osteopathybooks

Course curriculum

CONTENT Scientific Osteopathic Approach to Infants and Children 12 1. Introduction 12 1.1. Is Osteopathy Beneficial for Newborn, Infants, Toddlers and Preschool Children? 12 1.2. Terminology 13 1.3. Evidence Based Practice (EBP) 13 1.4. The Craniosacral Rhythm or Primary Respiratory Mechanism – PRM 14 Osteopathic Approach 19 1.5. Consciousness of the Child 20 1.5.1. General 20 1.5.2. Sensation and Perception 21 Osteopathic Approach 26 1.5.3. Pain in Children 27 2. Preventive Measures Before and During Pregnancy 33 2.1. General 33 Osteopathic Approach 36 2.2. Maternal Health Conditions and Their Effects on Pregnancy and Fetal Development 37 2.2.1. Diabetes mellitus 38 2.2.2. Epilepsy 38 2.2.3. Hypertension, Heart Disease, and Kidney Disease 38 2.2.4. Preeclampsia and Eclampsia 38 2.2.5. Asthma 39 2.2.6. Thyroid Disorders 39 2.2.7. Sickle Cell Disease 40 2.2.8. Systemic Lupus Erythematosus 40 2.2.9. Summary 40 2.3. Maternal Medication and Substance Use During Pregnancy 40 2.3.1. Prescription Medications and Fetal Risk 41 2.3.2. Tobacco and Secondhand Smoke Exposure 41 2.3.3. Alcohol use 41 2.3.4. Opioid Use 42 2.3.5. Cocaine and Other Illicit Substances 42 2.3.6. Summary and Clinical Recommendations 42 Osteopathic Approach 43 3. Bonding 44 3.1. General 44 3.2. Postnatal Bonding and Early Contact 44 3.3. Touch and Early Interaction 45 3.4. Behavioral and Emotional Correlates of Bonding 45 3.5. Parental Roles and Complementary Bonding 46 3.6. Neurobiological and Sensory Aspects of Bonding 46 3.7. Intrauterine Bonding 47 3.8. Empirical Evidence of Prenatal Bonding Effects 48 3.9. Influence of Touch 48 3.9.1. Physical and Physiological Effects 49 3.9.2. Psychological and Emotional Effects 49 3.9.3. Mechanisms of Action 50 3.10. Conclusion 50 Osteopathic Approach 51 4. Influence of Nutrition on the Development of the Child 52 4.1. Breastfeeding: Nutritional and Physiological Considerations 52 4.2. Breastfeeding Difficulties (Mother) 54 4.2.1. Sore Nipples During Breastfeeding 54 4.2.2. Flat or Inverted Nipples in Breastfeeding 55 4.2.3. Onset of Lactogenesis and Factors Affecting Milk Production 55 4.2.4. Low Milk Production 56 4.2.5. Mastitis 58 4.3. Breastfeeding Difficulties (Child) 59 4.3.1. Ineffective Sucking 59 4.3.1.1. Etiology 60 4.3.1.2. Clinical Indicators of Ineffective Sucking 60 4.3.1.3. Assessment Protocol 60 4.3.1.4. Possible Etiologies 61 4.3.1.5. Management Strategies 62 Osteopathic Approach 63 4.3.2. Slow or Poor Infant Weight Gain 65 Osteopathic Approach 66 5. General Normal Development Milestones 67 5.1. Using Milestones to Follow Up the Development of Children 67 5.2. The First 12 Months 68 5.2.1. By 2 months old, your child should be: 68 5.2.2. By 4 months old, your child should be: 69 5.2.3. By 6 months old, your child should be: 69 5.2.4. By 9 months old, your child should be: 69 5.2.5. By 1 year old, your child should be: 69 5.3. 1 to 2 Years 70 5.3.1. By 15 months old, your child should be: 70 5.3.2. By 18 months old, your child should be: 70 5.3.3. By 2 years old, your child should be: 71 5.3.4. By 30 months old, your child should be: 71 5.4. 3 to 5 Years 71 5.4.1. By 3 years old, your child should be: 71 5.4.2. By 4 years old, your child should be: 72 5.4.3. By 5 years old, your child should be: 72 5.5. If the Above Milestones are Not Met 72 5.5.1 Autism 72 5.5.2. ADHD 74 Osteopathic Approach 76 6. Birth 77 6.1. The Birth Process: Physiological, Hormonal, and Developmental Perspectives 77 6.1.1. Presentation and Types of Delivery 77 6.1.2. The Fetal Experience of Birth 78 6.1.3. Hormonal Regulation During Labor and Birth 78 6.1.4. Oxytocin Sensitivity and Labor Onset 79 6.1.5. Mechanical and Structural Adaptations of the Fetal Skull 80 6.1.6. Conclusion 80 Osteopathic Approach 81 6.2. Trauma 83 6.3. Neonatal Physical Birth Trauma 84 6.3.1. Head Trauma 84 6.3.2. Caput Succedaneum 84 6.3.3. Skull Fractures 85 6.3.4. Extracranial Hemorrhages 86 6.3.4.1. Cephalohematoma 86 6.3.4.2. Subgaleal Hemorrhage 86 6.3.5. Intracranial Hemorrhages 86 6.3.6. Brachial Plexus Injuries 87 6.3.7. Moulding 88 6.3.7.1. General 88 6.3.7.2. The Fetal Skull 89 6.3.7.3. Assessment 94 6.3.7.4. Repositioning of Plagiocephaly 95 Osteopathic Approach 100 6.4. Possible Difficulties During Labor and Delivery 103 Osteopathic Approach 106 7. Development of the Autonomic Nervous System (ANS) 107 7.1. Central Influence on Autonomic Functions 107 7.1.1. The Insula 107 Osteopathic Approach 111 7.1.2. The Hypothalamus 111 Osteopathic Approach 113 7.1.3. Organization of the Nervous System 113 Osteopathic Approach 118 Osteopathic Approach 120 8. Development of Proprioception 124 8.1. Cervical Sensorimotor Control 124 8.2. Neurological Development of Postural Control 125 8.3. Proprioception 126 8.4. Sensorimotor Functions 135 8.5. Reflexes 136 8.5.1. General 136 8.5.2. The Vestibulocollic and Cervicocollic Reflex 137 8.5.3. The Cervicoocular Reflex (COR) and the Vestibuloocular Reflex (VOR) 141 8.5.4. Retained (or Reappearance of) Primitive Reflexes with Influence on the Cervical Spine 145 8.5.4.1. General 145 8.5.4.2. Primitive Oral and Motor Reflexes 146 8.5.4.2.1. The Sucking Reflex 146 Osteopathic Approach 147 8.5.4.2.2. The Snout Reflex 149 Osteopathic Approach 149 8.5.4.2.3. The Rooting Reflex 150 Osteopathic Approach 150 8.5.4.2.4. The Spinal Galant Reflex 151 Osteopathy Approach 153 8.5.4.2.5. The Palmomental Reflex 153 Osteopathic Approach 153 8.5.4.2.6. The Glabellar Tap Reflex 154 Osteopathic Approach 154 8.5.4.2.7. The Asymmetric Tonic Neck Reflex 155 Osteopathic Approach 156 8.5.4.2.8. The Symmetrical Tonic Neck Reflex 158 Osteopathic Approach 159 8.5.4.2.9. The Moro Reflex 163 Osteopathic Approach 164 8.5.4.2.10. The Palmar Grasp Reflex 166 Osteopathic Approach 166 8.5.4.2.11. The Babinski Reflex 166 Osteopathic Approach 166 8.5.4.2.12. The Tonic Labyrinthine Reflex 167 Osteopathic Approach 170 8.5.4.2.13. The Landau Reflex 171 Osteopathic Approach 171 8.5.4.3. Causes of Delayed Newborn Reflex Integration 172 8.5.4.4. Signs of Delayed Newborn Reflex Integration 172 8.5.4.5. Promoting Primitive Reflex Integration Through Play 173 8.5.5. Some Other Reflexes that can Influence Cervical Dysfunctions 176 8.5.5.1. The Optokinetic Reflex (OKR) 176 8.5.5.2. Trigeminocervical Reflex (TCR) 179 Osteopathic Approach 180 8.6. Lesions in the Cervical Spine 180 Osteopathy Approach 181 9. Development of the Microbiome 182 9.1. General 182 9.2. Evidence-Based Probiotics for Children 187 9.3. Common Indications in Pediatrics 188 9.4. Clinically Documented Probiotics for Pediatric Use 189 9.5. Antibiotics 190 9.6. The Endocrine Pathway 191 9.7. Neural Pathway 191 9.8. Differences with Adults 192 9.9. Infant Feeding Patterns 193 10. Quality of the Cerebrospinal Fluid 195 10.1. General 195 10.2. Cerebrospinal Fluid (CSF) Volume in Children 196 10.3. Cerebrospinal Fluid (CSF) Composition in Children 197 10.4. Location and Movement 199 10.5. Production and Resorption of the Cerebrospinal Fluid 203 10.5.1. Classical Hypothesis 203 10.5.2. Bulat – Klarica – Oreskovic Hypothesis 207 10.5.3. Blood - Brain Barrier (BBB) 207 10.5.4. The Glymphatic System 209 10.6. Brain Weight 212 10.7. Functions of the Cerebrospinal Fluid 213 10.8. Specific functions in children 214 10.8.1. Mechanical Protection and Buoyancy 214 10.8.2. Regulation of Intracranial Pressure and Volume 214 10.8.3. Chemical Stability and Homeostasis 214 10.8.4. Removal of Metabolic Waste 214 10.8.5. Nutrient Transport and Growth Factor Distribution 214 10.8.6. Immunological Protection 215 10.8.7. Role in Brain Development 215 10.9. Substances that Cannot Pass the Blood – CSF Barrier are: 215 10.10. Composition of the CSF 215 10.11. Influencing the Cerebrospinal Fluid Quality 218 10.12. Normal Blood Pressure (BP) in Children 221 10.12.1. Physiological Basis 221 10.12.2. Normal Blood Pressure Ranges (Approximate Averages) 222 10.12.3. Classification (According to AAP Guidelines, 2017) 222 10.12.4. Measurement Considerations 222 10.12.5. Clinical Relevance 223 10.13. General Assessment of the Cerebrospinal Fluid Quality 223 10.14. Osteopathic Approach to Influence the Quality of the CSF 223 10.14.1. General 223 10.14.2. Cardiovascular Approach 225 10.14.3. Membranous Approach 226 10.14.4. Observation of Face and Skull 233 10.14.4.1. Normal Proportions 234 10.14.4.2. Frontal Plane Dysfunctional Proportions 235 10.14.4.3. Horizontal Plane Dysfunctional Proportions 236 10.14.4.4. Sagittal Plane Dysfunctional Proportions 237 10.14.4.5. Sagittal Plane Dysfunctional Proportions 238 10.14.4.6. Remarks 238 10.14.5. Spinal Approach 238 10.14.5.1. General 238 10.14.5.2. Integrity Goal 240 10.14.5.3. The Upper Cervical Region in Relation with the CSF 245 10.14.5.4. Approach of the Autonomic Nervous System 247 10.14.6. Osteopathic Treatment of Asymmetry in the Child’s Head and Spinal Dysfunctions 249 10.14.6.1. Sutures 249 10.14.6.2. Mobilization of the Upper Cervical Region (Occiput, Atlas, Axis, C3) 250 10.14.6.3. Mobilization of the Skull in 3 Dimensions 254 10.14.6.3.1. In the Sagittal Plane 254 10.14.6.3.2. In the Frontal Plane 256 10.14.6.3.3. In the Horizontal Plane 257 10.14.6.3.4. The Temporomandibular Joints 260 10.14.6.4. Mobilization of the Body in 3 to 4 “Dimensions” 262 11. Assessment of the Newborn, Infant, Toddler or Preschool Child 269 11.1. Vital Signs in the Newborn 269 11.2. Newborn Screening 269 11.2.1. Blood Spot Test (Heel Prick) 269 11.2.2. Hearing Screening 270 11.2.3. Pulse Oximetry Screening 270 11.2.4. Clinical Importance 270 11.3. Newborn Physical Examination 271 11.3.1. Physical Appearance 271 11.3.2. Neurological Examination: Primitive Reflexes 278 11.4. Preschool Screening 279 11.4.1. General 279 14.4.2. Testing and Treating the Cervical Fascia 279 Osteopathic Approach 285 12. Sleep 288 13. Conditions/Pathology in Infants and Children 291 13.1. Hydrocephalus 291 13.2. Meningitis 294 Osteopathic Approach 295 13.3. Atlantoaxial Instability 295 13.4. Pseudo Subluxation of the Cervical Spine 297 13.5. Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) 298 13.6. Transient Tachypnea of the Newborn 299 13.7. Jaundice 300 13.8. Meconium Aspiration Syndrome 300 13.9. Apnea of Prematurity 301 13.10. Transient Tachypnea of the Newborn 302 13.11. Respiratory Distress Syndrome in Newborns 303 13.12. Persistent Pulmonary Hypertension of the Newborn 306 13.13. Pneumothorax in the Newborn 308 13.14. Congenital Heart Disease 310 13.15. Congenital Cataracts 312 13.16. Developmental Dysplasia of the Hip (DDH) 312 13.17. Cryptorchidism (Undescended Testes) 313 13.18. Cystic Fibrosis 314 13.19. Sudden Infant Death Syndrome 315 13.20. Spina Bifida 318 Osteopathic Approach 322 13.21. Lactose/Milk Intollerance 323 13.22. Umbilical Cord and Navel Problems 325 13.23. Fever or Low Body Temperature 326 13.24. Pyloric Stenosis 327 13.25. General Warning Signs in Newborn 329 14. Conditions where Osteopathic Treatment could be Considered 331 14.1. Early Brain Stimulation 331 14.1.1. General 331 14.1.2. The Science Behind Early Stimulation 333 14.1.3. How to Provide Early Brain Stimulation 334 14.2. Otitis Media 337 14.2.1. General 337 14.2.2. Pathophysiology of Otitis Media 338 14.2.3. Symptoms of Otitis Media 339 14.2.4. Causes and Risk Factors for Otitis Media 340 14.2.5. Prevention of Otitis Media 341 14.2.6. Treatment and Management of Otitis Media 341 14.3. Eustachian Tube Dysfunction 342 14.4. Otitis Media Externa 354 14.5. Vestibulocochlear Nerve Dysfunction 355 Osteopathic Approach 355 14.6. Whiplash in Children 356 14.7. Cervical Spine Injuries in Children 357 14.8. Atlantoaxial Rotatory Subluxation 358 14.9. Torticollis 359 Osteopathic Approach 359 14.10. KISS Syndrome 360 Osteopathic Approach 361 14.11. Gastroesophageal Reflux 361 Osteopathic Approach 363 14.12. Infant Colic 364 Osteopathic Approach 365 14.13. Constipation 367 Osteopathic Approach 368 14.14. Excessive Crying 369 Osteopathi Approach 370 14.15. Ankylogossia (Tongue-Tie) 371 14.16. Minimal Brain Dysfunction Syndrome and Developmental Coordination Disorder 373 14.17. The Hypothalamic Syndrome: A Rare but Devastating Pediatric Disorder 375 14.18. Elbow pull or Nursemaid’s Elbow 376 14.19. Note on Cervical Manipulation in Infants and Children 377 14.20. Scientific Proof 379 15. Reflex Integration Therapy (RIT) 380 15.1. General 380 15.2. Key Component: Reflex Integration Exercises 380 Osteopathic Approach 380 15.3. What Reflex Integration Therapy (RIT) Can Do 381 16. Bibliography 383 Annex 1 404 M-CHAT R scoring 404 Acknowledgment 405 Luc Peeters 406