This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
or
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
There’s
one question that many of today’s new parents or parents-to-be are asked over
and over again. “Have you got a Snoo?”
For
the unenlightened, the Snoo is a controversial $2000 piece of baby tech that
automatically soothes your baby to sleep by imitating calming sensations of the
womb.
It’s
a smart bassinet that can listen for when your baby is fussing or crying and
gently rock them, claiming to often calm crying in less than a minute.
The
Snoo is like an extra set of arms for new parents – if that set of arms also
had in-built Wi-Fi, microphones, white noise speakers and a motor.
The
device is the brainchild of American pediatrician Harvey Karp, who wrote the
book The Happiest Baby on the Block
and pioneered a “5 S” approach to newborn babies: swaddle, side-stomach
position, shush, swing and suck.
It’s
become wildly popular with many new parents, given its allure of extra sleep
for babies and their parents alike. Sleep deprivation can be one of the
toughest aspects of parenting.
Snoo’s
parent company, Happiest Baby, says Snoo boosts sleep by one to two hours a
night from the very first days of life, and that by two to three months of age,
most “Snoo babies” sleep more than nine hours a night.
Those
are lofty claims and it’s understandable that some parents would be open to
shelling out thousands of dollars for a bassinet, even one with plenty of bells
and whistles.
A
couple of disclaimers: Snoo parent company Happiest Baby sent over a review
unit for the purposes of this write-up, so I didn’t pay the RRP. Secondly, I’ve
only had one baby so far, who is at this stage a happy little two-month-old
boy, so I don’t have a non-Snoo baby to compare.
Our
experience, two months in at least, has been pretty remarkable. It’s no silver
bullet by any means: our baby can often wake up at random times as all babies
do, and sometimes won’t settle in the Snoo at all. But there have been plenty
of moments of calm in what can otherwise be a chaotic, stressful and intense
time.
One
stand-out feature is that the Snoo automatically ramps its rocking speed up or
down depending on if the baby is crying or settled, and often it works.
It’s
not a cure-all for a crying or fussing baby. But at the same time, it’s hard to
put a dollar value on a decent night’s sleep.
It
does sometimes feel like a bit of a cheat code, and that’s what can make some
parents and some paediatricians feel uncomfortable with it.
And
that’s where the controversies come in. Critics say technology such as the Snoo
could potentially negatively affect baby bonding, and that it can create bad
habits by making the baby too reliant on rocking or white noise.
“I
remain somewhat reluctant to have so much gadgetry around a newborn baby,”
Australian pediatrician Dr Daniel Golshevsky, better known as Dr Golly, says in
a blog post.
The
Tweetycam baby monitor was one of our favourites.
“I
see countless babies with untreated causes of unsettled behaviour, from colic
to eczema, protein intolerance to reflux, and everything in between. I deeply
believe that glossing over these treatable conditions does a disservice to
babies.
“Prevention
is the key, so yes – babies should/can snooze without Snoos.”
Snoo
parent company Happiest Baby says, on the other hand, that its device is safe
to use, and that it’s easy to wean babies off its sound, swaddle and motion.
It
points to research commissioned by the company that has found that Snoo’s
rocking, swaddling, and white noise combo works just as well as parents’
soothing to calm fussy babies quickly, and that 90 per cent of nurses surveyed
say that Snoo reduces infant fussing.
We
haven’t yet reached the weaning phase ourselves, given babies can use Snoo for
up to six months and our little one is just two months. On some occasions, we
have had to settle him in bassinets that aren’t the Snoo, and we’ve found we
are doing all the same things the Snoo does for us – rhythmic rocking, swaying
and playing varying levels and types of white noise.
Is
it worth the $2000? Like so many baby purchases, you need to keep your
expectations in check. It’s not a cure-all for a crying or fussing baby. But at
the same time, it’s hard to put a dollar value on a decent night’s sleep. And
we’ve been having an increasing number of those in recent weeks.
It’s
not for everyone, but the Snoo has been the most useful, high-impact gadget
I’ve used in a long time. And I’ve used a lot. Like so many baby purchases,
it’s also worth checking out Facebook Marketplace: used Snoos typically retail
for around half the price of their brand-new counterparts.
What else did we try?
Australian company Tweetycam’s range of products really impressed and its baby monitor ($239) was our favourite.
The monitor doesn’t use Wi-Fi – meaning no real security concerns– instead relying on a technology called FHHS to send the signal from the camera to the monitor.
The Tweetycam also monitors the room temperature, which is a real plus, and its picture and sound quality are excellent. The monitor itself is easy to use with no smartphone app required, and its battery life lasts about 12 hours. There’s definitely benefit in having a standalone monitor rather than needing to open a smartphone app every time you want to check on your baby.
The Tweetydreams nightlight and sound machine is also strongly worth considering, and at $120 is good value. That product requires a smartphone app, however, which can be a bit fiddly. A basic nightlight that just switches on and off has worked best for us, particularly when trying to bumble your way around in the middle of the night.
Our other favourite baby monitor for those who do prefer a smartphone app is the Lollipop smart baby camera ($319). It’s incredibly versatile, wrapping around the baby’s cot or bassinet, for example, or standing upright on its own. The Lollipop sends you phone notifications whenever it detects a noise, and you can monitor it from any device, be it a smartphone, tablet or desktop. Its picture quality is top-notch and it comes in fun colours such as cotton candy, pistachio and turquoise. Other things to consider
The Snotty Boss nasal aspirator has been a godsend, and is superior (and decidedly less gross) to the manual method of sucking snot from baby’s nose. I didn’t try a “smart sock” – the baby monitor that tracks pulse and oxygen levels via a sock on the baby’s foot. That felt like a step too far.
And lastly, it might seem obvious to say, but technology is no replacement for human interaction. Parenting is a messy, tricky and intense thing, but no amount of technology will substitute for spending time with your little one. There are just some things that can make it that little bit easier.
Updated 12:26PM June 14, 2024, First published at 10:30PM June 13, 2024
Anthony Albanese says a total ban on under-16s from accessing social media is a “good way to go” in curbing the serious online harms impacting children, declaring that Peter Dutton was just playing “catch up” by promising to legislate such a ban within the first 100 days of the Coalition taking office.
The Opposition Leader on Thursday doubled down on his pledge to use age verification to stop children accessing social media before the age of 16, saying it was “inconceivable” for tech giants to allow 13 year olds on to their platforms.
CyberCX chief strategy officer and former eSafety commissioner Alastair MacGibbon told The Australian tech giants made significant profit from allowing as large a cohort on to their platforms as possible and that mandates stopping them from “monetising our kids” were needed.
“I applaud politicians for actually starting to talk about taking action on something that I think deep down most people in the public have wanted a stance on for a while,” he said.
However, Mr MacGibbon said the technology that would be needed to implement such a ban “still has a long way to go”.
Opposition communications spokesman David Coleman said the Coalition would announce the measures it would use to implement the ban in due course, but pointed to the fact social media platforms were already using age verification technology in some circumstances.
“They do it for Facebook dating in the US, they do it for Instagram if you change your age from say 15 and say you’re 18 – because in that case it’s so obvious the person is probably a child, they have to look into it – but they’ve been doing that for some time. So the idea that the technology doesn’t exist, or it’s not possible, is wrong,” he said.
“We’ll release further details in due course, but plainly, the companies will be required to comply with the new law, and that will include penalties if they don’t.”
Labor invested more than $6m into an age assurance trial earlier this year, but the initiative is largely aimed at investigating technologies that can prevent people under 18 accessing adult content such as pornography.
It is not yet clear whether the trial will look to test the technology on social media access.
In response to Mr Dutton on Thursday handing “an offer of friendship to the government to make sure that we can join up together on this really important issue”, the Prime Minister indicated a ban would have bipartisan support.
“A ban, if it can be effective, is a good way to go,” he said.
But in a veiled swipe at Mr Dutton, Mr Albanese said the Opposition Leader was a latecomer to the issue. “It’s good that he’s caught up, and I welcome him catching up,” he said.
When asked if raising the age to 14, as South Australia is currently investigating, or 16, Mr Albanese said 16 was reasonable.
The increase in momentum for social media bans comes as eSafety research found a small number of “harmful voices”, including that of Andrew Tate – known for his misogynistic views – dominated online conversations about masculinity.
As an oldie this proposal has no effect on me, but I wonder about the choice of 16 as the cut off age. As at that age, the range of the level of maturity is very wide with some pretty mature and some really still pretty immature and young.
My feeling is that above age 12 or 13 there is a role for parents to decide what usage privileges are appropriate.
Of course as the article points out it is pretty hard to find or implement technology to regulate just what happens!
How do readers think this issue should be managed?
There
is one important thing to know about Apple’s big move this week into artificial
intelligence: it’s not here yet, and strictly speaking it may never be here.
Many of the headline announcements, including the Siri overhaul and the deal Apple struck with OpenAI, which may see OpenAI’s ChatGPT occasionally popping up in response to Siri requests, fall under an AI system Apple calls “Apple Intelligence”.
Technically, Apple has only announced Apple Intelligence for the USA (or, to be even more pedantic, for “US English”), promising to start rolling out some AI features in the American autumn as part of the next major software update to the iPhone, iPad and Mac.
Apple has yet to reveal when, or even if, Apple Intelligence will come to Australia. The only public (or indeed private) statement is that “additional languages will come over the course of the next year” after the US English launch. So it could be 2025 before it rolls out here.
While it’s possible Australian users will be able to get earlier access to the features simply by going into the settings menus of their device and switching its language to US English, the geographic limit appears to be about more than just language (see private cloud compute below).
Early indications are Apple may enforce the limit through other means, too, such as checking the home address of the Apple iCloud account users will need to access the services. All is not lost, however.
Apple Intelligence versus machine learning
Apple Intelligence refers primarily to the set of services that will require up-to-date hardware to run: the stuff that will need a Mac or iPad running an Apple Silicon chipset, or an iPhone greater than, or equal to, the iPhone 15 Pro.
Many of the interesting new AI features don’t fall under that umbrella. The enhancements to Apple’s browser Safari, for instance, which will allow web users to summarise and even index the content of websites, come under a different category that Apple generally refers to as “machine learning” rather than “Apple Intelligence”.
(In numerous background briefings I’ve had in the Apple Park headquarters in Cupertino this week, that’s the pattern that has emerged. If Apple is calling it “machine learning”, you won’t need a new iPhone for it, and it won’t be initially limited to the USA. Technically, Apple Intelligence could accurately be described as machine learning, too, but as you’ll see in a moment, it’s a much bigger and more ambitious framework than adding a bit of ML to a single app.)
The new calculator for the iPad falls under “machine learning” and should be available when iPadOS 18 is launched in September or October
Another example of this machine learning/Apple Intelligence divide is the Photos app that appears on iPhones, iPads, Macs and, from July 12, on Apple’s Vision Pro.
It’s receiving a significant update, with new features such as the ability to organise photos according to the grouping of people and pets in them. All the photos with only you and your dog will be separated out into one group, while photos with you, your dog and your mother will have another group.
That’s a machine learning feature that every Apple user will get.
But click on one of those photos to edit it, and only customers who qualify for Apple Intelligence will see a button for a new “Clean Up” tool that scans an image, finds people who don’t belong in the photo, and deletes them.
In addition to the machine learning and Apple Intelligence features, Apple has also announced scores of other new features in devices that have nothing to do with AI or ML.
iPhone users will be able to type in messages and schedule their delivery up to two weeks in advance, so they can send birthday wishes when they remember to do so, rather than risk forgetting to do so on the day itself.
(A handy tip coming from Apple insiders who have been testing that feature for months is to schedule the message for a random time – 8.07am rather than 8.00am, for example – so the recipient doesn’t realise they’re not top of mind.)
It’s fair to say, however, that the most exciting features fall under Apple Intelligence, and that the wait for them to arrive could feel like a long one.
How it will work
At
the core of Apple Intelligence is a database called the semantic index.
Whenever
an iPhone, iPad or Mac gets a new message or takes a new photo, or whenever the
user creates a new document, the same mechanism that indexes the file so it can
be found by Apple’s existing Spotlight search system will also send it off for
processing by an AI indexer, which will extract the meaning
of that document and store the meaning in the semantic index.
Where
Spotlight might index, say, a new iPhone photo by the date and time it was
taken, the semantic indexer might identify the people in the photo, match them
up to people in the phone’s contacts database, and index them by the
relationship they have to the iPhone’s owner.
Semantic
indexes are protected by the same hardware-based “secure enclave” system that
Apple uses to secure ultra-sensitive information such as passwords, and Apple
insists they will never leave the device they’re created on.
Even
when an Apple customer has multiple devices sharing data, the semantic index
will never be shared between them. It will be created and maintained separately
on each device.
Another
database sitting on an Apple Intelligence device will contain a list of what
Apple calls “app intents”.
It’s
like an app store, except instead of holding lists of apps, it holds a list of
the functions that the installed apps on the device can perform in an automated
way.
If,
say, the iPad version of Adobe’s Photoshop was able to take an image saved in
the PNG format, and automatically export it as a JPEG file, Adobe would be able
to inform the iPad of that function by calling up the app intent system when
Photoshop was first installed on the iPad.
In
addition to all of that, every Apple Intelligence device will contain dozens of
different AI language models for analysing and generating text, as well as
“diffusion” models for analysing and generating images.
Compared
to the large language and diffusion models used in the cloud by chatbots such
as OpenAI’s ChatGPT and Google’s Gemini, Apple’s models will be smaller and
more numerous, each of them fine-tuned to perform a specialised task using as
little processing power as possible.
(Samsung’s
latest Galaxy phones and Google’s latest Pixel phones employ the same
architecture: they contain numerous small models, which swap in and out of the
phone’s AI processor depending on the task.)
Now,
sitting above all of this will be a software layer known as an “orchestrator”,
and it’s here that the fun begins.
The
orchestrator takes incoming requests from the user, decides what data from the
semantic index is needed to fulfil those requests, which model is best suited
for the task, looks into the list of intents to see what apps might be able to
perform functions useful to that task, and sets the wheels in motion getting
the job done.
Using
Apple Intelligence, it might be possible, for instance, for a user to ask Siri
to find a picture of an uncle (identified using the semantic index), put a
party hat on his head (using a diffusion model), convert that picture to a jpeg
file (using the Photoshop function listed in the app intent database), and
email it him (address from the semantic index, email function found in the app
intent database) on his birthday (from the calendar, via the semantic index).
Private Cloud Compute
Some
jobs, however, will require language or diffusion models that are simply too
large, or require too much processing power, to be stored on the iPhone, iPad
or Mac.
To
run such models, Apple is filling data warehouses around the world with custom
AI servers it’s building using the Apple Silicon chips that go into Macs and
iPads, and running a highly secure version of the iPhone’s operating system,
iOS.
That
rollout is starting in the US, and it’s part of the reason Apple Intelligence
will be only in US English when it first appears.
These
“Private Cloud Compute” data warehouses are integral to Apple Intelligence,
since they’re the only way Apple can send data from the user’s very private
semantic index to the cloud, without breaking Apple’s promise that Apple
Intelligence is private and secure.
When
the orchestrator on a device running Apple Intelligence decides a job is too
big for the models stored on the device itself, it may decide to bundle up the
job, together with context data from the semantic index, and upload it to
Private Cloud Compute.
There,
the model will process the request, return the results, and then delete any
record of the request.
(Unusually
for a cloud server, PCC computers have no storage devices whatsoever, so not
only can they not save semantic index data, they can’t even save the error logs
and other logs that administrators usually rely on to manage server farms. It’s
an ambitious strategy designed to assuage concerns about AI privacy.)
OpenAI
There
is a final scenario, however, that has led to some controversy with the likes
of Elon Musk.
If
the orchestrator decides that the job is too big even for Private Cloud
Compute, it will put some warning messages on the screen telling the user
they’re about to leave Apple airspace
and fly off into the unknown.
If the user agrees to throw caution to the wind, the orchestrator will bundle up the job and send it to a third-party system for processing.
On Monday, the only third-party Apple had inked a deal with was OpenAI, though officials said they expected to get Google on board, too, allowing jobs to be sent to Gemini.
It’s likely, however, that OpenAI and Google are both stopgap measures, until Apple’s own Personal Cloud Compute systems have models that can handle generic generative AI tasks themselves.
The real point of giving the orchestrator the last-resort option of going to a third party is to handle highly specialised AI tasks, such as medical models that take images of skin shot on an iPhone, and look for signs of skin cancer.
The very moment Apple gets its own Personal Cloud Compute system to a level good enough to handle more generic generative AI queries, it’s nearly certain it will decide it’s cheaper, more private and better PR for the orchestrator to take that option instead of using OpenAI or Google.
The only thing uncertain is how long it will take Apple to get its models to that level. But before we even get to worry about that uncertainty, we have another one to deal with.
Just when is any of it coming here? John Davidson attended Apple’s Worldwide Developer Conference as a guest of Apple.
I have to say I have read this
through a couple of times and I am not sure just where it is all heading. I suspect it will be a while before that is
clear as well as when it is going to reach good old OZ
I suspect this is more of the
revolution I have been chatting about in the last few months.
These newer technologies are seeming
to have a life all of their own as they advance and I have to say I am still
not sure what the actual destination is!
A
prolific circumcision doctor has lost his battle to perform operations while he
appeals a medical board decision, as new details emerge about one of his
newborn patients suffering an “amputation or partial amputation” of his penis
and another needing a blood transfusion.
Dr
Hershel Goldman, who estimates he has performed 20,000 circumcisions, has
sought to overturn an April ban imposed by the Medical
Board of Australia that prevents the Melbourne doctor from performing
circumcisions. His appeal remains ongoing, and Goldman applied to have the ban
lifted until the appeal concluded.
But the Victorian Civil and Administrative Tribunal rejected the 63-year-old’s request to delay the ban ahead of a full appeal hearing and decision this year.
In a May 30 decision published by the tribunal this week, it was alleged that Goldman performed a circumcision on a seven-day-old baby “where amputation or partial amputation of the penis occurred”.
The baby’s family claims that Goldman “pressed on with the ritual prayers for several minutes and delayed providing care to the infant” after their baby bled more than usual after the operation.
“Further, once confirming the amputation, concerns have been raised that Dr Goldman had no procedures in place to manage the complication, with management of the emergency being undertaken by guests at the party who were also medical practitioners,” the family told the Medical Board of Australia’s immediate action committee.
Goldman’s clinical records do not detail when he phoned an ambulance.
In another case considered by the board, another of Goldman’s seven-day old patients required sutures and a blood transfusion after a circumcision in a family home.
It is alleged that after the procedure, Goldman applied a bandage to the baby boy and instructed the parents to keep his nappy on for four hours.
Goldman
then advised the family he was travelling interstate and provided no on-call
coverage after he left their home, they told the committee.
When
the parents removed their son’s nappy four hours later, they said they
discovered “significant bleeding”. They said they contacted Goldman and he
advised them to travel to a hospital 40 minutes away for a review. The baby
required stitches and a blood transfusion at the hospital.
The
family in the second case also raised concerns about Goldman’s hygiene
practices and claimed he washed his hands in the kitchen sink and used a tea
towel to dry them before performing the procedure.
Goldman
told the committee that bleeding requiring sutures was not a sign of any error,
but that sutures were required in a small number of circumcision cases.
He
denied telling the infant’s parents that they should not remove his nappy for
four hours after the circumcision.
Goldman
said he told the parents to check the infant during routine nappy changes
within four hours of the procedure.
He
also denied he had poor hygiene and submitted that he used surgical antiseptic
after washing his hands with soap and water and dried them on a clean tea towel
supplied by the baby’s parents.
In
the first case, Goldman maintains that a partial amputation – not full –
occurred but acknowledged the seriousness of this complication. He also denied
the parents’ claims he performed the circumcision in poor lighting.
The
doctor submitted to the tribunal that he should be allowed to continue
performing circumcisions in clinical settings only, and not in people’s homes,
while the appeal process was ongoing.
Goldman
told VCAT he had performed circumcisions for 40 years, and that what he
referred to as the partial amputation was his first major complication in that
time.
He
argued he would suffer a “devastating financial impact” if he was banned from
performing circumcisions. It would also have a detrimental impact on the Jewish
and non-Jewish community, as half his clients were Muslim, he said.
But
VCAT deputy president Ian Proctor said the evidence did not give him confidence
that the serious risk posed by Goldman could be satisfactorily reduced by
banning only in-home religious procedures.
“The
paramount principle of the protection of the public and public confidence in
the safety of services provided by registered health practitioners outweighs Dr
Goldman’s personal interest in continuing his circumcision practice and
community interest in him being able to do so,” Proctor said.
The
substantive appeal will be heard at a later date.
Surely this is a procedure that
should only happen in ideal conditions (light, anti-sepsis etc.) in the hands
of someone who is fully trained in the procedure and how to manage any
complications.
The idea of this procedure happening
at a party suggests to me all those involved had / have essentially “taken
leave of their senses!” You can die of hemorrhage from this for heaven’s
sake!!!!
Worse still , it seems this bloke is
only in it for the money!
Heaven spare us from such nonsense, and practitioners of this ilk.
What a terrible story!
The first rule in the caring
professions is “first do no harm” and for this reason alone for-profit back
meddlers should stay away from all those who can’t provide informed consent for
their treatment on their own behalf!
A few days ago this appeared:
Chiropractors give themselves green light to crack
babies’ backs after four-year ban
Chiropractors
have given themselves the green light to resume manipulating the spines of
babies following a four-year interim ban supported by the country’s health
ministers.
In
a move that has been slammed by doctors as irresponsible, the Chiropractic
Board of Australia has quietly released new guidelines
permitting the controversial treatment for children under two.
The Royal Australian College of General Practitioners (RACGP) hit out at the decision, saying there was no evidence supporting the spinal manipulation of babies and children and that the practice should be outlawed. “There is no way in the world I would let anyone manipulate a child’s spine,” said Dr James Best, the College’s Specific Interests Child and Young Person’s Health chair.
“The fact that it hasn’t been ruled out by this organisation is very disappointing and concerning. It’s irresponsible.”
Spinal manipulation involves moving the joints of the spine beyond a child’s normal range of motion using a high-velocity, low-amplitude thrust.
In March 2019, the Chiropractic Board of Australia announced an interim ban on the spinal manipulation of children under two, following public outcry over a video of a Melbourne chiropractor holding a two-week-old baby upside down.
The chiropractor then used a spring-loaded device on the newborn’s spine and tapped him on the head. Then-Victorian health minister Jenny Mikakos described the footage as “deeply disturbing”.A Safer Care Victoria report at the time, which involved a systematic review by Cochrane Australia, found no strong evidence that spinal manipulation helped childhood conditions such as colic, back/neck pain, headache, asthma, ear infections or torticollis (twisted neck), despite it commonly being spruiked as a solution to these issues.
“The
major finding of this review is that the evidence base for spinal manipulation
in children is very poor,” it said.
A follow-up review last year by Cochrane Australia, commissioned by the
national healthcare watchdog AHPRA (the Australian Health Practitioner
Regulation Agency), reached the same conclusion.
The
initial review, provided to all Australian health ministers, recommended that
spinal manipulation should not be done on children under 12. It also
recommended urgent research to develop an evidence base for spinal manipulation
on children and advanced training for those providing paediatric care.
However,
in November the Chiropractic Board of Australia put out a statement to
“clarify” to members its expectations regarding paediatric care. It said a
range of care could be provided to children, including manual therapy, soft
tissue therapy and manipulation, if practitioners understand how children’s
needs differ from adults and modify their care appropriately.
Neurosurgical
Society of Australasia Board executive Dr Patrick Lo, who is also the Victorian
chair of the Royal Australian College of Surgeons, said children were
particularly vulnerable to injuries from spinal manipulation.
Melbourne
chiropractic Dr Ian Rossborough has been criticised for performing a
controversial technique on a four-day-old baby.
“Adults
have a balanced neck, head and shoulders – everything is supported – whereas
kids have a very big head-to-neck ratio,” the neurosurgeon said.
“If
you flick it around, the lollipop ball will fall off. That’s our major concern.
Those areas are so critical to the function and development of the child and we
are putting those at risk.”
Lo
said he had treated young adults who had suffered disc prolapses following
spinal manipulations performed by chiropractors. He said some of his colleagues
had treated patients who had experienced strokes following spinal manipulation.
Lo
will raise his concerns about the new guidelines for chiropractors at an
upcoming meeting with Safer Care Victoria.
Doctors
have been at war with chiropractors over the treatment of babies and children
for more than a decade.
In
2013, The Age reported on the disputed case of a Melbourne
paediatrician who claims he treated a four-month-old baby after one of her vertebrae was fractured
during a chiropractic treatment for torticollis, which causes the neck to twist
to one side.
And
in 2016, the RACGP urged its members to never refer patients to chiropractors
after a YouTube video emerged showing a
Melbourne chiropractor flexing a newborn baby’s back before pressing firmly on
her spine to produce a cracking sound. The movement, which was meant to treat
colic and reflux, caused the baby to cry.
A
spokesman for the Chiropractic Board of Australia said its updated policy would
ensure safe and appropriate care by chiropractors who treat children under 12.
He said this guidance was based on current evidence and information.
When
asked why Safer Care Victoria’s key recommendation – that spinal manipulation
not be performed on children under 12 – had not been incorporated into the new
policy, he said the board had considered the review’s common themes. He said
these included “best practice and evidence-based care, proper informed consent,
practice within the chiropractor’s skill”.
AHPRA
has received 335 notifications about chiropractors since 2021, with five of
these relating to child patients. A total of 96 notifications resulted in
regulatory action, such as cautioning a practitioner, imposing conditions on
their registration or accepting an undertaking from a practitioner.
A
Safer Care Victoria review identified very little evidence of patient harm
occurring in Australia, but noted “it was clear that spinal manipulation in
children is not wholly without risk”.
“We respect every parent’s right to choose appropriate healthcare options for
their child – when weighing up treatment options, you need to consider any risk
associated with that care against any potential benefits,” a Safer Care
Victoria spokeswoman said.
The
Australian Chiropractors Association said the review found that chiropractic
care for children was extremely safe. It said that in more than 29,000 online
submissions, there were no reports of harm to a child receiving chiropractic
care.
“Chiropractors
are registered professionals, completing a rigorous five-year university
degree-level course, equipping them with the expertise to appropriately tailor
their care to children of all ages,” a spokesman said.
The
association welcomed the board’s updated statement on paediatric care.
My view is that consenting adults
can do what they like with their bodies but they should not impose non evidence
based interventions on their progeny! It follows therefore that chiropractors should
stay away for all under 18 IMVHO!
This view is confirmed when we read
this saga:
Call for age limit after chiropractor breaks baby's neck
By Julia Medew and
Amy Corderoy
A
baby's neck has been broken by a chiropractor in an incident doctors say shows
the profession should stop treating children.
The injury was reported to the Chiropractic Board of Australia, which closed
the case without reporting it to the public and allowed the chiropractor to
keep practising as long as they undertook education with an ''expert in the
field of paediatric chiropractic".
The Sun-Herald has also seen evidence that chiropractors have been entering Sydney hospitals, including neo-natal intensive care wards and surgical wards, to treat patients without the required permission.
NSW Health has warned that any chiropractor working in a hospital without permission could put patients at risk, while the Australian Medical Association NSW says the behaviour is "outrageous".
Melbourne paediatrician Chris Pappas cared for a four-month-old baby last year after one of her vertebrae was fractured during a chiropractic treatment for torticollis - an abnormal neck position that is usually harmless. He said the infant was lucky to make a full recovery.
''Another few millimetres and there would have been a devastating spinal cord injury and the baby would have either died or had severe neurological impairment with quadriplegia,'' he said.
Dr Pappas complained to the Australian Health Practitioner Regulation Agency, which referred the case to the Chiropractic Board. Three weeks ago, he received a letter from AHPRA saying the case had been closed after the chiropractor committed to completing further education.
Dr Pappas said he was concerned the decision was an endorsement of chiropractic treatment for infants when there was no scientific evidence to support it.
''I think they have put the chiropractor's interests before the interests of the public,'' Dr Pappas said. ''[Treating infants] is inappropriate and it carries a very small but real risk of causing damage, and in some cases, devastating damage.''
A review published in the Pediatrics
journal in 2007 also found serious adverse events relating to spinal
manipulations in children, including a brain haemorrhage and paraplegia.
However, the president of the Chiropractors' Association of Australia,
Laurie Tassell, says chiropractic treatment is as safe for children as it is
for adults, and chiropractors should be able to treat patients in hospital, if
authorised.
"Chiropractic care can be remarkably gentle," he said. "Being
a five-year, university-trained spinal health expert, a chiropractor will
modify their adjustment techniques to suit the age and spine of each individual
child."
President of the Australian Medical Association Steve Hambleton said the
board needed to either produce evidence supporting chiropractic treatments for
children or rule out paediatric care. ''The AMA is not aware of any evidence
that chiropractic manipulative treatment of infants and children offers any
benefit at all,'' he said.
The Sun-Herald has seen Facebook
conversations in which chiropractors discuss methods of sneaking into
hospitals. Images, obtained by blogger Reasonable Hank, include one of a baby
being adjusted in a hospital.
AMA NSW head Brian Owler said it was "absolutely outrageous" for
chiropractors to treat patients in hospital without permission. "None of
us can go into an emergency department of a hospital and start treating
patients without proper credentials and medico-legal coverage," he said.
A spokeswoman for NSW Health said treating patients without notifying the
hospital may be improper conduct and it could be reported to the Health Care
Complaints Commission.
Chiropractors
have once again been banned from manipulating babies’ spines after a health
board reversed its controversial decision to allow the practice.
The about-face by the Chiropractic Board of Australia follows revelations in this masthead that
practitioners had quietly given themselves approval to resume spinal
manipulation of children younger than two from November after a four-year ban.
