Re-Evaluating Common Pediatric Complaints Through the Lens of Osteopathy

Anatomy and physiology are highly emphasized in osteopathic medicine, with the use of palpation of the body as an integral tool. Hands-on palpation allows us to assess motion: Is there motion? Is motion restricted? Is it symmetrical? Can the anatomy move better to enhance nerve function?

Through an osteopathic lens, we can re-evaluate common pediatric complaints:

Colicky Baby (or “Fussy Baby”)

This presentation is challenging because parents are exhausted trying to understand why their child is not at ease. Conventional medical views often focus on dietary causes – recommending a food diary for breastfeeding moms or switching formulas – and/or maintaining that the child has reflux.

An additional variable I invite providers to investigate is anatomical restriction, including restriction in the head, which compromises the nerve functions of the gut (the vagus nerve). This incredible nerve that provides a necessary balance to our nervous system comes from the brain out of a hole in the skull, specifically the occiput bone. This bone is in the back of the head and is one of the most common restrictions of newborns from birth.

Optimizing proper motion within the different cranial bones enhances the physiological expression and tone of the incredible nerves that exit the skull from the brain.

Poor Breastfeeding Latch

Cranial nerve number 12 comes directly from the brain through a canal between the occiput and temporal bones on both sides of the head, with the main innervation to the tongue. Compression between these bones at birth impinges on the canal through which the nerve flows, restricting its full proper function. This life-saving suction function is a vital stepping stone for a child’s survival, growth, and development.

A common occurrence is a mother’s poor milk supply. This can occur due to several variables that must be explored (diet, stress, sleep). As a variable, we need to take into consideration the child’s latch and the quality of suction at the breast that stimulates milk production. If a child’s suction is not sufficient in a few months, the milk supply diminishes.

Torticollis

A common pediatric finding is torticollis. This is when the baby has a head turn preference. Torticollis can range from a subtle presentation – such as a neck preference – to a more drastic presentation, such as an inability to turn one's head. There are many circumstances that can lead to torticollis: the baby’s position in the belly, cords around the neck, positioning during
birth, pitocin use during labor, and pushing more than two hours.

I recommend that torticollis not be viewed as something babies grow out of. This head motion restriction complicates the breastfeeding relationship, the child's comfort, and the body’s compensatory pattern down the spine and sacrum. It can also challenge the child’s neuromuscular skeletal development and strengthening.

The neck muscle that most commonly becomes hypertonic (contracted) during this presentation is called the sternocleidomastoid muscle. This muscle is attached to the sternum (“sterno-“), clavicle (“-cleido”), and the mastoid process of the temporal bone (mastoid). Restriction of this muscle inhibits motion in these areas of the body. This is the subtle pattern in an adult whose head tilts to one side when posing for a picture or conversing.

Ear Infections

The occurrence of one ear infection is most commonly an indication of restriction within the cranium that didn’t allow proper drainage of the tube that drains the ear. Medical management is appropriate but does not address the root issue as to why this child has an ear infection. Some parents choose to have surgery to address recurrent ear infections, and although that may be the right choice for that child in order to lessen antibiotic exposure and sickness, it does not address the root cause.

We shouldn’t settle in our ways, accepting common illnesses and procedures without inquiring why. Why THAT child and not another? What did their birth history look like? Was it a C-section? Was there pitocin used? Was the baby breastfed or solely bottle-fed? How many ear infections have they had? How does their tongue function? Were there difficulties with breastfeeding? Torticollis? Was this a fussy baby? Did they like tummy time?

In my clinical experience, osteopathy has significant use in the pediatric setting as a preventative and non-invasive approach to restoring the body’s function to its most natural processes.