What osteopaths do is complex and hard to explain without either sounding completely woowoo or confusing parents with convoluted explanations, because it involves the whole of anatomy, physiology, neurology, embryology and the specific case history of the patient in every treatment. Human bodies are far more complex than most people know and skilled practitioners like me who have trained extensively and have years of clinical practice are capable of detecting through a highly developed sense of touch (called palpation) a wide range of things that are going on in the body. In fact, I refer to palpation as seeing with my hands. My favourite explanation of what cranial osteopaths do with babies is one I heard recently from a colleague: “I’m helping them to unfold”.
Understanding the interaction between the osteopath and your baby - "what are you doing to doing to her - she's so relaxed!"
I get asked this frequently by parents who bring their babies to me for cranial osteopathy.
“It looks like you’re just holding her – why is she so calm? Am I holding her wrong? If I hold her like that, will she sleep?”
The answer is almost always no – although I might suggest alternative feeding positions, or use of a feeding pillow, especially as the baby grows and gets heavier. In addition, I am not just holding the baby – my hands are doing a lot of work, sensing what’s going on within the body, and to do that I have to be calm and relaxed, which the baby picks up on; I engage with their nervous system, and encourage the sympathetic (fight-fight-flee) part to relax, and that results in the baby becoming calm and settled (usually!)
"So you're just relaxing her? why can't I do that?"
Not at all. As well as being skilled physical therapists, Osteopaths are trained to medically evaluate and diagnose problems as well. The process starts as soon as you arrive at the practice. From the moment the patient enters the practice, I am mindfully observing general movement and “attitude”; is the baby’s behaviour, level of engagement and movement appropriate for their age and stage of development; if asleep, are they peaceful, do they hold their head to one side, where are their hands, is their car seat the appropriate one for them – are they comfortable or squished up.
After taking a case history and once the baby is settled on the treatment couch I perform a clinical observation and examination. I also ask the parents if there is anything they have noticed that they are concerned about - these are usually strawberry patches or other birth marks, but occasionally skin discolouration can indicate underlying issues and should be checked out. All this time the I am chatting to the parents, getting more information, seeing the interaction between them and the baby, as I test for limb movement, perform basic neurological tests and check the baby’s skin for temperature and tone (neurological rather than colour). Now onto palpatory evaluation and treatment.
The most obvious sign of physiological dysfunction is on the surface – changes in skin temperature, texture, tone etc give us information about the neurological and vascular activity in the area; just under the skin there is the subcutaneous fat layer which should be present and squishy in babies. Then we have the bone/cartilage layer. I feel for smoothness in this layer, a give and take motion and sense of the bones “breathing”. Underneath the bones we get into deep layer palpation, where we are looking at the meninges of the skull, in the wider body this translates as the fascial layers, interrelatedness of structures and at patterns of strain / torsion through the body, and the fluid drive - the movement of fluid around the body, in the form of extracellular fluid, cerebrospinal fluid, mucus and lymph.
Deeper still, my hands are not looking any more but listening. In cranial osteopathy we feel / listen for various different rhythms in the body, the most commonly worked with is called the Involuntary Mechanism or Primary Respiratory Mechanism. This is an extension and flexion movement that goes though the whole body at the rate of about 6 cycles per minute. Just like we have voluntary and involuntary muscular movement, we have voluntary and involuntary bony movement as well – the involuntary being mediated by the IVM. Interestingly, the same rate of 6 cycles per minute has been linked to calming of the Vagus nerve and to interospection which is a connection with our inner neurological feedback system.
Treatment is very gentle, and very often babies and children will get a faraway look on their face when they are being treated as they become relaxed and enter a sort of meditative state. It is my opinion that all kinds of physical therapy, from physio to reflexology and obviously including osteopathy, basically work by downregulating the sympathetic nervous system and enabling the body to heal itself – in fact, one of the central tenets of osteopathy is “the body has its own self-healing mechanisms”. I would encourage parents to step back and allow themselves to soak up the relaxing atmosphere of the treatment room too – not only because the more relaxed you are, the more relaxed your child will be, but also so that you can benefit from having space to be without having to do for a while.
Once the baby’s body has found it’s position of ease, or neutral, I will end the session for that day, explain what I have found, make any suggestions (eg raising the head end of the moses basket for babies with reflux) and talk about ongoing treatment. I don’t see people unnecessarily and I don’t pathologise normal childhood issues but I do usually need to see babies more than once, I can help children feel more comfortable through normal developmental stages like teething and I encourage mums to come for regular treatment too.
"Will the effects last after treatment?"
Very emphatically yes - profound changes have happened within your baby's body - on a physiological as well as a physical level. They very often sleep well after a treatment, they are usually hungry at the end of a treatment (even if they've been fed just before) and will also usually do a big poo! So it's best to come prepared for all eventualities!
My real job is to support you as a parent and I'm always happy to answer questions by text, email or phone - so please do get in contact.
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