As a student in manual osteopathy, I often heard from teachers and osteopathic practitioners on how wonderful osteopathy is in the treatment of a newborn. In 2016, when the time came for me to choose a subject for my thesis, it was obvious to me that I wanted to investigate a bit further on why and how to treat newborn in my practice. I thought that if I could help someone, why not starting at the very beginning of their life. I also thought that if I was going to learn about paediatric osteopathy, why not ask osteopaths who specialize in their treatment and learn from the best. I left Revelstoke to travel around Canada to meet with manual osteopaths who have been treating babies, for some of them, 3 decades, and ask them kindly to share their experience with me. The subject of gastro-esophageal reflux naturally came up for me, as it is one of the most common complaints in paediatrics. The following is a quick resume of my findings during my thesis and later in my practice as it allowed me to help many little ones since..
Gastro-Esophageal Reflux in Newborns
Gastro-esophageal reflux or GER is defined as the passage of the acid content of the stomach into the esophagus. This gastric acid can travel all the way up into the mouth and sometimes in the nasal cavity. Up to 85 % of babies will have it at some point before the age of one. It can be accompanied with regurgitation, most of the time after breastfeeding or after their meal but it can also occur a few hours after feeding. Regurgitation is not a good predictor of the severity of GER as gastric acid in the esophagus and in the upper respiratory system can be very uncomfortable because of the burning sensation it triggers. Many babies will unfortunately be suffering in silence. Furthermore, a recent study from the Department of Paediatrics at Oxford Universities has revealed that babies feel pain as much as four times more intensely has adult. So imagine that burning sensation you get when you had the wrong combination of food and alcohol being amplified four times! Very uncomfortable, right? If the lining of the esophagus becomes affected by the constant irritation, it can lead in some cases to Barrett’s Esophagus and Gastro-Esophageal Reflux Disease or GERD and may require surgical procedure.
The “Happy Spitters”
Most of us have seen babies regurgitate and smile back at us right after. These little ones are referred to as “Happy Spitters”. It is commonly believed that minor regurgitations are normal in early life. It is a known fact that the digestive system can take up to 6 months after birth to fully mature and acquire the necessary motor coordination to keep the food down in the stomach. But Dr. Viola Frymann, a prominent doctor in Osteopathy from the United Stated reported that it is no more normal for a baby to vomit than an adult. Dr. Frymann stated this vomiting directly results in the irritation of the vagus nerve as it exits the base of the skull, an area found in tension in more than 80% of babies following birth. In an earlier blog Becky outlined the importance of the vagus nerve and its tributary functions…here is just another example.
What causes babies to have GER?
It would be too easy to believe that GER is caused by only one thing. What I found is that there is a list of factors that seem to be often involved in its appearance. The more factors involved the more the chances that a newborn will have GER. The newborn’s parents will bring him/her into our office at Ananta Wellness & Osteopathy saying that their newborn is inconsolable or cries all the time and they don’t know what is going on.
Here is a list of contributing factors:
• Twins; restricted intra-uterine environment
• Breech position intra-uterine, at birth or breeched in birth canal
• Caesarean section
• Epidurals
• Delays during labor or labor stopping
• Use of forceps, vacuum and ventouse
• Stress during pregnancy
• Stress in family or with parents
• Difficult birth
• Abnormal head presentation during labor
• Cord wrapped around neck, head or limb
• Premature babies
• Fetal distress
• Intra-uterine positioning (baby seems to be always on the same side of mom’s belly)
Signs that your baby may have GER
Sometimes GER will not be a major problem but it can contribute to other infantile issues. If the baby is uncomfortable because of burning, he or she will most likely try to alleviate the pain by adopting a certain posture or general attitude that can easily be seen and parents will often agree that they see their newborn in those positions. The easiest way for a baby to not be in pain is to move his head away from his stomach so you will see a baby that either side-bends like a banana and will often be arching backward, especially when eating and if mom has a strong milk let down.
Here are some signs that your baby has GER:
• Difficulty feeding; pulls away from the nipple often
• Seemingly difficult latch
• Banana or side-bending position
• Difficulty sleeping at night
• Parents feel they have to feed their young often
• Chronic bronchitis, bronchiolitis or rhinitis
• Chronic ear infections
• Baby doesn’t like being on tummy time or only wants to be on tummy
• General irritability
• Regurgitates on every feed or hours after feeding
• Difficulty gaining wait
How do we treat babies with GER?
The osteopath will make a complete history of all events concerning pregnancy, childbirth and the health of the newborn. Everything is listed to be able to recognize what may have influenced the condition of the newborn. Subsequently, an objective evaluation is performed to assess the posture, mobility and vitality of the newborn:
• The overall posture of the baby and the position of the head
• The shape of the skull to detect possible cranial deformities
• Symmetry of the face, upper and lower limbs
• Overall mobility of the spine and pelvis
• Abdominal flexibility
• Respiratory capacity through the diaphragm
Following this comprehensive and precise evaluation, the Osteopathic Practitioner at Ananta Wellness & Osteopathy will be able to draw up a treatment plan. Osteopathic techniques are gentle and respect the adaptability of the newborn. Treatments can be shorter and most of the time the osteopath will be able to complete their intervention by giving you advice, exercises and positioning to do at home to consolidate the treatment.
Early intervention in osteopathy is the essence of prevention. As long as the child is growing, anything is possible. Osteopathy does not replace the follow-up with the family doctor or the paediatrician, but when everything seems normal and the baby is still not comfortable, osteopathy offers an alternative by optimizing the system of natural self-regulation of the patient’s body. And lets face it, an inconsolable baby can be a very stressful for parents, so do yourself and your baby a favour by starting his or her life in good caring hands.