Birth injury

One of the most common questions we get asked in the practice is “Why could babies need a check-up?”. To answer this question, we need to look at one of the biggest physical stressors that can affect an infant which is childbirth.
 
Birth injury, unless major and life threatening, is under-recognised and under-treated (Gottlieb, 1993).  In a recent study of 200 infants presenting to a clinic with pain and other physiologic disturbance, 95% demonstrated notable birth trauma.  In a much earlier and larger study of 1250 newborns, 89% showed some mechanical strain or restriction (Frymann, 1966).  Many injuries including asymmetry of the head, facial asymmetry, torticollis, asymmetry of the mandible, nasal septum deviation and spinal, rib or clavicle dysfunction often go undetected until associated health problems arise.
 
It is increasingly common for births to be assisted with vacuum extraction instruments or surgery (Kozak and Weeks, 2002).  Vacuum extraction has been shown to be a strong predictor of early cessation of breastfeeding (Hall et al, 2002).  Even under normal conditions, birth consists of significant traction and rotation of the baby’s head and with sufficient force, clavicle fracture is seen as an “unavoidable side effect” in up to 10% of vaginal births (Miller et al, 2013).
 
Babies with mild injuries have a high rate of cessation of breastfeeding, however a study by Miller et al (2009) found that 79% of new mothers presenting with feeding problems were able to exclusively breastfeed after a short course of manual therapy.  More research is needed here, however these are promising results.
 
Aside from feeding issues that may be associated with birth trauma, there are some other really important cues to look for in babies to see if they may be experiencing pain:

1. Being fed every 2hrs.  Pain relief from feeding generally lasts 1.5-2hrs so if your baby is feeding every 2 hrs, this could be driven by pain.
2. Constantly sucking. Need for the dummy to settle and/or prolonged breastfeeds.
3. Settles with movement and/or constantly needing to be held.

 
So if you baby is exhibiting any of these behaviours, give our Practice a call today so we can screen for musculoskeletal issues and help support you and your baby thrive as they grow and develop.
 
 
 
 

References

• Frymann, V., 1966. Relation of disturbances of craniosacral mechanisms to symptomatology of the newborn: study of 1,250 infants. The Journal of the American Osteopathic Association, 65(10), pp.1059-1075.
• Gottlieb, M.S., 1993. Neglected spinal cord, brain stem and musculoskeletal injuries stemming from birth trauma. Journal of manipulative and physiological therapeutics, 16(8), pp.537-543.
• Hall, R.T., Mercer, A.M., Teasley, S.L., McPherson, D.M., Simon, S.D., Santos, S.R., Meyers, B.M. and Hipsh, N.E., 2002. A breast-feeding assessment score to evaluate the risk for cessation of breast-feeding by 7 to 10 days of age. The Journal of pediatrics, 141(5), pp.659-664.
• Jean Kozak, L. and Dawson Weeks, J., 2002. US trends in obstetric procedures, 1990–2000. Birth, 29(3), pp.157-161.
• Miller, J., Fontana, M., Jernlås, K., Olofsson, H. and Verwijst, I., 2013. Risks and rewards of early musculoskeletal assessment: An evidence-based case report. British Journal of Midwifery, 21(10), pp.736-743.
• Miller, J.E., Miller, L., Sulesund, A.K. and Yevtushenko, A., 2009. Contribution of chiropractic therapy to resolving suboptimal breastfeeding: a case series of 114 infants. Journal of manipulative and physiological therapeutics, 32(8), pp.670-674.