Oxthink

Nobody is really sure what causes asthma. Many theories have been proposed. None has proven to be a scientifically accepted, universal explanation.

This article seeks to contribute to that debate by offering a less widely recognised reason why asthma may have become so prevalent over the last half-century.

Pushchairs have existed throughout the twentieth century, but it was in the mid-1960s, with the invention of the folding umbrella pushchair by Owen Maclaren, that they radically changed their design, with a much stronger emphasis on practicality.

Lightweight, compact, versatile and cheaper, pushchairs became the main source of infant transportation, superseding the bulky, monstrous prams that previously dominated. Unfortunately, to all intents and purposes, it meant that the satisfaction of baby transportation was driven more by parents’ requirements than by the baby’s needs.

Could this development have actually been detrimental to the baby? It certainly coincides with a substantial increase in asthma rates among young children.

The theory goes as follows. The way we position and handle a baby will impact its development.

When a baby is first born, its spine has a convex C-shaped curve. Over the following few months, a secondary curve, known as the cervical curve, develops. This precedes the third phase – the lumbar curve – which develops when the baby begins to crawl. Full spinal development does not occur until between twelve and eighteen months, when walking has been achieved.

These early years are obviously a very sensitive, very formative time for spinal development. Yet during this time, we will put our babies in pushchairs, into positions that are not necessarily natural to them. However you want to describe it… slouched, hunched, scooped, slumped… babies and young children can spend considerable time with their backs unnaturally curved.

Even worse, the baby will often be sleeping in these seated positions. Pushchairs and car seats are notorious for sending infants to sleep. In fact, many parents use the pushchair walk or drive time in the afternoon as an opportunity for the infant to nap.

Sleep is the time when infants grow. They are therefore potentially experiencing growth phases when in a strained, unnatural position. Under such circumstances, it would be all too easy for any growth to be distorted. Their bones – particularly around the spinal cord – may become misaligned, misshapen or unbalanced.

Such imperfect, unnatural growth may not be readily noticeable, but it may nevertheless be sufficient to impact their bodily functions – in this case, on their ability to breathe efficiently.

In fact, these deformities may only affect the child as it gets older and makes greater demands on its body.

The mispositioning of the bones puts pressure on the nerves around the neck and chest, so the child’s airways do not respond as they should when exposed to certain undesirable elements – pollutants, dust, allergens. The child then experiences an asthma attack because their body is not able to defend itself from the foreign intruder.

Nowadays, there is much better guidance on pushchair use for newborn babies, stating that they should be kept flat and that they should not spend too much time in their pushchair or car seat. The importance of having horizontal placement is widely recognised for correct spinal development. This may account for the slight reduction in childhood asthma growth over the last decade.

Yet this advice is very general. There is limited information on when the growing infant should progress from a lying to a seated position.

One must also question whether parents always heed this advice. They may be deterred from purchasing a carrycot by the added expense, or they may find that the baby outgrows it too quickly.

Health professionals know that poor posture leads to poor breathing – shallow, distorted and restricted. By “incarcerating” babies in inappropriate pushchairs and car seats, we are not only hindering their natural growth and development, but we are also remodelling it into an unnatural and potentially disabling shape.

There has only been limited research into any direct link between spinal development and asthma.

In 2004, Hostbaeck identified a correlation between back pain and asthma among infants and adolescents.

Lopes (2006) identified postural distortion patterns in asthmatic patients. This made it more difficult for them to breathe.

Lunardi (2011) reported that patients with asthma had certain physical characteristics: they tended to lean their heads and shoulders forward, their chest wall had less expansion, and they were less flexible in the thoracic spine.

Some chiropractors do promote treatments as a means to cure or, more likely, ease asthma suffering. They claim that chiropractic treatment can help correct poor posture and spinal alignment, thereby eliminating nerve obstructions around the lungs. In so doing, releasing the restriction, it allows the thoracic cavity to expand as required. Currently, the evidence appears mainly anecdotal.

Of course, pushchairs cannot be singularly responsible for asthma. Our posture is influenced by other factors as well, which may explain why asthma can develop in people at various stages of life, including adults. Children will experience knocks and falls, which can have an impact; they will spend too long slouching in front of the television or on games consoles; they may be obliged to carry heavy rucksacks or bags to school.

Similarly, with adults, poor posture can be caused by our sedentary lifestyle – driving, desk jobs, being overweight, and watching too much television.

Ultimately, we must accept that whenever we move away from what nature intended, there will be consequences. Nature intended for babies to be carried. It may therefore be that, by using pushchairs as widely and often as we do, we are affecting our physical development and thereby the ability of our bodies to function effectively. Asthma could be one such consequence.

© Copyright Steve Oxley 2017