EFFECTS OF BIRTH ON BABIES – AN OSTEOPATH’S UNDERSTANDING BY PAMELA SYNGE DO
Restriction of movement throughout a baby’s spine can occur prior to birth, particularly when the baby is very big or if there are twins or triplets. As the amount of room for the baby to move gets smaller towards the end of the pregnancy, the baby / babies may get stuck in one position. This may cause, for example in a breech position, pressure on the top of the head with the head and neck tilted to one side. With twins, one twin may move a lot but the second twin may be stuck in one position for a long time and moulds in this position.
The birth itself may cause restriction of movement throughout the spine, especially in the neck and shoulder region. With a vaginal birth, the head may be coming down the birth canal at an odd angle and this may lead to the head getting stuck. This in turn may lead to the labor failing to progress and the delivery ending with the application of suction, forceps or even C-Section.
Even the most straightforward vaginal birth may cause impaction of the upper neck and shoulder area.
Acceleration and induction (artificial rupture of the membranes, gel and oxytocin) cause stronger uterine contractions which exaggerate the forces going through the baby’s spine and particularly the upper neck.
C-Sections can also cause mechanical joint restrictions throughout babies’ spines, especially if a lot of tugging and pressure is required to deliver them.
Shoulders may get stuck during both vaginal and C-Section deliveries. The most extreme example of this is shoulder dystocia, but the upper ribcage and collar bones may be subjected to strong forces during all types of delivery. This will result in the baby being difficult to wind, dress and raise the arms. This may cause discomfort when the baby is put on its tummy and reluctance for the baby to weight bear through flexed elbows. This in turn may lead to the baby either lying face down with its arms by its sides or immediately flipping onto its back. Thus in turn may result in the baby not crawling later on but preferring to bottom shuffle instead.
Restriction of movement in the upper neck may lead to problems particularly with breastfeeding. It may cause headaches and disturbed sleep, and because the nerve supply to the stomach controlling acid production and peristalsis (movement of the gut) exits the skull next to the top joint in the neck, upper neck impaction may cause congestion in this area which could affect this nerve and contribute to or even cause reflux.
Problems with breastfeeding are multifactorial. Maternal problems with breastfeeding may arise from poor milk supply. Inverted nipples will cause a problem with the latch. A poor diet or lack of fluid intake in the mother will affect the quality of her milk. A thrush infection in the mother’s nipples may cause severe pain when breastfeeding and thrush in the baby’s mouth may cause it discomfort while nursing. Tongue tie may be an important factor in breastfeeding problems. If snipping the tongue tie is recommended, it can make a huge change in the way the baby uses its tongue while breastfeeding.
But from an Osteopathic viewpoint, restriction of movement in the baby’s upper neck will have a profound effect on the ease and comfort with which the baby can latch on and stay on the breast.
The top joint in the neck is designed to allow the head to tilt backwards and forwards in a nodding movement. The second and to a lesser extent the third joint in the neck allow the head to rotate from side to side. To be comfortable on the breast, a baby will tilt its head back, rotate it and bend it to either side, open its mouth wide, latch on around the areola and suck and swallow rhythmically. If the baby is comfortable on the breast, there should be no reason why it should pull off the breast and bit the nipple.
If it is fussing trying to latch onto the nipple, its latch is small so its mouth is around the nipple and not around the areola, it will be draining some of the milk lobes in the breast but not others. This predisposes the undrained lobes to mastitis. Draining the whole breast encourages milk production; if the latch is poor the milk supply will not be optimal.
When the baby’s upper neck is not able to tilt backwards and rotate and bend to either side with ease, this can lead to discomfort in the upper neck with the baby coming on and off the breast, tugging at the nipple and fussing at the breast. Some babies will adapt to this by becoming very fast feeders and getting all the milk they need in a five minute feed rather than in a leisurely fifteen or twenty minute feed.
Preference for one breast or another would indicate an upper neck restriction of movement and this could further manifest in a preference to lie on one side of the head when sleeping, leading to a flat patch (plagiocephaly) on that side of the back of the head.
If there is restriction of movement in the baby’s upper neck, this may cause congestion at the base of the skull and this may manifest as puffiness around the eyes, sticky eyes and congestion in the middle ear predisposing to glue ear and middle ear infections. This can also cause headaches and disturbed sleep with children waking frequently crying or later on with what are thought to be night terrors.
Gentle Osteopathic release of the restricted joints throughout the body can help to make these babies more comfortable. With breastfeeding problems, sleep disorders and reflux, treatment to the neck and shoulder area may resolve problems especially regarding a small latch or preference in feeding from one breast (tongue tie should not cause the baby to feed better on one side or the other – it causes a problem with the use of the tongue but not rotation of the neck or the inability to open the mouth wide).