Pregnancy and Children: Cautions with Hands-On Therapies

If you are pregnant, or caring for a baby or child, a hands-on therapy raises a different set of questions than it does for a healthy adult. Pregnant bodies change, and the evidence base for babies and young children is thin. This page summarises what public health sources say, in plain terms: advice for pregnancy and breastfeeding, what is known about spinal manipulation in children, and how little we know about specific techniques. It does not recommend or discourage any therapy. Individual situations differ, and your own doctor, midwife, paediatrician or other qualified health professional has the final word.

Pregnancy: start with your maternity care provider

The most consistent message across the sources we opened is to talk to the people already looking after the pregnancy before trying something new. NHS Wales, in its osteopathy guidance, says that if you are pregnant you should seek advice from your GP or midwife before you see an osteopath, and that you should also see an osteopath who specialises in muscle or joint pain during pregnancy. The same page says you can see an osteopath during pregnancy, so the advice is about sequence and suitability, not a blanket ban.

The NHS pregnancy pages take a similar line on complementary therapies in general. They state that not all natural remedies or complementary therapies are safe in pregnancy. They advise telling your midwife, doctor or pharmacist if you are using such therapies, consulting a qualified practitioner if you decide to, and telling that practitioner you are pregnant before any treatment is discussed. They add that complementary remedies or therapies cannot replace conventional antenatal care. That page focuses on herbal, homeopathic and aromatherapy remedies, so we read it as general guidance rather than a statement about any particular hands-on technique.

In the United States, NCCIH's page on women's health says, about exercise, that you should talk with your health care provider to make sure there is no medical reason you should not exercise, and to learn whether to adjust your activities, including yoga, during pregnancy. It says the same kind of thing about ginger supplements: consult your health care provider. It does not address manual therapies in pregnancy, and we found no US or UK page among those we could open that gave a technique-by-technique ruling. If you want help preparing for that conversation, see questions to ask your doctor first.

What the sources do not say

It is as important to be clear about gaps. The pages above do not rate the Bowen Technique, massage or other gentle hands-on methods as safe or unsafe in pregnancy, and we did not find a source we could open that does. Absence of a warning is not the same as a finding of safety. For how to weigh whatever research does exist, see what research shows for manual therapies.

New, severe or worrying symptoms in pregnancy are a reason to contact your maternity care team promptly instead of seeking a therapy first. See red-flag symptoms that need a doctor for the general list.

Breastfeeding

The sources are sparser here. NCCIH notes, for example, that little is known about whether ginger or higher amounts of fenugreek are safe while breastfeeding, which is a reminder that safety questions do not end at birth. For hands-on therapies we found no specific guidance, so the reasonable course is the one the NHS gives for pregnancy: tell the practitioner you are breastfeeding, and tell your midwife, health visitor or doctor what you are trying.

Babies and children: what NCCIH says

NCCIH's page for parents is candid about the state of knowledge. Its bottom line is that we know a lot about usage rates of complementary health approaches for children but little about their effects and safety. It adds that studies have looked at many approaches for different conditions, but the evidence generally is not strong enough to show what works and what does not, and that many approaches have not been tested for safety in children.

On manual methods specifically, the page says that biofeedback, guided imagery, hypnosis, mindfulness and yoga have some of the best evidence of being effective in children for certain symptoms and are low-risk, but that spinal manipulation, a common complementary approach, is associated with rare but serious complications. Spinal manipulation means a quick, controlled movement applied to the spine, and it differs from gentle massage or light touch methods. Our reading is that the NCCIH sentence applies to manipulation, not to every hands-on technique, but the page does not break the category down further.

It also gives practical steps. Make sure your child has an accurate diagnosis from a licensed health care provider. Do not replace or delay conventional care or prescribed medicines with something that has not been proven safe and effective. Ask your child's health care provider about effectiveness and possible risks. If you look for a practitioner for a child, NCCIH says to ask about their experience in coordinating care with conventional providers, their experience in delivering care to children, and their education, training and license. More on that process is in choosing a practitioner and what to ask.

Spinal manipulation in young children: the research

A 2020 rapid review in the journal Chiropractic & Manual Therapies, by Corso and colleagues, looked at the safety of spinal manipulative therapy in children under 10. A rapid review is a faster, streamlined version of a systematic review, which means it follows set methods to find and appraise studies. The authors reported that most adverse events were mild, such as increased crying and soreness. They described one case report of a severe adverse event (a rib fracture in a 21-day-old) and another of indirect harm in a 4-month-old, where a diagnosis was delayed. Reported rates of mild events ranged widely, from 0.3 percent to 22.22 percent.

The authors concluded that the risk of moderate and severe adverse events is unknown, and that it is unclear whether spinal manipulation increases the risk of adverse events in children under 10. They called for research to determine how often events occur. In plain terms, the review does not show that manipulation is dangerous or safe for young children. It shows that the data are too limited to say. The delayed-diagnosis case is a useful reminder of a different kind of risk: a hands-on therapy used for a symptom, such as a tilted head, can delay medical assessment of its cause.

Bowen-specific claims for babies and children

You may see claims that the Bowen Technique helps babies or children with colic, sleep or breathing. None of the sources we were able to open evaluates the technique in babies or children, so we cannot describe any pediatric evidence for it. Our position is the cautious one: treat pediatric claims as unproven unless you see high-quality trials, and read how to read health claims before relying on testimonials. For general background on the technique, see what the Bowen Technique is.

If a practitioner tells you a baby or child needs treatment to prevent a problem later, or discourages seeing a paediatrician, treat that as a warning sign and ask your child's doctor. Ahead of any visit, what a first session involves, and staying safe can help you plan what to ask.

The short version

For pregnancy, breastfeeding and childhood, the public sources point the same way: speak to your maternity care provider or your child's doctor first, tell any practitioner about the pregnancy or the child's health, and keep regular medical care. For babies and children the evidence on hands-on therapies is limited, and we found nothing that supports Bowen-specific claims in these groups.