How Osteopathic Doctors Approach Health

Additional Core Osteopathic Concepts

It is important to enlighten you about the differences between the way in which a medically trained physician thinks and the way an osteopathically trained physician thinks.

When your child was born, it was, first of all, evaluated by the pediatrician. He was looking to make sure there was no congenital defect, either externally visible or invisible, such as perhaps in his lungs or the heart or the digestive tract, and also to make sure that all the systems were functioning efficiently. If your child was not examined by an osteopathic pediatrician, then something may be missing.

An osteopathically trained physicians does these same things but considers a number of other factors when your baby is born -- including using his or her hands to diagnose the condition of the body fluids, the nervous system, and the overall well-being of the baby. Osteopathically trained doctors recognize that the process of being born may be one of the most traumatic experiences in the baby’s life. Special attention is given to the twists and and compressions in the body’s tissues that may occur from the birth process itself.


"Far from representing a non-specific stress response, the profound rise in stress hormones in the newborn is responsible for key physiological processes in the adaptation to extrauterine life. But, what happens when stress becomes trauma?"

Researchers at Duke University Medical Center have studied the universal stress response in human birth and found that "birth and its attendant hypoxia represent the first major stress to which all mammals are exposed." Even a normal, otherwise uneventful vaginal delivery is accompanied by a surge of stress hormones, including catecholamines and corticosteroids. A Caesarean section, in which the physician cuts into the mother's body, causing a rapid change in pressure and extreme rise in stress hormones, can be much more traumatic. Far from representing a non-specific stress response, then, the profound rise in catecholamines in the newborn is responsible for key physiological processes in the adaptation to extrauterine life.

Research at Sweden’s Karolinski Institute has extensively documented the effects of birth trauma on later physical andbehavioral symptoms in childhood. There is significant research to support the contention that birth trauma contributes to various physical and psychological problems later in life. For example, birth trauma is positively correlated with anxiety (Banner, 1969; Gemmette, 1982; Ritzman, 1988); behavior problems in children (De Sousa, 1974); bipolar disorder (Kinney, Yurgelun, Tohen & Tramer, 1998); childhood neurosis (Van Zyl, 1977); conduct and antisocial personality disorder (Modlin, 1991); criminality (Arseneault et al., 1997); drug and alcohol abuse (Hull, 1984; Hull, 1986); dysfunctional relationships (Givens, 1987); autism (Verny, 1977); insidious trauma (Zimberoff & Hartman, 1998b); learning disabilities (Grotberg, 1970); autistic spectrum disorders (Gardener, 2011), cerebral palsy (Whittman 1992); epilepsy (Galon 2003); sensory processing dysfunction; and immune system disorders.

During delivery, as the baby's head descends into the mother's pelvis, the pubic bone exerts pressure on the presenting part of the baby's skull. If these forces exceed the limit of the tissue, the baby’s head may become strained. If these strains are not treated, then they become dysfunction.

In the study of 1250 newborn babies conducted at the Osteopathic Center for Children and published in the Journal of the American Osteopathic Association, it was demonstrated that only 10% of infants are without significant trauma to their body structure, including those structures that make up the head or skull and hold the brain and spinal cord. This is a figure that has been consistent in several studies that have been done on newborn babies.

The number of babies that have a gross, visible disturbance in the skull -- sometimes called plagiocephaly (the sort of deformity that you can see across the room), may be somewhere around 10% of all live births.

“The number of babies that have a gross, visible disturbance in the skull— may be somewhere about 10%. What about the other 80% of babies born who have a problem, but it is not visibly seen?” 
Viola M. Frymann, DO, FCA, FAA

But, what about the other 80% of babies born who have a problem, but it is not visibly seen?  They may not initially be presenting with significant clinical symptoms. The symptoms may go unnoticed or dismissed as normal. Some of these symptoms are common, but they are not normal. They may go unnoticed by the average pediatrician untrained in osteopathy. 

“It is no more normal for an infant to vomit after every feeding than it is for you or I to vomit after every feeding.”
Viola M. Frymann, DO, FCA, FAAO

The mother may tell the pediatrician that the child may be spitting up, “but just the normal spit up.” It is no more normal for an infant to vomit after every feeding than it is for you or I to vomit after every feeding. This problem is common, but it is not normal. To an osteopath, this is a sign that damage has occurred to the baby’s soft tissue. In a newborn, all tissue is soft tissue. Soft tissue injury can result in blood flow changes in the brain, irritation or entrapment of cranial nerves, and muscle problems that can lead to a myriad of symptoms.

The child may have had a little difficulty learning to suck, a difficulty that passed in 24 to 48 hours perhaps. The spitting up may continue for days or weeks sometimes, and very often the story we hear is "Well, it was assumed that the milk didn't agree with the baby." So, perhaps the mother decided to stop breastfeeding and try a formula. In many instances, that didn't solve the problem, and after several tries, some cereal was put into the formula to make it a little thicker, and often that appeared to solve the problem.

The fact that the baby was spitting up in that early period after birth, or that the baby did have difficulty learning to suck, is very important to us from a diagnostic viewpoint because it tells us that there was a degree of compression within the baby's head that irritated two of the important nerves that come out of the base of the skull: one is the 12th nerve, the hypoglossal nerve, which is responsible for the activity of the tongue and, therefore, is important in the sucking process; the other is the 10th cranial nerve, which is concerned with the activity of the digestive tract at this age. Those two symptoms may be very important pointers to the problem at that time.

During the years from birth to five years, the child is checked regularly by the pediatrician concerning his ears, throat, eyes, heart, lungs, and digestive tract. In other words, is this child's body functioning efficiently?

On careful questioning and examination, we may learn that the child never crawled appropriately, that the child slept fitfully, or the child has specific problems with the visual system or hypersensitivities to touch, light, or sound. All of these are indications that problems have developed in the child's neuromusculoskeletal system.


Studies published in the Archives of Pediatrics & Adolescent Medicine and other journals from around the world have demonstrated the benefit of osteopathic treatment in children with chronic ear infections. Studies show children with ear infections treated with osteopathy have fewer ear tubes, improved tympanography (a measure of the movement of the ear drum and existence of fluid in the ear), and a significant reduction in use of antibiotics. 

Ear infections are common. The ears are examined, and if the infections have occurred a number of times, there may be a hearing test performed and various tests that zero in on the ears. But the ear isn't something sitting out there in space. The ear is part of a total mechanism in this body. For example, the ear itself is held in what we call the temporal bone. (If you feel just behind your ear you will feel a somewhat pointed bone, which is the mastoid process.)

From the inner part of the ear, that is known as the middle ear, the Eustachian tube extends into the throat. Therefore, what goes on in the throat has a bearing on what goes on in the middle ear and vice versa. Not infrequently, the problem may begin as a sore throat, a cold, and it progresses to an ear infection. Therefore, the state of the throat and the state of the ear are very intimately related.

Let's come back to the temporal bone for a moment. The temporal bone articulates, or is connected to, most of the other bones of the head, directly or with one bone in between. So, if this child has had a fall on the back of the head in which the articulation between this bone and the occipital bone at the back of the head has been jammed, the bones cannot move freely, one in relationship to the other.

Perhaps at the time of the injury, the child cried for a little while, had a bruise there or a swelling, and it passed. A few weeks later, an ear infection develops. If you stop to think about it, you will find the ear infection has developed on the same side on which the head injury occurred.

The blood supply to the ear by way of the arteries, the venous drainage from the ear by way of the veins, and the lymphatic drainage is impaired if that normal, rhythmic mobility of the temporal bone is interrupted. If there has been an injury, it has interfered to some degree with the inherent mobility of that bone. Furthermore, if the child fell on the back of the head, that fall may have disturbed the alignment of the bones of the neck. The blood supply passes through the neck up into the temporal bone.

So the ear problem is not confined to the ear. It may be related to certain things that have happened in levels below the ear. Now we begin to see that we cannot localize ear infection in an ear because it is tied in to other parts of the body. Of course, the circulation begins at the heart and ends at the heart, so anything between the heart and the temporal bone may be a factor in that circulation. The lymphatic drainage is associated with certain structures in the neck, going all the way down to below the collar bone. Anything in this area may have a bearing upon that ear infection.

It is not uncommon to get the story that this child has had ear infections over and over again. Perhaps the first ear infection occurred when he was six weeks of age. He was treated with an antibiotic, and he got over it; two months later there was another ear infection. He was treated with antibiotics, and he got over it, and six weeks later there was another ear infection; and so it has gone on, perhaps for several years, one after another.

At some point the parents decide there must be some other way. Also, by this time, the child may have reduced hearing in one or both ears.

This is the time to go back structurally and inquire whether there is any evidence of injury at birth that may have started the process and inquire whether there had been any injuries since then to which the child is now responding with this susceptibility to infection.

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