Tobias Moteberg would not be confined to the chiropractor's waiting room. The 1-year-old grinned mischievously at his mother before he bolted down the hall at a half-run, half-waddle.

"I play!" he announced, heading for the toy-filled room where he'd have his checkup.

A year ago, Tobias had his first visit to a chiropractor. He's the newest Moteberg to receive chiropractic care, joining four other siblings ranging in age from 3 to 16.

"We knew that as our children were growing that we would seek chiropractic care as they had growing pains and accidents," said his mother, Kimberly Moteberg. "And Tobias, he's a mover and a shaker."

The Motebergs see Dr. Anne Langford, a St. Paul chiropractor who specializes in pediatric care.

"For an infant, their only way to tell a parent they don't feel good is by crying," she said.

Most parents interpret crying to indicate hunger, fatigue or a digestive issue such as reflux. But in Langord's experience, it also could point to a spinal alignment issue that could be fixed by chiropractic adjustment.

When the time for Tobias' checkup came, he made himself at home in a room that looked nothing like the typical doctor's office. The walls were covered in a three-dimensional ocean scene, and there were buckets of toys. Tobias headed straight for a fire truck.

"With a 2-year-old, you've got about 20 seconds to get it done because they're either yelling at you or want to be done," Langford said. Hence, all the toys to distract them.

His mother lay on the adjustment table with Tobias on top of her, while Langford gently probed along his spine.

"It's hard to describe to a young kid what they're going to feel," she said. "So I always have them near Mom and Dad so that they're not afraid."

She carefully turned Tobias' head to the left and to the right. When he heard the tiny pops from his adjustment, his eyes widened.

"Their spines are just like an adult spine but a miniature version," Langford said. "The chiropractic care is relative to their size."

According to the Centers for Disease Control and Prevention, 3.1 percent of children in the United States were treated by chiropractors in 2012.

"That's a total of almost 2 million children in 2012 that received chiropractic and osteopathic care," said Dr. Elise Hewitt, president of the pediatrics council for the American Chiropractic Association. In her practice, she frequently treats infants who are having trouble sleeping or nursing.

Langford most commonly sees babies with persistent ear infections or reflux (colic). She said many parents bring their children to a pediatrician as soon as the youngsters get a runny nose, which often leads to an antibiotic prescription.

"So parents get frustrated. They've been at the pediatrician for two or three months and their kid has been on three or four antibiotics," she said. "More often than not, it's a structural thing that's causing the ear infections. So they end up here."

Langford sees a similar cycle with reflux.

"The million-dollar question is: Where does it come from?" she said. "And the answer is birth."

Kimberly Moteberg agreed. She visited Langford throughout her pregnancies and shortly after her children's births.

"I think we've always understood that there's such rapid growth when a child is growing, and the birthing process — I don't ever say traumatic, but it can be dramatic," she said. "So it has always sat right with us to have someone who understands the vertebrae be able to take a look at little guys early on."

Communication is key

Dr. Emily Borman-Shoap, newborn medical director at the University of Minnesota Medical Center, said she advises her patients to communicate with all the members of their health care team.

"Our goal as a medical part of the care team is to make sure the other therapies that are being offered are safe for the baby," she said. "I really don't know if it [chiropractic] might be helpful. I know there's a tiny chance it might be harmful, so it needs to be done carefully."

Anne Nelesen, a St. Paul mother of four, brought her son Peter to a chiropractor when he was 3 months old.

"He would start to get crabbier and crabbier and crabbier," she said. "He was so pale and fair and red-eyed from crying, and after an adjustment a peace would come over him."

But she hasn't always been a believer.

"Prior to Peter being adjusted, I always thought chiropractic care was kind of quacky," she said. "It was a little too alternative for me. But I really am a convert."

A polarizing issue

Nelesen isn't the only one who has experienced doubts. Chiropractic care can be a polarizing issue.

Moteberg has Facebook friends who send her articles warning of the dangers of excessive chiropractic treatments. She doesn't put much stock in those articles. "But I do know that any treatment in excess, well, I mean, you can drink too much water and die," she said.

With chiropractic care, there's more anecdotal evidence than documented research data.

"The problem with researching chiropractics is you either do the adjustment or you don't. You can never do a double blind study," Langford said. "With drugs, you either give them the sugar pill or the real deal, but you can't fake an adjustment."

Borman-Shoap said the lack of research makes it difficult to know which conditions in young children would improve with chiropractic care.

"What I usually tell parents is to have an honest conversation with the chiropractor about what kinds of treatments they plan to offer," she said. "And I do know that there are certain conditions I [as a pediatrician] would want to know about to make sure the child is getting proper treatment, like ear infections."

For her kids, Nelesen tends to take little bumps, bruises and sprains to the chiropractor. But she will go back and forth between their pediatrician and chiropractor for more serious problems.

Chiropractor Langord said, "I don't think that our two paths will ever collide completely because [pediatricians and specialists] work with acute management and we mostly do prevention and rehab. So it's two philosophical approaches. It's just different, not better, not worse. Just different."

Libby Ryan is a Minneapolis-based freelance writer.