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Doctors have condemned the return of the controversial practice by chiropractors of manipulating babies' spines, describing it as "deeply disturbing".
The lifting of an interim ban on the practice in the Chiropractic Board of Australia's updated guidelines has led to calls for state health ministers across Australia to intervene and ban the practice.
"It's reckless, as far as I am concerned," said Dr James Best, the chair of child and young person health at the Royal Australian College of General Practitioners (RACGP).
The Chiropractic Board of Australia issued new guidelines late last year, allowing spinal manipulation in children under the age of 12.
The board said the new advice "superseded" an interim ban on the practice dating back to 2019.
Serious concerns were raised about the practice following a 2018 social media post of a video showing a Melbourne chiropractor manipulating the back, hips and collarbone of a two-week-old baby.
The baby is shown crying as the chiropractor uses a spring-loaded device called an "activator" on his neck, tailbone and spine.
Dr Best has seen the video, which has since been taken down from Facebook.
"A shiver goes down my spine when I see that," he said.
The spinal manipulation of babies has been touted as a way to manage issues of colic, back and neck pain, ear infections and twisted neck.
But Dr Best said there was no evidence it was effective.
"It's certainly something I wouldn't do to my child, so I would advise parents to not allow this sort of practice to be done to your child," he said.
"The spinal columns of young children and babies are really susceptible to injuries."
In a statement on Thursday, a spokesperson for the Chiropractic Board of Australia said in 2022 it commissioned Cochrane Australia to review the effectiveness and safety of spinal manipulation in children under 12.
"Overall, the findings were consistent with the findings of other systematic reviews and the review commissioned by Safer Care Victoria (SCV) in 2019," the statement said.
The board said both the Cochrane Australia and Safer Care Victoria studies, as well as others, found not enough research had been done "to draw conclusions about the safety and effectiveness of spinal manipulation in children".
Despite this, the board still updated its guidelines to allow the practice to resume.
It said notification data to the health practitioners' watchdog, AHPRA, and "independent review consultation" by Safer Care Victoria revealed no "reports of serious harm in children receiving chiropractic care in Australia".
The board said it also considered community needs and expectations, specifically, what it said was the strong support for consumer choice voiced in the public consultation of the independent review.
"Public safety is our priority, and especially so when we consider the care of children," board chair Dr Wayne Minter said when new guidelines were released last year.
A spokesperson for the board said it had updated and strengthened its guidelines to ensure safe and appropriate care by chiropractors who treat children under the age of 12.
But Dr Best said there was not enough research or evidence to justify allowing chiropractors to manipulate the spines of babies and young children.
"They just don't have the safety data," he said.
"I would like health authorities and maybe even health ministers to intervene, I think this is something that should not be allowed."
A spokesperson for Health Minister Mark Butler said the minister had asked the Chiropractic Board for an "urgent explanation" of its decision, "in spite of two reviews concluding there was no evidence to support that practice".
Mr Butler also intends to raise the issue with state and territory health ministers during a scheduled meeting on Friday.