Chest-tapping ridiculed as 'joke' treatment

By Martin Johnston

health reporter

Chest-tapping physiotherapy on premature babies has been held up to international ridicule, according to an Australian expert opposed to the practice.

Dr Neil Campbell, a neonatal specialist at Royal Children's Hospital in Melbourne, said yesterday that during a "joke session" at a United States conference last year participants discussed the "10 most useless treatments" for babies in intensive care.

"Number one on the list, at last, was chest physiotherapy.

"For 20 years we have been telling everyone it's a waste of time and potentially harmful."

Dr Campbell said it destabilised babies, potentially triggering a sequence that could occasionally lead to brain damage, although not to the rare type of injury discovered at National Women's.

In contrast to that view, the inquiry into the 13 brain-damaged babies at National Women's, five of whom died, did link the injuries to the chest therapy, which was used to help remove secretions and practised from 1985 to 1994.

Only one other hospital in the world - in Birmingham, England - has reported cases of the rare brain damage in live-born babies. Fifteen babies suffered from it from 1988 to 1990 and all but one died.

Chest physiotherapy was practised at the hospital but doctors there did not believe it was the sole cause of brain damage. The treatment was not mentioned in a 1992 article on the injuries.

Staff of Mater Mothers Hospital in Brisbane told the Auckland inquiry that it had used chest physiotherapy on premature babies for 20 years without a reported case of brain damage.

Yesterday, however, the hospital said that owing to its involvement in the inquiry it was inappropriate for it to comment now.

Dr Campbell said Mater was a strong advocate of the treatment but had recently published a systematic review of medical literature on the topic.

The article concluded that there was no evidence of any benefit for the babies, he said. "I cannot imagine that Mater still practises the way it's advocated over the last 10 to 15 years."

Ten years ago, some form of chest physiotherapy, from finger vibration though to tapping with a face mask (as done at National Women's), was common in Australia but he doubted that was still the case.

National Women's general manager, Gary Henry, said comments raised at a recent conference had little to do with what happened at the hospital in 1993 and 1994.

"What people know in 1998 or 1999 is very different from what was known in 1985 when chest physiotherapy was introduced here, and I mean this wasn't the first place that introduced it."

If Dr Campbell had been concerned for 20 years then he should have published research material on the issue, Mr Henry said.

"If Neil Campbell published something 20 years ago that said chest physiotherapy was harmful, I would be absolutely staggered."