I have a special interest in and love of working with newborns. Treatment can begin on day one. It is a safe and very gentle approach.
Birth is a major transition for a baby, which involves a journey from darkness to light, warmth to not so much warmth, the first physical scar as the cord is cut, the transition from being sustained through the belly to breathing and feeding, and the first experience of skin to skin contact and touch outside of a fluid filled envelope. Some change all of a sudden!

In birth the passenger/passage fit is a wonderful natural design. The passenger (baby) is perfectly designed to travel through the passage (birth canal) although, when compared to other mammals, the "fit" is somewhat tighter!

Although caesarean rates have soared, the norm is a baby that can make the journey through the passage. In doing so Viola Frymann DO explains that the baby's head is made to give.

1) "the maximum accommodation to the forces of labour" i.e. is malleable
2) "the minimum trauma to the delicate nervous system" ie. is protective
3) "the utmost capacity for restitution after labour" i.e allows "elastic deformation" (changes shape back towards the original)

I. in accommodating labour the head of the baby shape shifts and telescopes ("moulds" or "de-forms"). The bones can override each other to make the head smaller. The degree of overriding is controlled by the dural membranes which also tether the nervous system internally.

II. the bones, membranes and fluid within the head transmit force in such a way that helps ensure that damage to the brain and spinal cord is unlikely.

III. The head has the ability to "re-form" or resort towards its original shape ("remould") after the journey through the passage.


Cranial Osteopathy is a wonderful tool to assist this process, helping the body in its own efforts to resolve birth strains (involving a change of shape of parts and relationship between parts).

I am often asked whether the body would resolve these strains without the assistance of the Osteopath. My answer is "only sometimes and usually more slowly" but, the body does have incredible powers of self healing. The restitution is assisted naturally by the baby's actions of sucking, yawning and crying.

The amount of moulding is affected by:

1) whether the baby is pre, full or post term (gestational age and maturity)
2) the shape of the mother's pelvis and any pelvic or back restrictions inhibiting the ability of the passage to accommodate the passenger
3) the presentation and position of the baby
4) medical intervention in labour including pain control and assisted or instrumental delivery
5) medical induction
6) whether the birth is vaginal or caesarean

All these factors determine the nature, degree and duration of forces exerted on the baby.

This is why we ask about your birth story before assessing the baby. If you had a hospital birth, the discharge summary is a useful document to keep a copy of and bring with you. If you attend before your birth , please remember to bring a copy of your maternity notes.

It is also why we do so much to encourage couples to prepare themselves for birth with credible and highly effective birth instruction, such as HypnoBirthing and Breathe to a Better Birth. I am aware of the difference a calm and gentle birth makes to the baby's cranial mechanism.

Premature babies
From a mechanical point of view, because premature babies are often smaller, there may be less stresses and strains retained from the birth journey in single pregnancies.
This is just as well as the connective tissues of premature babies are less well developed, making them more vulnerable and less able to withstand birth trauma.
Reflux is common in premature babies partly due to reduced stomach sphincter tone and in my experience, may respond well to cranial work to balance tensions around the diaphragm.

Flat heads ("Plagiocephaly")
Lack of symmetry in head shape in the first 3 days is more common in first babies, after assisted delivery or cephalohaematoma or when labour is prolonged.
Only rarely are flat heads in infants due to fusing of the head "joins". Usually the "joins" are not fused and early asymmetry can lead to flattening and a preference for lying with the head in one position.

The back of the head can flatten on one side or both - a condition named "deformational plagiocephaly".
This can cause feeding issues and often we and lactation consultants observe that head flattening and sucking problems coincide.
It is important to ensure that there is adequate mobility in the neck to allow full rotation both ways. Mild flattening does not usually cause significant issues but can potentially contribute to infantile postural asymmetry (IPA).
It does not affect the development of the brain, or nervous system.

Tips for avoiding or reducing head flattening:

Encourage turning (rotation) of the neck when baby is on their back by getting the baby to look both ways.
Use either bright objects or things that "jangle" (e.g. torches, mobiles, toys, bunches of keys).
Any cot mobiles should be placed at the foot of the cot rather than directly above the head.

Since the research on cot deaths the advice has been to not to let babies sleep on their tummies but, lying them always on their back has led to an increase in the incidence of head flattening. If you put your baby down on its side, remember to alternate sides. If you choose the side lying position, it is important to have cot bolsters that prevent the infant moving on to its front from its side while asleep. If ever you notice that this has happened, it is advised that the baby is moved.

Some experts favour the side positions to supine (lying on the back), because there is less chance of airway obstruction. Bolsters can also be used when baby is on its back.
If baby sleeps on its back, observe head movement and check that one side is not favoured over the other.

If the cot is against a wall, alternate which end the head is placed as the baby will be more likely to look into the room than at the wall. Avoid letting the back of the head rest on hard surfaces when baby is awake or asleep.

Some supervised time on their tummies while they are awake also helps reduce a tendency to flattening of one side of the head.
If baby is bottle fed, alternate the way round you hold them just as they would alternate sides if breast fed. When handling or lifting babies always support both the head and bottom (as if they were supported in a hammock) and only have the baby in a car seat when it is actually in a car.

Soft slings may be best when carrying your baby.


Wry necks in babies (infantile torticollis)
Wry neck can be associated with "flat heads" and a definite preference for one breast or feeding position. Even a slight rotation in the upper neck without obvious torticollis can give difficulty feeding on one side or a preference for the other.
Whilst you can experiment with different feeding positions, it is better to fix the strain in the neck or base of the head so that the baby is comfortable at both breasts.

The muscles of the neck are important in maintaining head position and keeping the airway open.
The eleventh head nerve ("spinal accessory") which travels through a hole at the base of the head/top of the neck ("jugular foramen") is important in developing and maintaining head control. Any strain in the area can affect the nerve's function and should therefore be fixed as early as possible. Wry neck also means that a baby often develops a preferred sleeping position and therefore it predisposes to "flat heads".
As well as attention to the head, it is important to keep the neck freely mobile and treatment assists in this way too.

Head nerve number 10 (the "vagus")
This nerve also passes through the jugular foramen and can be affected by these upper neck and cranial base strains. It exits the head in the area which often takes the brunt of pressure in labour.

Symptoms suggestive of problems with this nerve include:

1) high pitched crying during feeds (larynx affected)
2) reflux
3) baby disinclined to breast feed
4) lack of coordination of suck, swallow, breathe.



More about moulding
The infant skull is in more parts than the adult one. Some of the bones that make it up are still in parts including those in the base, side and top of the head. This gives the maximum capacity for shape shifting or "telescoping" to adjust to the birth journey.
Moulding can begin in the womb before birth, due to the size and position of the baby. An example is a breech baby whose head may be shaped by the pressure of the mother's diaphragm and even by the position of its own feet around its ears.

One bone in the base of the head (the part that sits on the neck) is in four parts. Movement between these parts can alter the spaces (jugular foramen and intraosseous cartilage) through which important nerves pass (head nerves 10 vagus and 12 hypoglossal). These spaces can also be affected by head congestion causing engorgement of the jugular vein.

Sucking and crying expand the roof of the baby's head after birth especially in the first 2 weeks. Strains in the base of the head also resolve to a degree but often need assistance.

The hypoglossal nerve (12) controls tongue movement and when affected these movements may be disorganised or weak. This in turn affects sucking. Nerves which conduct sensation like the head nerve number 9 ("glossopharyngeal") transmit feeling from mouth to brain. This nerve also controls the throat muscles involved in swallowing and, together with the vagus nerve, prevents milk getting into the wrong tube and entering the lung ("gag" or "pharyngeal" reflex). This prevents choking when feeding.

Breastfeeding
As mentioned earlier, the mechanical action of feeding helps remoulding and the resolution of retained compressive forces in the baby's head. The suck should be strong, symmetrical and sustained (with natural pauses). The throat and cranial base should be free of tension to allow proper suck and tongue motion.

Birth compression, tongue tie or the cord around the neck can all affect the throat and suck.

Face, jaw, head or chest tension patterns can affect the body's ability to coordinate sucking, swallowing and breathing. The sinuses of a baby are tiny but the nasal passages and throat must be clear and open to allow the baby to breathe while feeding. Head tension patterns often reflect in the face. Cranial sessions can help resolve any membranous tension in the head, allowing the face to move and work properly.

Early help may often mean early resolution of feeding issues which prevents milk stasis from interfering with milk production and makes mastitis or nipple damage less likely.

Breastfeeding is dynamic and, as mentioned earlier, involves many muscles acting on the bones of the head, neck and chest. They move the face, jaw, throat and chest in sucking (at the rate of about one suck a second), swallowing and in breathing. The head and neck nerves (C1-3 especially) are important in conducting this symphony of movements.

Breathing is most important. Any breathing issue no matter how minor will affect feeding and must be treated first. The head, neck, throat, diaphragm and chest must all be checked for any restriction that may influence breathing. These restrictions may be small but their effect might be significant.

Restoring even a small degree of motion at key areas makes a big difference to the wellbeing of the baby.

Birthing practices affect breastfeeding and also the way the palate develops. Early events such as the cord being clamped too early or cut too quickly, stalled, short labour or induction, the use of forceps, ventouse or C section and the drugs used in labour (which reduce babies early respiration and the strength of the first breath) can all influence the mechanics, shape and function of the palate and cause narrower arches. It is not our intention to question a mum's birth experience or to engender a feeling of despair. Good, sensible birth preparation of both body and mind is sensible, and cranial osteopathy may do much to resolve these difficulties.

Inappropriate use of dummies (pacifiers) may also have an impact and mum is best taking advice about their use, if she can. Tongue tie or a short lip frenulum can also affect the development of the primary dentition and be associated with a high palate or larger gaps between teeth.

Establishing good breastfeeding habits early gives the best chance for good oral and throat development, as well as seeking help for any problems that present themselves, before milk flow is affected

Seeking an experienced breast feeding counsellor/lactation consultant and cranial osteopath is well advised, alongside advice from your other caregivers.