CRANIOSACRAL THERAPY FOR INFANTS AND CHILDREN
Why do we treat babies and infants?
Effects of Obstetrical Interventions on the
Craniosacral System that Influence Breastfeeding
Benjamin Shield, Ph.D.
About the Author:
Benjamin Shield, Ph.D., has been a Craniosacral Therapist for over 30 years.He is an international lecturer and instructor of Pediatric Craniosacral Therapy.
He can be reached at:
Telephone (323) 932-1112
About Cranialsacral Therapy| Why do we treat infants?|
The Craniosacral System involves the structures from the head to the pelvis. This includes bones, sutures, fluids, membranes and other soft tissue components. At birth, these structures have a unique vulnerability.
When we think of an adult’s head, we imagine a relatively firm structure. At the time of birth, a baby’s head is primarily fluid and membrane. A baby’s head can be imagined as a sea of membrane with bones floating in that sea. Many of the bones that are individual bones as adults exist in babies as bones within bones. The
sutures resulting from the bones coming in contact with one another do not form until the ages of two through four.
This presentation of the baby’s head is to allow for the systematic reduction in the overall size of the head during the birth process. It also allows for the rapid expansion of the brain during the early years. And where this presentation allows for the safety and growth of the child, it allow makes the baby more vulnerable to obstetrical interventions.
One obstetrical intervention that can result in various possible injuries is vacuum extraction (ventouse). As the cup is applied to the vertex of the baby’s head, contents of the baby’s head is sucked into the cup. This includes bones, membranes, fluids and delicate tissues. Pressure is then applies to pull the baby out by tractioning this tissue. This force is not a linear traction, but also involves a degree of torsion as well.
As the tissue is suctioned into the cup, the Aqueduct of Sylvius, which is the channel that connects the third and fourth ventricles, can become kinked. These ventricles are fluid filled chambers and are involved in the circulation of the cerebral spinal fluid. Any restriction of this flow can result in a back pressure that can create increased intracranial pressure. This can result in hydrocephaly as well as multiple other pathologies.
The pulling and torsioning can also result in the displacement of cranial bones, membranes and cranial nerves that can last a lifetime. It can also create a type of shock to the baby that interferes with the bonding process and the baby’s ability to breastfeed.
Any injury or impingement to cranial nerves V, VII, IX, X, XI and XII can be detrimental to the baby’s ability to breastfeed. Cranial nerve V is involved with muscles of mastication (chewing) and is closely associated with suckling. Cranial nerve VII is involved with muscles of facial expression which are also actively used in the suckling process. Cranial nerve IX innervated the muscles of the throat and is involved with the baby’s ability to swallow. Cranial nerve X is involved with the baby’s ability to swallow, as well as the entire gastrointestinal system. Cranial nerve XI is involved with the baby’s ability to orient its head. So, injury to this nerve can restrict the baby’s ability to orient to the breast. Cranial nerve XII is involved with the baby’s ability to utilize its tongue while suckling.
Forceps can also injure these same cranial nerves. The medial, longitudinal and torsional forces can compress the pathways of these nerves. Forceps can also have potential injury to the brain stem where basic metabolic processes are monitored and controlled. Injury to the brain stem can have a significant effect on breastfeeding.
Both ventouse and forceps can result in creating forces that overwhelm the baby and interfere with its ability to engage with the mother and with its environment. Often the baby is left in a sympathetic state of fight or flight. More likely, the baby may be left in a state of parasympathetic shock and withdrawal. All which would affect the baby’s ability to breastfeed.
Craniosacral therapy can assist in normalizing the injuries of the obstetrical interventions. Through gentle, purposeful and respectful touch, craniosacral therapy helps to normalize the baby’s structure, remove impingements, and balance effects on the autonomic nervous system. I feel that not every baby needs to be treated, but every baby should have the advantage of being evaluated.
William Sutherland, the founder of craniosacral therapy, had a favorite expression. He said, ‘As the twig is bent, so grows the tree.’ If we can help to correct the injuries created by obstetrical interventions, we can not only assist the baby in optimal breastfeeding, but help prevent learning, structural, sensory, developmental and behavioral problems later in life.
Why do we treat babies and infants
Why do we treat babies and infants? The best answer was given by an osteopath who said, When we look at a child, we never know who or what it could be. And when we look at an adult, we never know who or what that adult could have been.’
Dr. William Sutherland, the founder of Cranial Osteopathy had a favorite expression. He said, ‘As the twig is bent, so grows the tree.’ If we are able to correct the lesional patterns that may begin as early as in utero, patterns that are created during the birthing process, or even postnatally, we are able to forestall many conditions that may plague the individual throughout life. We can assist in preventing behavioral and personality problems, learning disabilities, sensory disorders, and structural problems. It is an honor to work with these children and one of the sweetest things we can do as practitioners.
It is appropriate that we speak about treating children in the scope of cranial therapy. Children have been an inspiration for this therapy. It was only after Dr. Andrew Taylor Stills, the founder of osteopathy which led to Cranial Osteopathy, tragically lost his children to meningitis, that he began his investigation into the nature of his work.
Babies have numerous mechanisms that they are born with to help them to self-correct the lesional patterns that may develop at birth. They have the reciprocal tension membranes that act as an internal guide to bring the cranial bones and membranes into balance. When a baby cries, the increased cranial pressure helps to put the bones and membranes back into position. While crying creates an external pressure, suckling creates an internal pressure that helps to normalize the baby’s head. And as the baby suckles, the mother will do the most basic of all cranial techniques, which we see in cultures throughout the world. The mother will instinctively stroke the baby’s head while it suckles. As the baby creates motion of the cranial bones, the mother is stroking the baby’s head and assisting the molding process.
All of these things, as well as the baby yawning, self-corrective behavior, and the birthing process, itself, can help guide a child’s head into balance. But when the forces of birth are too great, they may overwhelm the baby’s ability to self-correct. Then it becomes our job, as therapists, to assist the child into balance. Not every child may need correction, but I feel that every child should have the opportunity of being evaluated.
When a child comes in for treatment, we want to use as many of the child’s resources as we can. Keeping the parents in close view of the child, adjusting our voice and tempo to soothe the child, having the temperature, light and sounds comfortable to the child is important. It is our goal that, as we work with care, that the baby will begin to embrace both the therapy and the therapist as resources, as well.
Babies constantly give us messages when they may be overstimulated or overwhelmed. Their movements may become jerky. They may stiffen or arch their back. They may turn red or pale. They may begin to cry inconsolably. Their body position may have difficulty crossing the midline. With these, and numerous other ways that the baby communicates, the practitioner assists the child to treat in a manner that is best for that child at that moment.
When we work with a baby, there are principles to consider before we begin to do anything clinical with our hands. Among the most important principles is to offer the child respect. Treat the child as we would hope to be treated. We also want to offer the child an environment of trust and safety. This is of fundamental importance. And as we treat, we want to have an ongoing conversation with the child, even if it is in our own thoughts. We want to constantly be asking the child if it wants more space and more possibilities where we are working. That way, the treatment is something that is done with the baby, rather than on the baby.
Babies are born into this world with an inherent ability to socially engage with their care givers and with their environment. This ability to socially engage is the most evolved way that a child can deal with stress.
If this ability is unavailable or overwhelmed, due to traumatic perinatal events, a baby may default to a less evolved manner of dealing with stress.This level is sympathetic activation or what we know as fight or flight. But babies, as we know, have little ability to fight or to flee, so often they may default to the least evolved manner of handling stress which is parasympathetic immobilization, shock and/ or dissociation.
These states that are created at such an early age can create an autonomic set point that can, if untreated, remain with the individual their entire lives. They can form the foundation of how we react to stress, even the types of illnesses we get.
The Pediatric Craniosacral Therapy classes offered in Spring 2007 brought the practice of craniosacral work and manual therapies into the hands of practitioners who wish to work with infants and children. The principle is to honor the consciousness of the infant, and the course involves infant centered therapy.
There were two classes offered. The first was Pediatric Craniosacral Therapy: Newborn through Age Two. The class incorporates a caring, common sense approach utilizing craniosacral techniques, prenatal and perinatal psychology, and principles of infant development. The class will include simple and effective therapeutic techniques to assist in normalizing the structure, balancing the nervous system, and resolving possible issues of the birth experience. The class is designed to be approximately one-half lecture/theory, and one-half practical/hands-on table work, with appropriate demonstrations.
The first day introduced the students to pediatric craniosacral work and present an overview of its relevance and applicability. The various conditions that pediatric craniosacral work can treat are discussed. There will be a presentation on successful ways to work with babies and infants, as well as their parents. How to best utilize the resources of an infant is explored. Also during the first day, we gave a presentation on the birthing/delivery process, birth presentation positions, and pelvic anatomy. There were lectures and demonstrations of craniosacral evaluation of babies and infants, system evaluation of newborns, and pediatric structural evaluations.
We discussed the various stages of birth and the specific cranial lesions that can occur at each stage are discussed, along with the specific treatment. The nature and treatment of craniosacral issues created by Caesarian, forceps, and vacuum extraction deliveries are discussed, as well as that of postpartum cranial injuries. Developmental patterns of babies and infants are discussed, along with appropriate cranial treatment for each stage of development. The second half of day four focuses on a complete one-hour protocol for the evaluation and treatment of newborns.
The second class is Pediatric Craniosacral Therapy: Age Two through Age Fourteen. Each stage of a child’s development presents its own challenges for both the individual and the therapist. This course has been created to understand and specifically treat children in each of these stages of development. Even the least complicated births involve some degree of trauma. This is true, as well, for the stages of childhood.
Various childhood conditions were discussed in detail. These included: autism, cerebral palsy, Down syndrome, hydrocephalus, epilepsy, dyslexia, gastrointestinal disturbances, vision problems, otitis media, torticollis, sinus and respiratory illness, orthopedic conditions, orthodontic problems, as well as many other conditions involving sensory disorders, learning disabilities, and behavioral problems.
Working with babies and infants can be considered one of the most important things a therapist can do. These classes bring the knowledge, skills and confidence to the practitioner.
For answers to your questions about craniosacral therapy, please contact Dr. Shield directly. For answers to your childbirth related questions, email us at: firstname.lastname@example.org