baby always turns the head one direction, has a flat spot starting on one side of the skull, fights tummy time, or refuses to nurse from one breast. Pediatricians often call this a positional preference or, when it is more pronounced, congenital muscular torticollis. Whatever the label, the underlying issue is asymmetric movement of the upper neck. The baby is not choosing the favorite side. The favorite side is the only side that moves freely.
I also see the cluster pattern this study documented. The baby who cannot turn the head left often also struggles to nurse on one side, sleeps poorly, and arches the back when laid down. Parents typically present the loudest symptom first. My job is to ask the next three questions and look for the rest.
What I do not see in my practice, because the U.S. system is not built this way, is referrals from a public-health visitor. There is no equivalent program in Tulsa. Most of my infant referrals come from word of mouth, from lactation consultants, from a small number of pediatricians who know my work, and from postpartum doulas. The Danish 44 percent figure is not a number I will replicate. The complaint pattern is.
What This Means for Parents
If you are a Tulsa parent reading this, here is the practical translation.
First, an infant who consistently turns the head one direction more easily than the other is showing you something mechanical. It is worth getting checked. The fix may be repositioning, tummy time strategy, lactation guidance, gentle physical therapy, gentle chiropractic care, or some combination depending on what is going on. The right starting point is an honest assessment of which side moves and which does not.
Second, the cluster pattern matters. If your baby has feeding trouble on one side, sleep difficulty, and a head-position preference, those are likely connected, not three separate problems. A clinician who treats them as one mechanical picture will get you further than one who treats each in isolation.
Third, ask about credentials. Chiropractors in the United States are licensed to treat patients of all ages, including infants. That said, training in pediatric care varies clinician to clinician. Ask any provider you are considering, including me, what their specific experience with infants looks like, what techniques they use, and what red flags would prompt a referral out. A good answer is specific. A vague answer is a flag.
Fourth, infant chiropractic care, when delivered appropriately, uses light sustained pressure, not the higher-force adjustments adults receive. The amount of force applied is roughly what you would use to test the ripeness of a tomato. If anyone describes anything more aggressive than that for a baby under one year, walk out.
Vanguard Chiropractic Connection
At Vanguard Chiropractic in Tulsa, the infants I see most often arrive with the same head-position story this Danish study describes. Parent noticed the baby always looks right, or always nurses better on the left, or has a flattening on one side of the skull. The visit usually starts with watching the baby move, palpating the cervical spine and pelvis with the parent holding, and walking through what positional changes at home might do over a one to two week trial before any hands-on work begins.
I work with each family on the specific picture in front of me. Some infants benefit from a few gentle visits combined with home positioning changes. Others need a referral to lactation, to physical therapy, or back to the pediatrician for imaging if anything in the history or exam suggests something beyond a positional pattern. The decision tree is built around the baby in front of me, not a protocol applied to every infant who walks in.
Parents in the Brookside and midtown Tulsa area who want to talk through whether a chiropractic visit makes sense for their baby are welcome to call or walk in. Individual results vary, and if I do not think chiropractic care is the right answer for your specific situation I will tell you so and point you toward what is.
Limitations and What Is Not Yet Known
This is a descriptive cross-sectional study. It captures who walked in the door and why. It does not measure outcomes, does not compare against any control, and cannot tell us whether any of these infants got better with chiropractic care, with anything else, or on their own with time.
Recall and documentation depended on chiropractors pulling data from their own records. Coding of complaints was not standardized across the 238 clinics that were invited. The 1,049 cases came from a subset of clinics that returned the survey, which introduces participation bias. Practices that did not respond may serve a different patient mix.
The Danish healthcare context limits external translation of the referral findings. The 44 percent healthcare-visitor referral rate reflects a public-health structure that does not exist in the United States. The complaint mix may translate. The referral pathway probably does not.
Parental report drives the symptom data. What a parent calls colic, what a clinician calls colic, and what the underlying mechanism actually is may be three different things. The category is broad on purpose, but breadth limits how precisely the findings map to specific clinical pictures.
The data window closed in October 2019. Healthcare delivery patterns since the pandemic period have shifted in ways the dataset cannot reflect.
What this paper does not establish is whether chiropractic care helps these infants. That is a separate research question requiring a different design. Several small randomized trials and prospective cohort studies have looked at infant chiropractic care for specific complaints, with mixed and generally low-certainty results. The Danish authors are clear that their goal here was to describe the population of infants showing up at chiropractic clinics, not to evaluate the care delivered. Any reader who walks away from this paper claiming it shows chiropractic care works for babies has read more into it than the data supports.
Forty-eight percent of infants showing up at Danish chiropractic clinics come in for asymmetric neck and spine movement. Crying and colic are a distant second. Most have had the issue for weeks or months before the visit. Half are referred by another healthcare professional, with the public-health visitor system carrying most of that load. The complaint pattern probably describes infant presentations in any country. The referral pathway describes Denmark. Both pieces are useful.
Editorial Disclosure
The Forward Review is editorial commentary, not peer reviewed. Written by Jason Forward, DC, a licensed chiropractor at Vanguard Chiropractic in Tulsa, Oklahoma. Commentary reflects clinical interpretation and does not represent the views of the original study authors, the journal Chiropractic & Manual Therapies, or any institution.
Scope of practice note: Dr. Forward treats infants and pregnant patients. He is not a board-certified pediatric chiropractor and does not hold Webster certification. Parents should always verify a provider's specific experience and training before infant care.
Conflict of interest: Dr. Forward is a practicing chiropractor who provides infant care in his Tulsa clinic. No financial relationships with the cited authors, the publisher, or any party to this work.
Corrections policy: Errors are corrected with a dated correction notice appended to the article. Original text remains accessible via revision history.
Level of evidence: Cross-sectional descriptive study (n=1,049 infants, nationwide Danish sample).
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